Matthew Yglesias » Endgame

Jun 17th, 2009 at 6:14 pm

Endgame

I feel like it’s been raining almost every day in DC for months:

—The New York Stock Exchange’s Sarah Palin shrine.

— An interesting discussion of bus lateness metrics.

— America’s closing car dealerships.

— Health wonks know that doctors are evil, but nobody knows that.

— An Iranian nuclear weapon would be bad no matter who’s running Iran.

— What was Khameini trying to accomplish in this election business?

Today is a good day for happy hour.

Comments
27

27 Responses to “Endgame”

Duvall Says:
June 17th, 2009 at 6:17 pm
Cool and light rain >>>>>>>> hot and humid. Don’t complain.
Shmoe Says:
June 17th, 2009 at 6:20 pm
“Today is a good day for happy hour.”

Kerplah!
Carlos Says:
June 17th, 2009 at 6:39 pm
Wow, docs are evil?
So, if 70% of Americans trust docs, and almost all of your knowledge about the healthcare system is second hand, why should we believe what you say over what physicians say?
I’ve always considered myself a liberal doc, and like almost all docs (incl. the conservative AMA) I support universal coverage, comparative effectiveness, changes to the way payments are made, and increased emphasis on preventative medicine. That’s like 90% of your agenda. And not agreeing with the last 10% makes me evil.
That’s Goerge Bush stuff, Yglesias. Oh yeah, I went there.
AssForAHeadDotCom Says:
June 17th, 2009 at 6:43 pm
MattY. Hack. Terkel. YouTube. Weigel. Idiots. Soros. Ad hom. MassiveIllegalActivity. Hacks. Libel. You’re all too dumb to respond to me. Read about it here. Hacks.
24AheadDotCom Says:
June 17th, 2009 at 6:43 pm
1. CAP’s “WonkRoom” has approved a comment I left pointing out that they were engaging in a smear, but they still haven’t posted a correction or clarification.

2. MattY favorite Rachel Maddow used a bogus quote to smear Rush Limbaugh. Fans of Wikipedia will enjoy the circular sourcing of that quote.

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This comment was brought to you by Soros Industries: “World Leader in Shock Collars and Other Ideological Monitoring and Control Devices Since 1972″
Brian Ulrich Says:
June 17th, 2009 at 6:46 pm
The highlight in Jafendar’s piece is the image of Khamene’i as a trapeze artist, which got me to laugh. Personally I always pictured him more as Palpatine without the blue lightning.
rapier Says:
June 17th, 2009 at 6:54 pm
What could Iran do with a nuke, or ten? This is not a silly question. There is a 60 year old body of work pertaining to the strategy and tactics of nuclear weapons. Directly or indirectly under the auspices of the military thousands of very smart, historians, military strategists, engineers, philosophers, economists, doctors, lawyers and indian chiefs studied all the issues surrounding their use.

The result was always the same. MAD. Now in the case of a tiny actors like Iran someday perhaps, or N Korea who does not have a deliverable weapon, the calculus is simple. They launch or set off a few, and then they die. The end. In Irans case essentially the end of Persian civilization. So they can blow up TelAviv I assume. Not a smart choice.

Now if Israel would launch against Iran, which is a distinct possibility, since Iran can’t counter, what would you do if you were Iran.

As for the nuke smuggled in somewhere and set off thus hiding the source. Can’t be done. All enriched uranium has a specific signature. It would be known quickly where the bomb came from, or the source of the fuel, which is the same difference.

Personally I believe we or Israel will eventually nuke Iran and kill upwards of 50 million people. Just because.
Petey Says:
June 17th, 2009 at 6:59 pm
“I feel like it’s been raining almost every day in DC for months”

What’s up with the existential horror permeating every Endgame post?

I think Matthew should renew his tobacco habit.
pseudonymous in nc Says:
June 17th, 2009 at 7:05 pm
That’s not really a great way to summarize Ezra’s point — one that he’s made several times — which is that people implicitly trust doctors to act in their best interests, to the exclusion of other interests, whereas doctors have inherently conflicting interests in the non-system that is US healthcare.

(You were offended when I talked about the terrible burden of doctors having to give up year-round grooming on their kids’ horses, but as I said in that thread, I wasn’t pulling that example out of thin air.)

It’s not ideal to be forced to second-guess your doctor. Is the MRI being ordered for genuine diagnostic reasons, or as defensive medicine, or because the doc has a referral kickback or an ownership stake in the imaging clinic? Is treatment being offered because it’s easier to bill? Or because there’s a higher margin? Or because it’s easier to get this procedure past the insurance drones who’ll play the not-medically-necessary card if given the chance? And so on.

Doctors aren’t evil. They are, however, part of a crappy healthcare superstructure, and cannot be seen as mere victims of its crappiness. Steve Pearlstein fleshes out the larger argument, including this very important point:

Docs seem to take it as a given that physicians in the United States should earn twice as much as doctors in the rest of the world — and five times more than their patients, on average. Mention these facts and you are guaranteed to get a lecture about the crushing debt burden that young docs face upon completion of their medical training. Offer to trade free medical education for a 20 percent reduction in physician fees, and you won’t find many takers.

You may find fault with Michael Moore’s SiCKO, but as he pointed out, GPs in London on the equivalent of $150k/year don’t consider themselves poverty-stricken. Perhaps it’s rude to ask, but would you consider $150k a year for GPs or $100k for hospital doctors or $250k for consultants (with reduced expenses on bureaucracy) a slap in the face?
Richard Steven Hack Says:
June 17th, 2009 at 7:16 pm
Matt: “An Iranian nuclear weapon would be bad no matter who’s running Iran.”

What is THIS pointless bullshit?

Once again for the retarded:

1) There is ZERO evidence that Iran has a nuclear weapons development and deployment program.

2) There is ALMOST ZERO evidence that Iran ever HAD a nuclear weapons development and deployment program, as opposed to a nuclear weapons database program.

3) This notion that there’s going to be a “green Iran” revolution is so much horse hockey. And even if there were, Iran would continue to enrich uranium for nuclear energy purposes, as is their right under the NPT.

Joseph Cirincione is babbling on HuffPo about this election business meaning that Iran will have to come kowtowing to the US and give up its enrichment program for concessions for the US. Where he gets this crap is beyond me. The election has changed nothing with regard to the nuclear issue.

As for what Khamenei was trying to do, once again, these articles spell it out:

Rafsanjani’s gambit backfires
http://www.atimes.com/atimes/Middle_East/KF16Ak05.html

The meaning of the Tehran spring
http://www.atimes.com/atimes/Middle_East/KF16Ak02.html
James Gary Says:
June 17th, 2009 at 7:25 pm
What’s up with the existential horror permeating every Endgame post?

You must not be on the East Coast. There’s a weird, rainy psychological stasis-vibe permeating the entire Eastern Seaboard right now. It’s like a Santa Ana, only caused by the exact opposite conditions and on the other side of the continent.
Greg Says:
June 17th, 2009 at 7:34 pm
You must not be on the East Coast. There’s a weird, rainy psychological stasis-vibe permeating the entire Eastern Seaboard right now. It’s like a Santa Ana, only caused by the exact opposite conditions and on the other side of the continent.

God, it’s nice.

Usually by this time in Chicago and New York, it’s like Burma.

Washington, of course, is usually as bad as Satan’s left armpit.
El Cid Says:
June 17th, 2009 at 8:26 pm
Via the Guardian:

Mervyn King, the governor of the Bank of England, tonight called for banks that are “too big to fail” to be cut down to size as he opened a deep rift with Alistair Darling over the future regulation of the City.

While the chancellor used the annual Mansion House gathering of City grandees to oppose a break up of the big financial institutions, King sketched out plans for a much more radical overhaul.

He voiced opposition to high street banks having taxpayer-funded guarantees for their speculative investment banking activities and expressed scepticism about changes to regulation in the aftermath of the run on Northern Rock that would limit the Old Lady of Threadneedle Street to delivering “sermons”.

In a clear divergence with the chancellor, King said: “If some banks are thought to be too big to fail, then, in the words of a distinguished American economist, they are too big. It is not sensible to allow large banks to combine high street retail banking with risky investment banking or funding strategies, and then provide an implicit state guarantee against failure.”

The governor argued that “something must give”.

“Either those guarantees to retail depositors should be limited to banks that make a narrower range of investments, or banks which pose greater risks to taxpayers and the economy in the event of failure should face higher capital requirements. Or we must develop resolution powers such that large and complex financial institutions can be wound down in an orderly manner. Or, perhaps, an element of all three,” King said.

Hopefully this sensibility can continue, and maybe even cross the Atlantic someday.
cmholm Says:
June 17th, 2009 at 8:31 pm
Per Brian Ulrich (#6), while reading Mr. Javedanfar’s piece, I was in more of a Dune frame of mind, what with the more intricate plans within plans.

I’ve long heard that Mr. Rafsanjani was loaded, but I wasn’t aware that Mr. Karroubi was so well connected commercially. I took the comment to mean that he too is very wealthy.

I’m a bit taken aback at Richard Steven Hack’s (#10) claim that there’s no evidence that Iran has a nuclear weapons program. In response, I’d point to some circumstantial evidence:

- Even as a first tier developing third world nation, Iran has only so much engineering talent and technological capital to go around. What they’ve got they’re blowing on things like…

- The long range missile program. During the Iraq war, Iran didn’t have any problem hitting Baghdad with the SCUDs they bought from N. Korea. Aircraft are much more efficient at getting ordinance on target, and post-war Iran has addressed its wartime combat aircraft issues.

- The secrecy over the enrichment program. They are obviously pouring a lot of capital and talent into this. Iran doesn’t have the proven Uranium reserves to economically justify the processing capability they’re building. Even if we allow for a measure of self-sufficiency, it would seem they’d get more bang for their buck developing more domestic oil and gas refining and delivery infrastructure.
roger Says:
June 17th, 2009 at 9:07 pm
Uh, Saudia Arabia, for all practical pursposes, has a nuclear weapon. Whose money funded the Paksitan nuke program? And why do you think that is?
On the other hand, this is TNR – where a in quote neo-con (actually, a participant in urging the bloodbath invasion and occupation of Iraq, a real kneeslapper) get quoted by a furrow browed TNR liberal, who is STRONG STRONG STRONG on defense – meaning he embraces the lunatic view of the world as per and Fred Hiatt.

It is funny, Egypt, in fact, has been threatened with a nuclear bomb attack before. The threat was made by Israel, conveyed to the Nixon whitehouse during hte 1973 war, during the first days of which the Egyptian army rapidly advanced upon Israel. Saints above, why o why wasn’t this little anecdote included in tnr’S latest we gotta bomb Iran bromide?
Ape Man Says:
June 17th, 2009 at 9:41 pm
Had a weird health care question that I’ve never seen discussed (I assume it has been discussed; I just haven’t seen it.)

Couldn’t we retain our current malpractice system but vastly curtail its breadth and scope simply by creating a federal fund that would provide Americans with maloutcome insurance?

Just create a system where, for example, if I go in to have my gall bladder taken out and I develop a systemic infection, I get a certain amount of compensation. I could choose to forego that compensation in favor of malpractice litigation, but presumably in all but the clearest and most egregious cases (the ones we all seem to agree are not “frivolous”) it would make a huge amount of sense to just take the money up front and forget about it.

Of course this would have to be coupled with some sort of statistical monitoring of the patient outcomes associated with specific health providers, but really shouldn’t we be monitoring that anyway? A hospital that’s causing a statistically unusual number of iatrogenic problems in its patients certainly should have to clean up its act, maloutcome insurance or no.
Evan M Says:
June 17th, 2009 at 11:53 pm
Oh Matt. I’ve known you since college, and love so much of what you write. But linking to Ezra Klein’s vacuous column on “Docs” makes me sad.

Every day at work we see how broken the medical system is. We live the nightmare of American medicine every day. It is a moral travesty. And though there are some powerful physicians (mostly older) who are against universal care, the majority of us are in favor of it. Even the crotchety AMA is swinging in that direction. So please, don’t say something stupid like “docs are evil.” It sullies your otherwise radiant intelligence.
Max424 Says:
June 18th, 2009 at 12:49 am
Fill those empty car dealerships with the ultra sleek, powerful, cat quick Tesla Motors Model S electric sedan, with a 5 minute rechargeable Toshiba lithium battery in it, and watch for the second coming of our generation’s Model T.

http://www.teslamotors.com/models/index.php

Where is that sick puppy Henry Ford when we need him.
Max424 Says:
June 18th, 2009 at 1:00 am
Anybody alive…out…there? Helloooooooooo…..

Electric cars are coming. Is America going to boldly lead or are we going to do what we do best these days. Bolster the ass end of progress.

I for one am sick of the shit-splatter. I would like to play on a winning team, just for a few brief moments in time, before I lay me down.
stras jones Says:
June 18th, 2009 at 1:01 am
Well, isn’t this a surprise – Matt’s carrying water for TNR’s brand of faux-liberal hawkishness. It’s like 2003 all over again.

Matt, you built up a good enough reputation on foreign policy over the last several years that a lot of people have been willing to forgive you for acting as a cheerleader for the invasion of Iraq. But that goodwill is based largely on the assumption that you actually learned something from Iraq. Your recent saber-rattling on Iran, combined with your relatively gung-ho support for the Afghan Surge, is putting the lie to that.
J Bean Says:
June 18th, 2009 at 1:41 am
And the statement that American docs make scad and scads more money than their European counterparts turns out to be yet another example of good old American exceptionalism. American GPs make salaries that are roughly in line with other western European GPs and the same for specialists (you want to be a Dutch specialist!) France is a bit of an outlier, but French docs get a giant tax break that amounts to an extra 25% after tax that non-medical citizens don’t get. You can see the 2004 data here.

Agreed that physicians should not own scanners and such any more than that they should dispense meds. In some countries where physician salaries are lower, that makes up a pretty significant part of their income (in Japan where docs formulate, dispense, own the hospital beds and the scanners, they also pay NO income tax!)
.
I know exactly one MD who owns horses. She owned them during the 22 years she served in the Air Force before she retired and went to medical school. I have to admit that I do employ a groomer every 6-8 weeks to lop the hair off my poodles, though. So you nailed me on the luxurious lifestyle.
bob h Says:
June 18th, 2009 at 8:34 am
I feel like it’s been raining almost every day in DC for months:

It has been in NJ for the last three weeks. Republican dummies cannot understand that global warming manifests itself in increased precipitation; the equivalence of energy and moisture being too difficult to get their heads around.
David Says:
June 18th, 2009 at 8:53 am
But linking to Ezra Klein’s vacuous column on “Docs” makes me sad.

Ezra’s column was pretty reasonable I thought. What is so objectionable here?:

But doctor behavior, though generally admirable, is certainly not perfect. We’re still in a world, sadly, where study after study shows that the treatment we should get does not match the treatment we do get, where study after study shows that the treatments we do get are often not based on sufficient evidence. There are certain policies — things like comparative effectiveness review, or a reform of fee-for-service payment practices — that would improve the situation. But it’s hard for legislators to broach those subjects because doctors are a popular, and thus a powerful, constituency, and they reflexively oppose policies that could harm their salaries or limit their autonomy.

Matt’s the one who spiced things up and called doctors “evil;” that wasn’t Ezra.
Njorl Says:
June 18th, 2009 at 10:05 am
I feel like it’s been raining almost every day in DC for months:

At least it’s different rain. In the late 90s we’d get the same water falling on us every day. There was never any wind. The water evaporated all day in the 95 degee heat and fell back down as the sun set into the cloudless haze well above the horizon. Fish in the Potomac became confused as to where the river stopped and swam into the air.

It’s just fine now, except for the way the rain affects traffic.
onceler Says:
June 18th, 2009 at 10:24 am
Apparently you need to have this explained to you again.

Iran is not making nuclear weapons.

They are not failing to make them because they “can’t do it yet” or “don’t have the technology” or some other such silly crap. They can, and they do, but they haven’t.

That is what the IAEA repeatedly tells us when they go and inspect the materials. Iran could certainly have had a bomb YEARS ago, but have take exactly no steps to make one.

Do you really, really need to re-learn this basic lesson of the Iraq war? Why? How gullible are you?
Richard Steven Hack Says:
June 18th, 2009 at 10:34 pm
CMholm: “In response, I’d point to some circumstantial evidence:”

VERY circumstantial in the absence of ANY evidence of diversion of materials.

“- The long range missile program. During the Iraq war, Iran didn’t have any problem hitting Baghdad with the SCUDs they bought from N. Korea. Aircraft are much more efficient at getting ordinance on target, and post-war Iran has addressed its wartime combat aircraft issues.”

Nonsense. Iran can’t fly its aircraft anywhere without running into the US Air Force or the Israeli Air Force or the Saudi Air Force, all of whom probably are superior to their aging jets. Missiles, while inaccurate, nonetheless can be used to hit longer range targets with less probability of being intercepted, even if the effects are mostly psychological absent nuclear warheads – which the Iranians don’t have and couldn’t have for another decade.

“- The secrecy over the enrichment program.”

There is no secrecy. Iran has revealed all its enrichment facilities under the NPT. Also, Iran was never required to reveal some of the stuff until ninety days before actually entering nuclear material into the centrifuges. This ia innuendo at best.

“Iran doesn’t have the proven Uranium reserves to economically justify the processing capability they’re building.”

Citation, please. Last I heard, Iran has plenty of uranium.

“Even if we allow for a measure of self-sufficiency, it would seem they’d get more bang for their buck developing more domestic oil and gas refining and delivery infrastructure.”

They ARE developing more gas refining infrastructure to ease their gas shortage. The problem is money for infrastructure. Their oil reserves will both be depleting as Peak Oil arrives and their population is increasing such that in another couple decades they will be expending all their oil reserves for local power. Therefore they need nuclear energy so they can continue selling their oil reserves on the market to pay for infrastructure. This is an established fact and well accepted by analysts of the Iranian situation. So you comment is both ignorant and speculative.
gas safety london Says:
June 19th, 2009 at 6:12 am
What’s up with the existential horror permeating every Endgame post?

You must not be on the East Coast. There’s a weird, rainy psychological stasis-vibe permeating the entire Eastern Seaboard right now. It’s like a Santa Ana, only caused by the exact opposite conditions and on the other side of the continent

Matt Yglesias

Endgame

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