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Polite people don't like to talk about "class" in the United States.  This is a country where almost everyone calls themselves "middle class", and politicians pander to the term as if the whole notion of social class were some kind of commie plot. Or at least something our founding fathers left behind when they split from the veddy veddy class-conscious UK.  But ignoring something doesn't make it go away.  Of course society has classes.  Of course people can be classified.  Of course there are huge differences among people who call themselves "middle class".  And of course a simplistic split into lower, middle, and upper doesn't work.

Social class is not a simple vertical thing.  Yes, different classes tend to have different economic positions.  But there's a lot more to it.  A $50,000/year university lecturer and a $50,000 ironworker may make the same money but a group of them is likely to have different tastes.  (Individuals can vary; the class describes the more typical members of the group.)  Starbucks vs. Dunkin's.  Mad Men vs. Wrestlemania.  Prius vs. F-150.

Identifying class structure is more than an academic exercise in sociology.  It helps understand politics, and can be helpful in winning office.  It is certainly useful in marketing.  That's why some marketing types have done their own versions of it.  The idiot Mark Penn (Mr. Why Hillary Is Not Now President) whined that Obama was practicing class warfare, but he made his mark with class-based "microtrends", an attempt at identifying a very granular class structure.  (It clearly didn't work for her.)  And almost everyone recognizes that somewhere in "the 1%" is a group that just isn't like the rest of us.

I recently came across a post from last year by blogger Michael O. Church, called The 3-ladder system of social class in the U.S.  While I have some quibbles with a few details and even some of his key terminology, I think he's basically onto something.  And it provides a useful set of terminology for describing, in shorthand, complex class interactions.  His article is quite long but it seems well worth a look.

Before going into detail, I'll observe that real people often don't quite fit the actual descriptions of classes.  This doesn't invalidate the structure.  Rather, the classes -- Church identifies 13 -- strike me as archetypes.  A real person may be in between two or three of them.   The nice thing about his 3-ladder system is that they exist in 3-dimensional space, not a straight line or flat grid.  I'm not sure Church himself understood that, but he did note that there are "hybrids", and he missed classifying some major groups.   He also was "more precise than accurate" is sizing up each class's share of the US, but his numbers are a good indication as to whether he thinks a group is large or small, and that matters.

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Most of us alive today do not remember life before antibiotics.  I would have had one more uncle had penicillin been available a year earlier; up through the first half of the twentieth century, many now-minor diseases were fatal.  Antibiotics were the original miracle drugs, curing a range of bacterial diseases.

But the antibiotic era may be ending.  Antibiotics contain the seeds of their own destruction:  A few bacteria occasionally have mutations that lead to resistance, and those quickly multiply.  Thus an antibiotic's useful life span is limited.  In the 1960s, I used to take Penicillin G for various things.  It has been out of general use for decades.  A range of other members of that beta-lactam antibiotic family have been developed since then, each one chasing after the newly-resistant strains of bacteria that kept emerging.  And other antibiotic families chased after other types of bacteria, or served those with a common allergy to penicillin and its relatives.  For a few decades, the pharmaceutical industry kept up with the threat.

But now the bacteria are winning.  And we're not doing anything about it.  This is the microbiological cousin of global warming, a public health crisis that capitalism can't solve.


Should Congress fund a multi-billion dollar NIH program to develop multiple new antibiotics?

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Wed Mar 06, 2013 at 11:05 AM PST

Let's cut some entitlements!

by K S LaVida

Congress and the President are having trouble coming to agreements about how to deal with the "scary scary deficit".  It is of course a Very Serious Problem that Very Serious People have to address immediately, which is why the sequester had to be put into effect.  As an earlier Wreck List diary pointed out, the sequester was dreamed up by Gene Sperling and Jack Lew at the White House.

So the Very Very Serious People want the 99% who are poorer than them to make some sacrifices so that the bond traders can continue to make big profits and not pay income tax on their "carried interest" income.  It is Not Serious to expect them to pay more, after all, since the top 1% already pays more than 2% of total tax revenues!  No, the deficit has to be cut by cutting "entitlements".

Now I'll set the snark aside a second to clarify what the word means.  It's a very loaded term. In the specific context of the federal budget, an entitlement is a program that does not require annual appropriation; it is funded automatically by dedicated revenues.  Social Security and Medicare are thus "entitlements"; Congress doesn't have to reauthorize their spending every year.  Foreign aid, the space program, food stamps, and indeed the entire defense budget falls into the other category, "discretionary" spending, arrived at anew every year.  

Both of these words, of course, are loaded.  Entitlement is taken as a pejorative: Who is "entitled" to something they didn't earn?  It is ironic to hear the term used against aid to the poor, too; it comes from the perks of having a noble title.  (The Earl of Dypschytt is entitled to rents from the serfs on his estate, which is all of the good land in Dypschytt.  The Earl doesn't have to work; he inherited the title.)   Discretionary sounds like it has low value, like taking a trip to Disney World or getting a new home theater system.  Thus the words distort the discourse.

But anyway, I think there are too many entitlements.  Below the orange squiggle, let's start listing some that can be cut.  Even if they are technically discretionary spending and are just treated as entitlements -- often in the old (inherited) sense.  And even if they are "tax expenditures", those targeted deductions that lobbyists have bought and paid for.

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It's the kind of tragedy that leads to difficult legal decisions.  A woman took a generic drug, prescribed by her doctor for an on-label use approved by the FDA. She developed a rare, but known, side-effect, and suffered serious permanent damage.  Who's at fault?

The story in today's New York Times concerns Karen Bartlett of Plaistow, NH, who took sulindac.  It's a pain killer in the NSAID category.  The brand-name form, Clinoril, is made by Merck and was approved by the FDA in 1978.  The generic sulindac was made by Mutual Pharmaceutical. Ms. Bartlett got Stevens-Johnson Syndrome. Her skin began to fall off.  She was comatose for months and ended up legally blind, disfigured, barely able to walk, unable to work.  Her life is basically ruined.

But there was nothing "wrong" with the drug; it was made correctly.  The label warns of possible side effects.  But the Supreme Court ruled a couple of years ago that generic drug makers cannot be sued for harm caused by drugs when the warning label was inadequate. Generic makers don't print their own labels -- the brand-name maker does that, and the generics have to copy it.  But the brand-name drug didn't harm the patient. So in that case, the patient lost.  In the Bartlett case, the label had a warning; the question is whether the generic maker gets the same protection in this case when the rare side effect occurs.  Had she taken brand-name Clinoril, she would have won damages from Merck.

There are only two bad outcomes possible within the American legal and medical system as it exists.  So the Times article, and the Court, are ignoring the elephant in the room.


How should harm from generic drugs be handled?

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Wed Feb 13, 2013 at 12:43 PM PST

A Passion for Young People

by K S LaVida

This morning I was listening to Morning Edition on WBUR and they were interviewing Cardinal Sean O'Malley, Boston's Roman Catholic Archbishop.   The topic, of course, was the next pope.  No, it wouldn't be him -- he joked that he's buying a round-trip ticket to Rome.  But then he described what characteristics the new pope should have.

Cardinal O’Malley says the next pope needs to be a leader of deep faith, but should also have good communication skills, speak five or six languages and have a passion for young people.
Uh, no, Sean, that's exactly what keeps getting the church in trouble!

Yes, I know the phrase can have more than one meaning, but it's remarkably tone-deaf when it's used by these people.


Elmer Fudd has more common sense than the average Very Serious Person, the average Villager.  Wile E. Coyote was more perceptive than the average mainstream reporter.  Weepy Willie was less clownish than the typical network TV pundit.

Distinguishing between truth and lies isn't important to them.  It's all a cartoon.  Ordinary people might get hurt, but Road Runner and Wile always live on to see another harebrained scheme.  Elmer and the wascally wabbit always come back for more.  So why does it matter?

Hence we have Villager truth.  And that's what controls the conversation among the Very Serious People, including, alas, most Democrats in Washington.  For to defy Villager truthiness is to run the risk of being labeled conspiratorial or extremist.  And that's only okay if you're a Republican.

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Thu Dec 13, 2012 at 09:36 AM PST

It's not 1965 any more

by K S LaVida

Certainly not for health care. Republican proposals for dealing with deficits, made acute by their hostage-taking leading to the panic-striking fiscal curb, often involve slashing Medicaid.  Many conservative red states have very limited Medicaid programs already; they seem to want to bring the rest of the country down to Mississippi's pathetic level.  This is supposed to save money.

But there's a fallacy in reducing Medicaid.  The growth of medical costs has had a huge impact on the overall economy, sucking the life out of the private and public sector alike.  Medicaid is only a small part of it, providing benefits to the elderly in nursing homes as well as to lower-income people, some of them working at jobs that don't include medical benefits.  Medicaid was begun in 1965.  It might be easy for a conservative nostalgic for a time when more people "knew their place" to imagine that if Medicaid were rolled back, then people could fall back on whatever they did before Medicaid existed.  But that was a different world.  It can't work.

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Sat Dec 08, 2012 at 08:29 PM PST

Schedule II, or high on the list

by K S LaVida

Cannabis is now legal, under state law, in two states.  It is available by prescription in quite a few.  Yet federal law still bans it under all circumstances.  It is listed under Schedule I of the Controlled Substances Act, along with heroin, LSD, and other drugs that are flat-out banned.  Thus federal agents, especially the DEA, can bust anyone under federal law who is using it legally under state law.

When President Obama was first elected, he invited comments from the public as to what his agenda should be.  Legalizing marijuana was high on the list (pun intended).  Yet he has steered the opposite course.  Dispensaries in California have been busted, and US Attorneys are warning people that just because their state legalized it, that won't protect users against federal pot busts.

I'm frankly not sure what the President is smoking, but his enforcement of the Controlled Substances Act has been far more enthusiastic, shall we say, than many of his supporters expected.  While the law still exists, he has done nothing to change it.  Public opinion now favors legalization, at least under some circumstances.  And Obama's supporters are not the kind of social-conservative bluenoses who hate it on principle, nor the kind of racists who originally proscribed it because it was seen in the 1930s as a "negro drug".  He's appealing to people who wouldn't support him anyway.  But the White House has been afraid or unwilling to make any moves, and we're now facing a crisis of federalism where the liberal side, for once, is siding with states.  That doesn't sound like a great idea.

But there is an answer that is so limited in scope, so hyper-cautious, that there is really very little risk to it.  It isn't the long-term answer, but it is about 50 years too late.  It would make a great gift to America to have it in his State of the Union Address next month.

The President should simply propose to Congress that Cannabis be moved from Schedule I to Schedule II.


Should President Obama call for medical marijuana to be moved to Schedule II?

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That the electoral college is obsolete is more than obvious.  That it was ever a good idea is more than questionable, but as the rest of the world grows more democratic, it is a quaint vestige of a less-democratic era that hobbles the United States in many ways.  In this most recent election, the vast majority of campaigning took place in about ten swing states.  The rest of the country was largely ignored.  This impacted voter turnout, which in turn impacted Congressional and state elections.  So the mere fact that it is undemocratic is not the only reason why it has to go.

But that doesn't mean that it's easy to do it right.  A lot should change before a national popular vote replaced the electoral college system.  While some states have laws that pledge their electors to the winner of the national popular vote if and when more than 270 electoral votes are governed by similar laws, that is more of an expression of desire than a practical plan.  We haven't amended the constitution in years and it's potentially a dangerous process, but it would make more sense to do one amendment that makes all of the required reforms.


Should we reform the Presidential vote?

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The election special.  A thick edition of the weekly newsmagazine featuring 100 photos that tell the story.  Okay, 50 of them are a two-page spread of campaign lapel buttons, something I rarely saw this year.  But after that, on page 87, two of the pictures, and the accompanying text, summarized for me the heart of the election.  Or at least the Republican side of it.  How they hoped to win, and how they lost, was right there.

A poncho, and a work shirt.

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Republicans love to call for a "balanced budget amendment" to the Constitution, to prevent deficit spending.  This comes from their adherence to disproven right-wing economic theories that were disproven in the 1930s.  All of modern economic theory post-Keynes demonstrates that the money supply needs to be managed, and in times of recession, more needs to be created.  You don't cut back in a recession; austerity makes them worse, cutting revenues further and causing huge unemployment and losses in production.

We now have a living laboratory experiment in what happens to a 21st century economy that is ruled by a balanced budget amendment to its constitution.  The results are, alas, what Keynes would have said.  Everything looks fine until the first recession hits.  Then it becomes a black hole and things collapse.

The example is the Euro zone, and the worst case is Greece.


Should we have another round of Fed-financed stimulus?

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I heard two things from Romney in the town hall debate that deserved a direct response, but didn't get one.  They may be too mathematical to fit the format of a debate, but they shouldn't be forgotten as the campaign progresses.

Romney gave details of his plan that were literally true, but whose implication was unclear to the public.  The net result is that he proposes that the rich get richer, and that his own taxes go to near zero.


Should the Obama campaign hammer these points?

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