A House Divided

We have a house divided against itself.  Disagreements on policy may be commonplace, but the level of animosity and the strategies being used in the struggle for control of this country are harmful, and unnecessarily so.

Although it makes a good story to call both parties equally responsible, it should be clear that the party known for saying “No” deserves it’s reputation.  They have vowed to pass no major legislation, and they are doing what they threatened.  Their actions have deliberately blocked trade agreements, appointments to the executive branch, and infrastructure projects.

By keeping the United States from doing things that both parties agree need to be done, the Republicans have harmed the economy of the United States.  It is no coincidence that their intransigence and the difficulty they have in achieving compromise has contributed to the recent downgrade of the credit of US Treasury debt.

Just one example is necessary, but there are numerous others.  The best example is the recent standoff regarding raising the debt ceiling.  Both parties agreed that it was necessary (except for some Republicans that refused to understand that the reason for raising the debt ceiling is to pay the debts that Congress has already authorized), but the Republicans decided to use the debt ceiling as “leverage” to accomplish their political agenda.

In order to do this, it was necessary to threaten not to raise the debt ceiling and cause the Treasury to not be able to pay all of the obligations that this country has.  Is there any doubt that the refusal was because of the Republicans?  No, and this was clearly stated by the Standard and Poors in their statement regarding lowering our credit rating.

“The political brinksmanship of recent months highlights what we see as America's governance and policymaking becoming less stable, less effective, and less predictable than what we previously believed. The statutory debt ceiling and the threat of default have become political bargaining chips in the debate over fiscal policy.”

And they have said that, given the opportunity, they will do it again.  Mitch McConnell, the Senate minority leader, said this about the actions and intent of his own party:

“I think some of our members may have thought the default issue was a hostage you might take a chance at shooting. Most of us didn’t think that. What we did learn is this — it’s a hostage that’s worth ransoming.”

“Taking the country’s debt limit hostage” is not just a metaphor, it is a description that fits, and McConnell has embraced.

From the debt-ceiling crisis, to the FAA shutdown, to the refusal to vote on appointments to executive branch departments, and the efforts to make enforcement of the laws passed by Congress impossible, the Republican Party has adopted a policy of intransigence.  We have had trade agreements with several countries, South Korea, Columbia and Panama, that the Republicans have attached strings to in order to pass.  Even the Heritage Foundation has objected to this tactic for these agreements.

“The Obama Administration—after allowing U.S. free trade agreements (FTAs) with South Korea, Colombia, and Panama to languish unapproved for nearly four years—lately appears eager to push Congress to ratify all three soon. The problem now is that some in Congress are trying to make their approval contingent upon an extension of the Trade Adjustment Act (TAA).
 That would be a mistake. The three FTAs are intrinsically worth passing without any strings. Congress should act on them without further delay.”

Domestic projects that could at least stabilize the job market are also languishing because Republicans refuse to consider them or seek to defund them.  Their whole agenda has been to do nothing about anything, or to undo things that have already passed.  They are earning their reputation as a “do-nothing congress.”

As a strategy, it has been effective.  It is a morally bankrupt strategy however.  When there are things that both parties agree in principle could be done to help the economy, but one party (lest anyone forget, the Republican Party) steadfastly refuses to do (and takes steps to deliberately block), that party is clearly acting not only irresponsibly, but contrary to the best interests of the United States.  And they know it.

It is therefore not surprising that Standard & Poors chose to downgrade the credit of the United States regardless of the ability to pay the outstanding debts owed.  Whether it was the right thing to do is another question, and, according to Robert Reich, they got it wrong.

“If we pay our bills, we're a good credit risk. If we don't, or aren't likely to, we're a bad credit risk. When, how, and by how much we bring down the long term debt -- or, more accurately, the ratio of debt to GDP -- is none of S&P's business.”

When there is legitimate concern about whether a policy will be beneficial or harmful, virtually any strategy might be condoned – even obstructionism – but when there is uniform agreement regarding the necessity of legislation, legislation that must pass or legislation that will clearly assist the function of government, it is insanity to block said legislation or to even threaten to vote against it solely for political gain.

Republicans have been relatively transparent about their ultimate political goals, but we must question their methods.  Is the goal of the Republican Party to damage the economy in the hope that a damaged economy will assist in the defeat of President Obama in the next election?

That would be beyond the pale. Self-inflicted wounds should not risk economic suicide.  It is pure insanity. 

This democracy can certainly withstand political shenanigans when the stakes are high, but there should be some common sense involved.  If the results of political brinksmanship are harmful to the economy, it’s time to stop and reassess the risks and benefits.  Congress should be united in their efforts to improve the economy if both sides are already in agreement that a particular measure will be helpful. 

The economy has had enough problems without having Congress poking holes in our delicate boat.  Staying afloat should be the first priority even if steering the boat is the ambition of both parties.

In my humble opinion, changes in how congress operates are necessary, and these changes have been necessitated by the actions (and inactions) of the Republican Party.  It’s time to take the knives away from the minority party (be they Democrats or Republicans) before they injure the institution of government itself.

Failing that, we can only hope that the serious threats currently faced by the economy will be addressed seriously and logically.  If politician says “I will not compromise”, he or she should be placed in a metaphorical penalty box for the remainder of his or her term in office.

Invoking the 14th

The recent downgrade of the United States credit rating by Standard & Poors is not based on the actual ability of the United States to pay its debts, but rather mostly on political calculations and the nature of the fiscal crisis as their report admits.  In fact, the concerns expressed relate to the ability of the US political system to effectively deal with the fiscal crisis, so the downgrade was almost entirely an indictment of the political uncertainty as it might affect stability.

“[W]e see the path to agreement as challenging because the gap between the parties remains wide. We believe there is a significant risk that Congressional negotiations could result in no agreement on a medium-term fiscal strategy until after the fall 2012 Congressional and Presidential elections.”

There is no specific mention of the debt-ceiling negotiations, but with a system so dysfunctional that there was a significant risk of some form of “default” on our credit, this crisis does illustrate the difficulties in reaching agreements.  This strategy of “holding the country hostage” in order to achieve political goals has meant that a number of self-inflicted wounds have been made and are continuing to be made that can and will affect our economy.  Furthermore, it seems reasonable to assume that this “standoff” will likely rear it’s head yet again at the next opportunity.  Mitch McConnell has virtually promised this in this statement:

“I think some of our members may have thought the default issue was a hostage you might take a chance at shooting. Most of us didn’t think that. What we did learn is this — it’s a hostage that’s worth ransoming.”

With the debt-ceiling crisis behind us, discussions about whether the President should have invoked the 14^th amendment in order to raise the debt ceiling without congressional authorization have devolved into accusations that he is a wimp, spineless or a bad negotiator.  Most people seem to think this action would have been virtually unchallenged, or that any challenges could have been met relatively easily without any “unintended consequences.”  A few have considered some of the potential problems, mostly for the President, but the possible scenarios carry significant risks to our economy, the world economy, and our system of government.

For anyone familiar with the debt ceiling, skip this paragraph.  The debt ceiling is a law enacted by congress in 1917 that was intended to limit the amount of debt the country could accumulate.  All debt incurred by the United States is through legislation enacted in the House of Representatives and approved by the Senate and signed by the President, so the law is intended by congress to enforce fiscal discipline on congress itself.  It has been viewed as a signpost for the future to tell them to cut back spending.  Whether it had the intended effect is debatable, and it has been raised a total of 74 times since the law was enacted.

It wasn’t until this House of Representatives decided to use the debt ceiling against itself that a crisis was created.  The threat was that if a budget could not be passed that met certain criteria (which changed a few times), then the House (and possibly the Senate) would not vote to raise the debt ceiling, and, given that the debts are appropriations already made, that would mean a credit default.  (For now, we’ll ignore the congressmen that claimed there was no need to raise the debt ceiling.)

The 14^th amendment has a long history and dates to the end of the Civil War.  Congress did not want to be responsible for any debts incurred by the Southern States, but wanted to be clear that it would pay any debts owed by the North.  Only sections 4 and 5 apply to the public debt.  They read as follows:

Section 4. The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions and bounties for services in suppressing insurrection or rebellion, shall not be questioned. But neither the United States nor any State shall assume or pay any debt or obligation incurred in aid of insurrection or rebellion against the United States, or any claim for the loss or emancipation of any slave; but all such debts, obligations and claims shall be held illegal and void.

Section 5. The Congress shall have power to enforce, by appropriate legislation, the provisions of this article.

Those advocating that the President invoke the 14^th amendment in order to raise the debt ceiling, borrow money by issuing treasury bonds, and pay outstanding debts focus on the first sentence of section 4 and claim that, since the debts of the US shall not be questioned, the congress does not have the authority to refuse to pay those debts.  In effect, they are saying that the debt ceiling law is unconstitutional.

While the debt ceiling law is possibly schizophrenic, it is not necessarily unconstitutional, and there has been no ruling to that effect.

In any case, there are several potential problems with having the President override Congress in order to issue Treasury bonds for the payment of our debt.

It’s Illegal

Regardless of whether it would be good, bad or indifferent, it is a standing law.  It has not yet been ruled unconstitutional, and it is unclear who has standing to have it ruled so.  As the law stands, only Congress has the authority to order the issuance of bonds for the payment of the public debt just as they alone have the authority to apportion money and levy taxes under Article 1, Section 8, and this includes specific references to “pay the Debts.”

Even if you think it would be a good idea to bypass congress and raise the debt ceiling, the law as it stands prohibits that.

Impeachment and Conviction

A simple majority of the House of Representatives is required to impeach a President, and they have done it twice before.  The grounds for impeachment would be that President Obama would have broken the law and therefore committed a “High Crime.”  This would not necessarily even include the High Crime of violating the separation of powers and usurping the authority of congress, although I’m sure a case could be made for that, particularly since Section 5 of the 14^th amendment specifically appoints congress to enforce the provisions of the amendment.

The Senate would be given the task of trying the President.  The question before them would be the simple one:  Did the President disobey a law?  It is not the Senate's prerogative to question the validity of the law (they alone cannot invalidate a law passed by both houses and signed by a previous president), and in any case the law has been observed 74 times before. 

Unless the Senate abdicates its responsibility, the only reasonable conclusion is that President Obama would have, in fact, disobeyed a law.  A vote otherwise would be an admission of partisanship, and it would be a lie.  It is unclear what punishment would be chosen, but certainly removal from office would not be impossible.

Fate of the Bonds

What would the world make of bonds that were issued by order of a discredited President of the United States?  Would this country even honor them?  If Congress proceeded to honor those bonds, it would de facto validate the President’s actions and invalidate their own impeachment proceedings.  To do otherwise would destroy the full faith and credit of the United States, and might even throw into question the validity of any US Treasury bonds.  This puts congress into an impossible situation of making one of two really bad choices.  A Hobson’s choice of their own.

Imagine for a moment what that would do to the prices of our bonds, the bond market, the stock market, and the world economy?

Setting a Precedent

Even if the President “got away with” invoking the 14^th amendment and congress did nothing, the specter of this President or a future President using this precedent in other ways might alter the separation of powers indelibly and permanently. 

Not only could he have avoided future problems with the debt ceiling, but a President might also use the precedent to authorize payment of other debts despite a need for congressional authorization.  At this time, for example, Congress has not been able to reauthorize the Federal Aviation Administration, thus idling around 74,000 government employees and private contractors.  Are their contracts legitimate debts owed because of appropriations of congress?  Would the President then honor those debts by authorizing the work that they have been contracted to do?

Could congress “defund” a program that has been funded by legitimate appropriations, or could the President “invoke the 14^th amendment” in order to continue funding?

There is a concern that the President might take this success as grounds to authorize any funding that congress has been unable to accomplish legislatively.

It could even be taken further.  If the President can disregard a law passed by Congress with impunity, what further limits to his power would there be?  The wisdom of the separation of powers has been validated many times over, and unrestrained executive power would eat away at our system of government.

It is not these specific scenarios that should worry us necessarily, but the uncertainty regarding everything relating to relations between the executive and legislative branch.

Unforeseen Consequences

As Donald Rumsfeld so eloquently stated:

[T]here are known knowns; there are things we know we know.

We also know there are known unknowns; that is to say we know there are some things we do not know.

But there are also unknown unknowns – the ones we don't know we don't know.

That is a pretty good description of uncertainty.

Conclusions

For every scenario I have described, there are smart people who would say that there is some way around each of them.  Even in the best scenario, there would be confusion and uncertainty in both the government and the economy (if not outright breakdown).  Anyone who claims to know the outcome of this grave course of action suffers from hubris, overconfidence, ignorance, or unsupported hopefulness.

Layering a constitutional crisis on top of the debt-ceiling crisis on top of an existing economic crisis is not a recipe for a good outcome.  Economies are fragile things that run on trust and trust alone; a fact that has been overlooked recently by the political establishment (and most particularly the Republican Party).

Perhaps one could imagine that the self-destructive actions of congress might lead to catastrophe some day, and the actions of a President could save the nation from disaster (or at least reduce the impact of their actions), but if that day comes, we will no longer have a representative democracy. 

A failure of the system that unimaginable would be a failure of democracy itself.  If that is even conceivable, then the downgrade of our credit rating would not only be justified, it would be prescient.

Shock Doctrine, Part Deux

Naomi  Klein’s book, The Shock Doctrine, examines how American policies have taken advantage of moments of crisis to exploit “disaster shocked people and countries.”  She refers to this tactic as “disaster capitalism – the rapid-fire corporate reengineering of societies still reeling from shock.”

In the United States since 2001, the American government, and particularly the Republican political party, has continued to take advantage of various crises in an effort to shape our government into an image they had envisioned.  The major difference now is that instead of taking advantage of existing crises as described in Klein’s book, they are manufacturing crises in order to create the circumstances that drive dramatic shifts in policy.

Federal budgets may be mundane affairs to create, but they do speak to our national priorities – our soul, if you will.  Debate has generally taken place calmly in the halls of Congress, and through legislation passed by a majority of the House of Representatives and the Senate, policies that are primarily directed by the majority have been enacted.  The Drama of the Filibuster has been a rarity and utilized by the Senate minority to either stop legislation or to modify it by compromise.  House and Senate rules have also been used to block legislation, appointments and budgets when these were important enough to the minority to jeopardize their ability to compromise or when compromise was impossible.

The use of cloture has become routine recently to the point that, in order to vote on virtually anything in the Senate, a 60 vote majority is required which virtually guarantees that the minority will have control of the agenda and the legislation passed.  This in itself is a new trend, but layered on top of the minority control of the Senate is the use of “leverage moments” when the minority uses a deadline that carries significant consequences in order to modify budgets or legislation.

The result has been what many are calling “dysfunctional government.”  A “government shutdown” would seem to be the last thing a government wants, but when steadfast obstinacy is your only tool, you see a solution to every problem by threatening to not pass critical legislation without certain demands being met.

As a strategy, it has been used by both parties with increasing frequency, but as you can tell from the graph, it seems to have taken off with the 92^nd congress – when Democrats held the majority.  It is also notable that the 110^th congress has had a number of cloture votes that exceeds previous congresses by a 2 to 1 margin.

Government shutdowns have generally been brief and have been used to indicate that the party refusing to negotiate was “serious” about their particular demands.  In 1980, a judicial interpretation of the “Anti-Deficiency Act” made operation of government functions limited to those necessary for protection of life or property during the shutdown.  The stakes got a bit higher with that ruling.

In each of these cases, the shutdown, or in some cases blocking legislation deemed important or even crucial to the functioning of government, was used in much the same way as the crises that Naomi Klein wrote about.  A sense of urgency was created (and that word is the correct one) and the solution required adoption of the minority party’s policies in order to continue.

Except for the government shutdown of 1995 which lasted 21 days, most government shutdowns have been relatively uneventful.  In the end, the Republicans received considerable criticism for the consequences of shutting down the government at that time, but they have continued to use the threat of shutdown as a means of getting their policies enacted (or blocking Democratic policies).

The most recent use of a deadline to pressure the majority into ceding to demands of the minority is, of course, the “debt ceiling” crisis.  It is, as all of the other government “crises”, manufactured.  Artificial.  Arbitrary.  But this time, also potentially devastating to the economy of the US and the world.

One wonders if the Republicans were serious that they would not raise the debt ceiling if their demands were not met.  If one takes hostages and threatens their lives, the threat must be credible in order to use that threat as a bargaining tool.  Given the consequences of failing to raise the debt ceiling, I doubt that any responsible person would have followed through on that threat, but then there is the TEA party.

The difference between politics of government shutdown and politics of possible US credit default are miniscule, and most of it was probably “political theater”, but the Republican TEA party faction and the Democratic Progressive faction are both so ideologically driven that compromise is all but impossible.  I truly feared that there could be no compromise in part because the Republican party is being threatened from within by the TEA party.  The rhetoric was clearly inflexible from even the leadership of the Republicans, and there was a real possibility that some Republicans might have been locked into their positions.  Many Republicans will face primary challenges for failing to adhere to the rigid stance of the TEA party and their own extreme rhetoric.

Fortunately, reason and consideration of the consequences of failing to act prevailed and a compromise was reached, but many agree that the compromise favors the minority party’s policies.

Governance by crisis creates three problems.  First, it essentially creates the conditions for minority rule.  Second, it risks undermining the credibility of the United States even when a compromise is ultimately reached.  Third, the most reckless and irresponsible party is rewarded for their dangerous actions.

The rules haven’t changed, but the game somehow changed.  It is as though the Republicans have exploited a flawed rule in order to ensure their victory in every confrontation.  It’s like a gambler that has found a way to win every hand of cards, a stock broker that has inside information, or a mobster who can make offers that no one could refuse.

This, I believe, is a threat to democracy.  There is a reason that the majority party is in the majority, and it is to reflect the will of the American people.  When the interests of the people are subverted by legislative maneuvers, the majority loses.  And in the end, we all lose.

Whether the government is described as dysfunctional or not, it is clearly not functioning the way it was intended by the Founding Fathers to function.  There is sufficient opportunity to force compromise when the government functions as it should without making majority rule impossible. 

It’s time for a change.  There should not be a way to create a crisis in order to bend the will of the majority to the will of the minority.   That is not representative democracy.

Obama's Hobson's Choice

I had a sinking feeling tonight after the Republican controlled House of Representatives could not get enough support from their own party to pass their own bill; not because I think it’s a good bill.  I don’t.  But this failure of leadership means that there will likely be no compromise with Democrats, and there will be no successful measure passed, and the country will likely default.

If the debt ceiling is not raised by Congress, Obama will be faced with a “Hobson’s Choice.”  This is a choice where there are no good alternatives.  And this crisis is entirely unnecessary – a contrived crisis manufactured in order to gain “leverage” and reduce the size of government.  At least, that’s the generous interpretation given the statements of some of the House and Senate Republican leadership.

The alternatives still remaining for Congress are to pass a clean debt bill, compromise, or deliberately do nothing.  I am reminded of Dorothy from The Wizard of Oz who, belatedly, discovered that all she had to do was click her heals together and say, “There’s no place like home.”  It’s that easy to pass a clean debt ceiling bill.  They could compromise with Democrats and Moderate Republicans forming a coalition in order to raise the debt ceiling.  

As of now, the President has rejected the idea of invoking the 14^th amendment to the Constitution which says that our debts shall not be questioned.  Even if he were to invoke that, we could expect that he would likely be impeached by the TEA party controlled House of Representatives. 

The rigid ideological position of the TEA party is still, at this late hour, focused on reducing the size of government.  The goal of reducing the size of government sounds nice to many people until they see how it affects them.  Before the last “almost” government shutdown which was resolved literally minutes to midnight, actions were taken to start the government shutdown, and you should have heard the ruckus.

Active duty pay was cut in ½ (they later received all of the money owed), and my anti-Obama relatives in the military were saying, “How could Obama do that!?”

When he was talking about perhaps not having enough money to pay social security checks if the debt ceiling was not raised, the elderly (and those who might have to be financially responsible for them) cried, “How could Obama do that?!”

The choices faced in this situation are all that and more.  Someone’s checks aren’t coming.  And you can expect a lot of bitching and moaning, and they will cry, “How could Obama do that?!”

The TEA party knows that Obama will be blamed, so why should they even consider raising the debt ceiling? 

Congress has already reached a stalemate regarding the FAA, and about 70,000 workers are idle.  Taxes that would be collected can’t be collected.  The cost will be tremendous even assuming that they eventually pass the authorization for the FAA.  That will be peanuts compared with what’s to come.

Every federal government related construction job, administrative job, teaching job and law enforcement job is on the line.  We can at least guess how the available money might be distributed.  Maybe the FBI and CIA would be paid (to keep the criminals and terrorists from having an open door), the interest on our debt will be paid (to avoid global panic and economic disaster), and, I think, Social Security will be paid. 

But with $172 billion to pay $306 billion in expenses due, a lot of people will be idled.  A lot of checks will not be paid.  A lot of citizens will be hurt financially.

I can’t even fathom the consequences of a credit downgrade on interest rates, hiring and investment, but I’ll bet it won’t be pretty.  With as many government checks not going out as are due, our buying capacity will be dramatically decreased, and there will be less stuff bought, less income, less profit, and ultimately fewer jobs.

The markets?  Oh, lord that’s gonna hurt.  I’ve already lost a bunch from the dropping market, and it will get a lot worse.

Much of the world has assumed that this crisis will be averted and all will sail on as usual.  There is still hope, but it diminishes each hour that a compromise can’t be reached.  The world, and the TEA party perhaps, expect the Democrats to cave.  They have before again and again, but this time I sense something different.  There is nothing left to cave into.  The Democrats conceded every demand.  Both deals considered have only spending cuts that amount to the amount that the debt will be increased (which is a totally arbitrary demand from the TEA party caucus).  Increased revenues, even from the most wealthy, are not even being considered.  There is nothing else left to give.

At this moment, and not until now, I fear that there can be no compromise.  No deals will be wrought out of this hostage taking of the debt ceiling (and the American/World economy). 

Perhaps a “good deal” was never the Republican agenda after all.  Perhaps we should have listened to them when they said, “We will not vote to raise the debt ceiling.”

If this is some TEA party misunderstanding, miscalculation or blunder, maybe they will learn from their mistake.  But how much will it cost us to pay for their mistake?

Trickle Down and Taxes

It was Will Rogers who coined the phrase “trickle down economics” when he commented that "money was all appropriated for the top in hopes that it would trickle down to the needy."  It didn’t work in the Great Depression, and it hasn’t worked since Ronald Reagan promoted this policy during his presidency.

The trickle down economic theory (supply side economics) makes the assumption that when the wealthiest individuals have more money, they will invest in their businesses promoting growth.  This, in turn, relies on two other assumptions:  First, that investment alone drives economic activity and second, that wealthy individuals invest because they have the money to invest.  As a corollary, the wealthy individuals would be expected to invest in their own businesses rather than types of investments that would be unlikely to promote the greater good of society.

The problem is that human nature does not follow the assumptions given above.  It seems that wealthy individuals invest in things that benefit themselves but may have little or no benefit for their business or any other specifically American business.

It turns out that there are many ways to spend money without investing in business, and for the wealthy, uncertain of the future, some means of protecting their wealth or otherwise enjoying the benefits of wealth are very personal.  Buying gold, for example, does virtually nothing for the economy.  Neither does purchasing another company.  Mergers and acquisitions are relatively safe bets, but the actual money exchanging hands tends to remain in the hands of the wealthy who already own most businesses, and if there is a benefit to the purchaser, it is the potential for creating a veritable monopoly.

Also, with respect to investing, the driving force of greatest import is demand instead of supply.  It does not behoove an investor to produce something that no one will buy.

Consequently, wealth accumulates with the wealthy who seek desperately to hold on to what they have rather than risk their wealth for the benefit of any business or nebulous benefit for society. 

Almost paradoxically, higher tax rates do promote investment.  Buying gold with after tax dollars when the tax rate is low may be a reasonable investment, but when tax rates are high, the government has the opportunity to use “loopholes” to allow the wealthy to hold on to a greater portion of their wealth by giving exemptions for investing in those things that truly do benefit society and the economy.

Allow me to give a hypothetical example.  The government would like to promote hiring.  Giving a wealthy businessman the choice between turning his money over to the government versus hiring more workers and growing his business will usually result in growing the business by hiring.  The same applies to capital purchases, growing the business within the United States (as opposed to foreign expansion), or almost any other goal that the government may wish to promote. 

Businesses do indeed seek to maximize profits, but they will do so through the path of least resistance.  It seems that foreign investment and expansion is significantly more profitable than domestic investment and expansion because of several advantages offered by foreign countries, not the least of which is a labor force that is disorganized and unaccustomed to high salaries.  It is the businessman’s dream of virtual slave labor or indentured servitude. 

Tax policy, carefully targeted at the income of the wealthy with specific loopholes that benefit the profitability of his company by directing domestic investment will promote expansion of his own business domestically.  It is the personal income of the wealthy that guides investment strategies as much as “what’s good for business.” 

In the Randian world, the positivists would assert that the wealthy, given the choice of using tax loopholes to preserve their wealth versus doing what would be most profitable for the business (at the expense of the United States) would choose a third option:  Leave the country.  There are two reasons this anticipated exodus of the wealthy would not take place in significant numbers.  First, moving to another country while still a citizen of the United States does not automatically exempt one from paying taxes to the United States.  A tax attorney wrote, “As U.S. citizens, we are taxed on our worldwide income.”  To the extent that there are advantages, that too can be changed.  Second, most people who are considered American would not wish to move from the country of their birth.  It is unrealistic to suppose that anyone with sufficient wealth would automatically leave his family, friends and society.  Relinquishing U.S. citizenship is a poor choice for several reasons, not the least of which is that U.S. taxes continue to be in effect for a number of years after this rather drastic action (currently 10 years, I believe). 

Incidentally, for those who are wealthy and conducting business in the U.S., tax policy could also encourage both the business and the owner to move to the U.S. regardless of the actual tax rate.  Anyone, or any business, conducting their business in the U.S. would likely be persuaded to move their business to the U.S. rather than be excluded entirely or taxed at a higher rate than domestic businesses (either by statute or by virtue of “loopholes” that allow deductions to domestic businesses preferentially).

On the other hand, the Randians may have one thing right.  After a certain point, more wealth is not personally beneficial.  After the first or second billion dollars, this individual does not really need any more income.  He or she could take their billions of marbles and leave without risking anything significantly.  Who needs a million dollars a day when you already have thousands of millions of dollars in wealth after taxes?  This is true now, however.  Bill Gates finally realized that he does not need to get more money from Microsoft to be rich, but he has not decided to live in another country.  He could afford to give away all of the money he is still accruing from Microsoft stock.  And he is.  100% or even more. 

Besides, most people who choose to have their products manufactured in China would likely agree that China is a nice place to visit, but they would rather live in the United States.  Businesses have no such compunction however, but most business decisions are made by those who live in the United States – or would like to.

The threats of the Randian libertarians are hollow.  Call their bluff.  The Galts of the world, exercising rational self-interest, will remain in the United States, invest in a manner that will preserve their wealth, and pay their fare share of taxes.

Weiner, the Internet and Psyche

As I write this, the pressing question in the news is, "Should Anthony Weiner (congressman from NYC) resign?"  Since I started writing this, Anthony Weiner has resigned.

I dismiss the Republican arguments (all, naturally, recommending that this firebrand congressman resign) as partisan hypocrisy.  That doesn't mean they are wrong, but to take their self-serving recommendations seriously is impossible.  The main source for the accusation of hypocrisy is the continued service of David Vitter, currently a Senator from Louisiana, who was embroiled in a controversy regarding the “DC Madam”, a house of prostitution.  He was never asked to resign, and was subsequently reelected.

The Democrats themselves have been gathering in larger and larger numbers to recommend that Weiner resign.  They presented several arguments, some of which are also voiced by Republicans, including 1) He can not effectively represent his constituents after this embarrassing sexual impropriety, 2) The country is distracted from serious matters by this ongoing national joke, 3) He needs to take time for himself and his family, 4) He has engaged in at least one ethics violation:  Don't engage in behavior that would reflect poorly on the House of representatives or the United States, and 5) he lied to the media, fellow congressmen and congresswomen, and even his wife.

There are, of course, other reasons given, some more artfully articulated than others, but they lack specificity.  Some extrapolate from the other reasons given above:  "If he lied about that then he is vulnerable, or a liar, or hiding something else, etc."

Some said he shouldn't resign.  They argue that he never claimed moral superiority, others have done worse without resigning, he did not violate any laws, and there is no reason to think that this indiscretion will affect his effectiveness as a congressman.  We don't know the extent of congressional bad behavior, but the reasons for his behavior are as understandable as they are reprehensible.

There remains something that was not been given much attention, but is probably the most important thing to consider.  Has Weiner gone nuts (no pun intended)?  He looks and acts sane publicly, his apology seemed sincere and appropriate, he seems to understand that what he did was wrong, and he has vowed not to continue to do it.  So, he's sane, right?

Some say that, as a powerful man, he is predisposed to "risk taking" and may be more likely than most to engage is risky sexual behavior than most people.  I'll grant that, but there are some aspects of this particular indiscretion that scare the pants off of me.  Not literally.

First, when men take risks, they generally do so with an awareness of the consequences and a concerted effort to avoid detection.  Part of the thrill is avoiding getting caught, but Weiner took no precautions.  He did not disguise himself and, in fact, flaunted his identity to the women he had never meet personally.  Another congressman, Chris Lee, resigned in disgrace in a matter hours after he had been outed by a woman with whom he had been corresponding via Craig's List.  One photo of his bare chest was enough to shame him into resigning.  Weiner was certainly aware of that episode, but he was sending photos which were virtually identical in pose, if on occasion more explicit, with no apparent awareness that he too could be exposed and suffer extreme embarrassment and pressure to resign.  Watching a colleague fall next to you while you are engaging in the same behavior without any attempt to disguise yourself is beyond foolish; it's (politically) suicidal.

Second, he engaged in this behavior over a period of years with multiple women, even after marrying his current wife.  Being married does change things.  It is no longer just embarrassing, it is hurtful, and he should have known that.  He lacked the awareness that his behavior would affect his family.

The complete self-absorption, narcissism, lack of awareness and relentless pursuit of this activity in the face of risks that he could not see, but should have, leads me to believe that this is beyond a peccadillo; it's an illness.  He is right to seek "treatment" and, if he does, that would go a long way towards reassuring others that he is not likely to reengage in self-destructive behavior. 

If this is an illness, it would fall into one of several categories.  It might, for example, be a paraphilia.

Paraphilias are ... “characterized by recurrent, intense sexual urges, fantasies or behaviors that involve unusual objects, activities or situations and cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Tends to be chronic and lifelong, although frequency and intensity may vary.  Often not associated with distress.  Clients often claim the problem lies in others’ responses.  This is about justifying and normalizing their behavior to alleviate guilt and embarrassment.  Most deviant people choose to lower their inhibitions by justifying their behavior or engaging in distorted thinking that supports the behavior.”

The term "sexual addiction" is not included in the current version of the diagnostic and statistical manual (DSM-IV), but the topic is under consideration.  Addictive behavior, in sexual terms, would involve “compulsivity (inability to stop), continuation (despite consequences), and obsession (their minds are so preoccupied by these thoughts, other areas of their lives that they could be thinking about are neglected).”

It is not possible now to know if Weiner will have the characteristics that would suggest addiction, but clearly if the behavior continues despite this public shaming he could be considered addicted.  The question is whether he will continue the behavior despite consequences and neglect his work and marriage.

In any event, the behavior he has engaged in is deviant, incredibly risky, and harmful to his family and his occupation.  How likely is it that treatment will be successful?  How long will treatment take?  How likely is it that he will be able to function in his job after treatment?

It is too soon to know the answers to these questions, but my suspicion, based on the nature of the behavior, is that this will not be an easy road for former Congressman Weiner.  He has underestimated the problem from the beginning, and his unrealistic approach has thus far shown, if not a lack of sincerity, at least a failure to appreciate the inevitability of his current dilemma.  I am sure that Congressman Weiner is confident he can put this behind him, live a normal life, stay married, and eventually resume a life of public service in some capacity, but as much as he has underestimated the problem, I think he is overestimating his ability to change his habits.

In order to accept Congressman Weiner as their representative, the constituents will have to extend an extraordinary amount of trust or accept that they have a sexual deviant representing them.  Even assuming they would accept the latter, trust is still necessary, and his actions have already betrayed that trust.

If he should run for reelection, his constituents will decide if they are willing to be disappointed.  I hope that Congressman Weiner can gain some insight into his problems that he has so far failed to demonstrate, but his constituents should be prepared for disappointment.

Regarding the push for resignation addressed towards Weiner and not David Vitter, there is a perceived difference.  Most people understand infidelity, even with prostitutes, as being within the range of normal behavior (although that is not necessarily true).  Even without studying abnormal psychology, the behavior of Weiner clearly falls outside of the normal range of behavior.  Although usually unspoken, there is a fear of an undiagnosed psychiatric disorder; one that may have only now become uncovered, but that may affect every other aspect of his life in ways that cannot be predicted.  When people say, “I’m glad he’s seeking the help he needs”, they are saying that until he has been evaluated and treated by professionals, he should not be allowed to function as a congressman or in any position of responsibility.

My personal assessment is that human interaction via the Internet and social media is so foreign to our psyche that our normal impulses can be warped, and our normal inhibitions can seem unnecessary.  Perspective can be lost, and we have a strong tendency to fool ourselves.  Although unjustified, we may feel safe revealing thoughts, feelings and even images of ourselves that we would not share under any other circumstances because it all seems less real, or anonymous, or private.  It is therefore not at all clear that bizarre behavior via the Internet is reflective of deep psychological disorders.  It may actually be a distortion of our normal, if “antisocial”, nature.  There’s a paradox for you.

There are layers upon layers upon layers of psychological motivation that affect our behavior over the Internet.  The psychology isn’t new perhaps, but the circumstances that affect behavior are new – as new as the Internet as a means of communication.  Maybe it was necessary for Weiner to resign for his own health, but then maybe he is one of us that just went overboard and, given the embarrassment, he might be jarred back into reality.  Or maybe he is so deeply disturbed that he won’t be able to stop.  Even Weiner probably doesn’t know the future at this point. 

I will say that, given our almost universal lack of understanding of his behavior, it was probably necessary for him to resign for the benefit of his fellow congressmen. They might fear that he will begin to act bizarrely in public and moon C-Span, or shout out inappropriately (“You lie!”). 

With time, perspective and counseling, Weiner will understand his behavior and, I think, control it.  He is not the first to find himself embarrassed by the Internet, and I suspect he won’t be the last.  It’s human nature.

Gun Sense and Common Sense

Gun ownership, deaths, injuries and crime set the United States apart from the rest of the world.  Bolstered by the second amendment to the Constitution and a belief that having a gun will provide protection for the household, gun ownership is common. 

I won’t write about how many guns there are or who has them.  I won’t write about the types of guns or how much ammunition they hold.  I’ll just be writing about common sense.

The recent Florida law HB 155 prohibits a pediatrician from asking parents if they have guns in the house.  From the pediatrician’s point of view, it’s a public safety issue on par with safety devices for electric plugs, child safety seats, poison control and a host of other aspects of ordinary life that endanger children.  The NRA backed law sees the issue as one of freedom from being hassled about owning guns.

This law reminded me of something I saw years ago that I will never forget.  It shapes my thoughts and actions to this day.

I met a 13 year old boy in the operating room at Darnall Army Community Hospital during the fall of 1983 when I was on the surgical team on call that day.  We opened him up and found that a bullet had passed from his left side through his body and out the right side transecting the aorta and vena cava (in addition to other serious injuries).  There was too much bleeding, too much damage, and the boy died on the table.

I removed my bloody gloves and gown, got dressed and walked towards my car, but as I passed through the emergency room on the way to the parking lot, there was an elderly man in distress.  His shirt was off and he had electrodes attached to his chest, and he was wailing.  I was told that he was the boy’s grandfather, and he was the one that shot and killed his grandson.

The emergency room doctors told me that they had been hunting deer, and they were wearing camouflage.  The grandfather saw his grandson walking and mistook him for a deer.  I can only imagine the emotions that went through that man’s mind after he fired his rifle.  He was probably joyous at first, terrified when he saw his grandson instead of the deer he expected, and then he probably experienced guilt.

I have no doubt that his guilt was a contributing factor to his chest pain, and I have no idea if he lived or died that day.  I left him there, crying, but I’ll never forget the expression on his face.

Sometimes I see men in the fall wearing camouflage, or men tell me they’re going hunting.  Most are proud to tell me that they are taking their children or their grandchildren hunting with them.  Maybe they might be upset with me for recommending that they wear orange vests, but if they are, I tell them what I experienced, and I hope I never experience again.  Maybe they’ll listen, maybe not.

The Florida law would keep me from even asking if they are going hunting, although their clothing, from boots to hat, scream hunting.

The Florida law isn’t about gun ownership.  It’s a law to protect the sensitive ears of gun owners from stories like mine, and warnings about dangers, and recommendations for safety.  Maybe doctors aren’t qualified to make such recommendations, like keep the guns locked up and the ammunition separate from the guns.  Maybe the gun owning parents already know everything a doctor could possibly tell them about gun safety – and more.  But children still get guns and shoot themselves or others – on purpose or accidentally.  And hunters still wear camouflage without an orange vest in the hopes they can be more effective hunters.

Those, of course, are aberrations, lapses of common sense, bad judgment or neglect and not at all representative of the average American gun owner, but I can see no harm in hearing advice even if the person hearing it needs no warning.  The advice is, after all, only common sense.

A warning is only unnecessary if there is absolutely no risk of danger.  As long as there is risk, common sense should tell us that the voices giving warnings should not be silenced.

Is this such a dangerous concept?  “According to federal statistics, there are guns in approximately half of all U.S. households. Even if no one in your family owns a gun, chances are that someone you know does. Your child could come in contact with a gun at a neighbor's house, when playing with friends, or under other circumstances outside your home.”  This is from the NRA.  It seems they realize the risks of unsecured guns in homes, but hope that nothing happens.  They go on to say that you should teach your child about gun safety, but children aren’t adults; they aren’t as responsible, as knowledgeable, or as mature as adults.  The NRA still does give some good advice.  In this web site (http://www.nrahq.org/safety/eddie/infoparents.asp), they offer information that they would prevent pediatricians from offering. 

Almost everyone could agree that leaving a loaded weapon within reach of a child (depending on how you define child) would be child neglect, or possibly child endangerment, or possibly worse.  We find out about most cases like these after the fact – the cold fact of the injury or death of a child or adult resulting from the “accidental” or even intentional discharge of the weapon by a child.  By law, pediatricians, and indeed all physicians, are obligated to report child neglect and child abuse.  Many cases of child abuse and neglect come to the attention of the pediatrician, sometimes as a result of the questions asked during a visit.  When gun owners successfully stifle the questions, they are in effect saying, “It’s none of your business” if I decide to engage in behavior that is dangerous to my child.

But it is the business of the pediatrician.  It is the business of all of us, but pediatricians are uniquely placed to examine the child (literally) and speak with both child and parents.  The purpose is not nefarious and the result is not intended to be punitive.  The goal is keeping the children alive.

Do parents fear that they will be suspected of neglect?  They shouldn’t unless they gleefully admit to being neglectful.  “I let my kids play with my loaded weapons.  They like the noise the guns make when they shoot ‘em.  Heck, it’s better ‘n fireworks.”  The questions asked are only meant to determine if there is a situation that would put a child in danger.  Parents who are knowledgeable about gun safety are a blessing for pediatricians.  We, doctors, parents and children, are all on the same side.

If a family’s pediatrician seems to be “stepping over the line” and giving unwanted advice, the parents are free to find another pediatrician, or ignore the advice, but to deny that guns are a safety concern worthy of the attention of the pediatrician is ludicrous.  People should not be forced to see physicians (or other health care providers) with whom they disagree, but to silence the doctor in an effort to avoid the issue is, or should be, as illegal as it is willfully ignorant.

I’m sure there are parents who would like to silence doctors on the issue of diet and exercise for children.  Maybe the parents don’t want or need to hear it, and perhaps physicians can avoid offending by avoiding the subject, but that is contrary to the best interests of their patients.  All questions of child safety are uncomfortable for some parents, but the duty of the physician is to the patient, the child, even when it comes to “uncomfortable” issues.  At the very least, the discussion of guns and safety may be redundant.  At most, it is life saving. 

Imagine if the tobacco lobby persuaded a state legislature that pediatricians should not ask parents if they smoke.  Or imagine the automobile industry lobbying to prohibit pediatricians from asking parents if they are using appropriate child car restraints.  I wouldn’t be surprised if the automobile industry would like to avoid having parents think of their children dying in automobile accidents when they purchase a new car.  The list of lobbyists that might like to suppress the speech of pediatricians is almost endless. 

The only reasonable course is to allow pediatricians to do the best job they know to do, and if the patient/parent is unsatisfied, find another.  Laws prohibiting this speech are un-American, unconstitutional, and an intrusion of Big Government that should be an anathema to everyone regardless of political persuasion.