April 2008 – Page 4 – Rolling Doughnut

I was teased into a dangerous fixed-rate mortgage.

Just as subprime mortgage borrowers were teased into taking out loans they later could not afford when the interest rates spiked, scores of municipalities, schools, hospitals and even museums are now facing soaring interest payments on unconventional bonds that proved too good to be true.

Ready to be unleashed on any and every victim:

The District has begun paying an extra $1.2 million every month because its interest payments have doubled, and in some cases even tripled, on $601 million of these bonds. That represents nearly one-seventh of the city’s total debt and includes $24 million for the Washington Nationals’ new stadium, the District’s treasurer said. City officials were convinced by investment banks that these types of loans would be safe and cheaper than traditional borrowing.

Naturally, deceit (i.e. “teased into”) is the only explanation. We can’t expect politicians to be diligent when subjected to the avarice of evil capitalists. They couldn’t possibly be stupid or greedy themselves.

The surge in the cost of these bonds is the primary way taxpayers are being burdened by Wall Street’s credit meltdown.

The insatiable appetite among all politicians for spending unbounded by tedious constraints like tax receipts is the primary way taxpayers are being burdened. Without debt, there would be no upwardly-fluctuating interest payments.

Politicians lie to please us because we allow ourselves to be pleased.

Via Wired, the Los Angeles Times reports on a scheme to fight global warming. Or, rather, I should write that the scheme is claimed to fight global warming, although the specifics (unsurprisingly) suggest otherwise. Consider:

Motorists in Los Angeles County could end up paying an extra 9 cents per gallon at the gas pump, or an additional $90 on their vehicle registration, under proposals aimed at getting them to help fight global warming.

Voters would be able to decide whether to approve a “climate change mitigation and adaptation fee” under legislation being considered by state lawmakers and endorsed by the board of the Los Angeles County Metropolitan Transportation Authority.

So state lawmakers are offering a Pigovian tax, right? Their interest is in countering the negative externalities of carbon pollution, right? You know the answer, right?

The money would fund improvements to mass transit and programs to relieve traffic congestion at a time when transportation dollars from Washington and Sacramento are hard to come by.

Of course. Sin taxes always purport to be about reducing the offending behavior, but are never actually designed to correct the problematic outcomes. The politicians always end up saluting General Fund.

And it often comes with “words mean what I say they mean” baggage.

[Jon Coupal, president of the Howard Jarvis Taxpayers Assn] also objected to the measure’s being called a “fee” — which requires a simple majority for approval — instead of a “tax,” which requires two-thirds approval.

[Assemblyman Mike] Feuer’s bill would allow the MTA board to ask voters either for a fee of up to 3% of the retail price of gas, or for a vehicle registration fee of up to $90 per year. The money would pay for programs to reduce greenhouse gas emissions.

Want to bet how quickly lawmakers would revisit “3% of the retail price” tax if the retail price of gas falls, lowering tax receipts? Bonus points to anyone who can find an example of Assemblyman Feuer endorsing an expansive governmental role in lowering the price of gas. Oh, wait, scratch that. Finding an example is actually quite simple. Surprise!

Service to the President: What McCain wanted to say.

John McCain offered useful insights into his (dangerous) political mind at the Naval Academy on Wednesday. For example:

I’m a conservative, and I believe it is a very healthy thing for Americans to be skeptical about the purposes and practices of public officials. We shouldn’t expect too much from government — nor should it expect too much from us. Self-reliance — not foisting our responsibilities off on others — is the ethic that made America great.

But when healthy skepticism sours into corrosive cynicism our expectations of our government become reduced to the delivery of services. And to some people the expectations of liberty are reduced to the right to choose among competing brands of designer coffee.

Actually, my healthy skepticism is still healthy. I expect government to ineffectively deliver services it shouldn’t be attempting, even though it tries and tries and tries. And when it fails, my healthy skepticism knows that it will try harder, but with more money.

My definition of corrosive cynicism looks something like the Bipartisan Campaign Reform Act of 2002, a.k.a. McCain-Feingold. This is the belief that individuals can’t be trusted, so someone smarter must look after their interests for them. That brand of corrosive cynicism believes expectations of liberty should be reduced to the right to choose among competing brands of designer coffee. My healthy skepticism understands that competing brands of political speech are a form of liberty thankfully enshrined in the First Amendment. The corroded cynic speaks of quote First Amendment rights.

Continuing:

Should we claim our rights and leave to others the duty to the ideals that protect them, whatever we gain for ourselves will be of little lasting value. It will build no monuments to virtue, claim no honored place in the memory of posterity, offer no worthy summons to the world. Success, wealth and celebrity gained and kept for private interest is a small thing. It makes us comfortable, eases the material hardships our children will bear, purchases a fleeting regard for our lives, yet not the self-respect that, in the end, matters most. But sacrifice for a cause greater than yourself, and you invest your life with the eminence of that cause, your self-respect assured.

Senator McCain and I have different opinions on how our rights are protected. As noted above, we don’t share the same opinion on our rights. But the problem here is his idea of a “cause greater than yourself”. Who decides what cause is greater than me? Who decides whether or not my actions constitute sacrifice? And I’m not thrilled by the idea that “success, wealth, and celebrity gained and kept for private interest” is allegedly a “small thing”.

I’ve long believed that we are a citizenry who behave as though we are rightfully subjects of the government. Among his many faults, Senator McCain is too friendly to perpetuating that mistaken belief. We are electing the president of a government (previously?) limited by a constitution, not a king limited only by his mandate by his higher calling.

Link via Hit & Run.

How far do parental “rights” extend? What is the basis for limitation?

Passed to me by a friend, let’s draw the natural comparison on this story:

Thailand’s Health Ministry ordered hospitals and medical clinics to temporarily stop performing castrations for non-medical reasons, saying Wednesday that the procedure performed on transsexuals needs stricter monitoring.
…

“As of today, doctors can perform the surgery if there is a medical reason to do so — not for any other reason,” ministry spokesman Suphan Srithamma said.

The move came after a leading gay activist, Natee Teerarojjanapongs, called on the Medical Council to take action against clinics that perform castrations on underage boys.

I don’t have any knowledge of this topic beyond what this story offers. I assume it’s true that some number of males undergo castration to achieve “feminine qualities”. Like medically unnecessary circumcision, neither parental proxy nor choice by a legally incompetent individual should factor. Unlike medically unnecessary circumcision, this appears to be at the male’s request. But this is important to remember:

“It’s a totally wrong perception that castration will make boys more feminine,” Natee told The Bangkok Post last week. “These youngsters should wait until they are mature enough to thoroughly consider the pros and cons of such an operation.”

Unfortunately the real problem appears to be doctors overlooking the existing rule requiring parental consent for boys until they reach age 18. I don’t think there’s contention that enforcing this is reasonable.

So, instead, a thought experiment. I would like to assume that parents are rational enough not to sign off on this type of stupidity. I don’t assume that, of course, because the evidence proving otherwise is too strong. But apart from the distinction¹ on future reproductive capability from the two procedures, how is it any more reasonable to permit parents to impose circumcision than to permit them to impose castration? We can discuss degrees of violation, but that’s a distraction from the truth that they’re the same kind of violation. We don’t debate the depth to which it’s acceptable to stick a knife into someone, even though differences exist in probable outcome from the depth of the assault.

When considering surgery on minors, any intellectual journey towards acceptance after establishing medically unnecessary is unethical and illegitimate. There is no objective justification, so any legal permission granted to parents by society is subjective reasoning devoid of reason. It doesn’t matter if the topic is castration, genital cutting, breast augmentation or any other unnecessary intervention a second-party prefers. The individual isn’t just supreme, he is all that matters.

¹ Reproduction is not necessary for the individual to live, so its foundation is subjective, exactly like medically unnecessary circumcision.

Opinions tell us what, exactly, about policy?

From Friday:

In the [New York Times/CBS News] poll, 81 percent of respondents said they believed “things have pretty seriously gotten off on the wrong track,” up from 69 percent a year ago and 35 percent in early 2002.

Although the public mood has been darkening since the early days of the war in Iraq, it has taken a new turn for the worse in the last few months, as the economy has seemed to slip into recession. There is now nearly a national consensus that the country faces significant problems.

So fascinating, and yet, so very likely irrelevant. Having an opinion is fine, but it’s only useful if that opinion is founded on facts. If it’s based on an idea that we’re suffering partly because the government spends more than it receives, fine. If it’s based on an idea that the mortgage situation in America is partly because some borrowers risked more than they could afford, fine. But those don’t seem to be the case.

In assessing possible responses to the mortgage crisis, Americans displayed a populist streak, favoring help for individuals but not for financial institutions. A clear majority said they did not want the government to lend a hand to banks, even if the measures would help limit the depth of a recession.

How perverse does a person’s thinking have to be to decide that the warm glow of political happiness is more important than results? I’m looking very much in the direction of people laughing today at this story.

Of course, this isn’t an endorsement of what the government’s done recently. A good bit of our trouble is at least an indirect result of government policy. Artificially low interest rates aren’t a good idea. Attempts to squash a signal of imbalance possess a distinct head-in-the-sand mentality. The mortgage interest tax deduction isn’t a good idea because it distorts behavior. Perhaps that’s favorable, but maybe not. My decision to buy a house was a natural step in where I was in my life in 2005, but the potential deduction fit with my increase in income. It did not tip the decision, but I included it in my analysis.

Finally, this:

“What I learned from economics is that the market is not always going to be a happy place,” Sandi Heller, who works at the University of Colorado and is also studying for a master’s degree in business there, said in a follow-up interview. If the government steps in to help out, said Ms. Heller, 43, it could encourage banks to take more foolish risks.

“There are a million and one better ways for the government to spend that money,” she said.

This unquestioning acceptance that the government should have our money, that the only question open is how to spend it, is irrational and damaging. There is only one better way for the government to “spend” almost every dollar it spends: return them to the people who earned them. Or, in the case of the pending Free Money, don’t take out loans in our name and tell us we’re richer. And in the future, stop spending and stop taxing. Let me decide what I deem worthy of my money. I want you to do the same.

Other than those objections, this poll is useful.

Overheard on the Internet

Anyone who follows discussion of circumcision on the Internet will encounter regular moments of an overwhelming desire to hate mankind. It’s impossible to avoid. People are so devoid of any logic or consideration for the child that disgust is the kindest emotion I can achieve. For example:

But I was also thinking, for all you mummies to be out there, are you thinking of getting your son circumcised? And for those of you with girls or who don’t know what you’re having, would you get your baby circumcised ? Does anybody know the pros and cons in doing so ?

If you’ve paid attention to my Circumcision category, you know that actual discussion of pros [sic?] and cons will likely not follow, which is how it plays out. Like here:

It’s completely a personal decision … You cannot make your decision based off of anyone elses opinion. …

I am here in the US and it is a very common practice. It wasn’t even a question for us. Here it is done one day after birth. Neither one of my boys even flinched when it was done. The PlastiBel that they use here takes all of 2 seconds to perform and it’s done.

You should really research it so that that you and OH feel that you have made the decision that best suits your beliefs. Good Luck!

Notice¹ that this response ignores the original question. Instead, it’s a typical defense of parents making a “personal decision” not based on any other person’s opinion, with any other person being inclusive of the healthy child. Whatever suits them is somehow acceptable.

But it gets more blatant:

…

I am not the sort of person to push my views on anyone else but that is what we would do.

Hope you make a decision that you and babies (sic) daddy are happy with.

…

She is mistaken; she is exactly the type of person to push her views on someone else. Her husband is that type of person, too. Neither of them considered that their son might not want to be circumcised. They imagine that only their opinion about his body mattered.

Some inject a little sanity into the discussion, saying it should be illegal. But then comes the inevitable softening to saying it should be a personal decision for the parents based on good reasons. Why? Has one parent on this board who chose to circumcise given any indication that common sense intervened? It should be illegal. That is the only reasonable stance based on more than one analytical approach. Why step away from that? To avoid offending? The legally-permitted violation will continue for some time. There is no reason to enable it longer. Don’t be afraid to call people out on their selfish delusions².

<sarcasm> With all of these arguments for and against the procedure </sarcasm>, I can’t say I’m surprised by the original commenter’s decision:

yeah I think I’m going to get my boy circumcised, seeing as it protects him from all sorts of infections and sexually transmitted diseases, but I heard a story about a man who lived here in winnipeg
He got circumcised when he was a baby and they ‘accidentally’ cut his penis off! Can you believe it ?

It protects him from UTIs in the first year of life, but the risk is minute without circumcision. (Girls suffer more than intact boys.) And the data on STDs is equivocal, at best. (Condoms? Bueller? Bueller?)

The man she speaks of is David Reimer. His circumcision was attempted using cauterization, which is not an accepted method. While he is important to remember because he was a victim of a botched, unnecessary circumcision, there is (unfortunately) at least one recent example from Canada. The child died.

To the first response I quoted above, the circumcising doctor used a PlastiBell ring on the child.

¹ Notice also that the (unverifiable) claim that it didn’t hurt the child is irrelevant. The ability to make a surgical intervention pain-free could justify any number of barbaric procedures. Need matters first, which didn’t exist here. Then, when need exists, a scientific conclusion that the most extreme intervention that is circumcision is warranted because no lesser interventions will correct the malady.

Also, did the child suffer any during the healing period?

² From one mother’s rambling comment excusing her selfishness:

I am happy with my decision, and I am sure my sons will never come to me saying they wish they still had their foreskin.

I’ve heard this so many times. No parent ever thinks it will happen to them. I know she’s psychic enough to know what her son will want, but what if he asks? And what if he asks because he’s not happy about it? Or is he not allowed an independent thought?

Delicate Decision: Post 4 of 4

On Monday the Los Angeles Times offered a typical analysis of infant male circumcision. There are many points to address from this story, so I’ve broken them up into multiple posts. (Posts 1, 2, and 3.)

Point four:

FOR nearly all of Nada Mouallem’s pregnancy, she and her husband, Tony, had a running argument. She wanted to have their son circumcised. He didn’t. “Many days, I’d go off and research all the pros. He’d go and research all the cons. Then we’d get together at night and fight,” she says.
…

For the Mouallems, family tradition and religion were not factors. “We kept those separate and focused only on the scientific reasons,” says Tony Mouallem, who was against circumcising his son because he didn’t think it was necessary. Plus, he’s not circumcised. “You have to work a little harder to keep it clean, but that’s not a big deal.”

His wife, Nada, however, worried about the responsibility of keeping her newborn’s penis clean. She thought circumcision would help reduce the risk of infection and disease. “I wasn’t keen on my baby having a surgical procedure, but then I thought, why not if we can offer him more protection?”

In the end, Tony sided with his wife. Their son was born Feb. 10, and was circumcised the next day. Tony held him during the procedure. “There was no bleeding and he didn’t even cry,” he says. “I’m still not convinced it was medically necessary, but I didn’t want to burden my wife with the worry of cleaning it. And maybe it will be easier for him in the locker room.”

Choosing surgery over responsibility is the abdication of an obligation when having children. No one states that an intact penis can’t be kept clean. Even ignoring the absurdity that it’s more difficult to clean in his early years when his foreskin adheres to his glans and shouldn’t be retracted, keeping your children clean and eventually teaching them to care for themselves is parenting. Anything else is the selfish subjugation of the child’s needs to the parents’ whims. In this case, that whim is further discredited because the father presumably understands how to keep an intact penis clean.

Post Script: This most fits the “typical” analysis. These “balanced” articles always contain a couple who can’t decide. And the couple always chooses “yes”.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Male Circumcision and HIV.

Delicate Decision: Post 3 of 4

Point three:

Robert and Cara Moffat of Los Angeles, who are expecting their first child, a boy, in May, had no trouble deciding, and plan to have their son circumcised. Robert, who is 30 and circumcised, said, “I grew up with it, and my wife has a preference for it, so that’s what we’ll do. We’re doing what the family is comfortable doing.”

His father is happy being circumcised, so the boy will be happy with it. This is an unverifiable assumption at birth. His mother prefers having sex with circumcised partners. This is irrelevant because I presume she does not intend to have sex with her son. So it leaves the conclusion that his future sex partner(s), who they apparently know will be female, will prefer that he be circumcised. This is an unverifiable assumption at birth. Finally, “what the family is comfortable doing” is hardly a principle of ethics, liberty, or science.

Also note that the parents have said nothing about (potential) medical benefits in forcing this on their son. Yet, they’re allegedly qualified to decide that their son will want this. And legally we’re all supposed to think this is reasonable.

As parents and task forces sort through the variables surrounding this intimate decision, [Dr. Andrew] Freedman offers parents in turmoil this comforting advice: “Rest assured. No matter what decision parents make for their son, most men think whatever they have is just fine.”

There are four potential realities for an adult male when he is finally legally protected to make his own genital decisions the way females are protected from birth. He can be intact and happy. He can be circumcised and happy. He can be intact and unhappy. He can be circumcised and unhappy. In the first scenario, he could do something but he wouldn’t. In the second, he can’t do anything but he doesn’t care. In the third, he can do something and he will choose either the perceived benefits of circumcision he seeks or not facing the drawbacks from adult circumcision. In the fourth, he can do nothing and society rejects his opinion as an individual.

In the first two scenarios, we conclude that the child validates the parents’ decision. We mistake an unrelated outcome for causation. In the third scenario, whatever we conclude, we’ve achieved the minimum standard of liberty that the male retains his right to choose (or reject) medically unnecessary procedures. In the fourth scenario, we either deny its validity or babble on about the rights of the parents. This generally involves some hand-wringing about parents making lots of tough choices while actively missing that none of the other choices involve removing parts of his anatomy. (You didn’t forget that parental rights are greater when speaking of sons, did you?)

Dr. Freedman’s opinion tells every man in scenario four his parents’ opinions about his penis matter more than his own. Anyone who argues this refuses to reconcile the complete lack of medical need with any notion of ethics and individual rights. Just because science can (allegedly and potentially) achieve an outcome does not mean it should try to achieve that outcome. That is a slippery slope unbounded by any consistent rule or principle.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Male Circumcision and HIV.

Delicate Decision: Post 2 of 4

Point two:

In the first year of life, 1 in 100 uncircumcised [sic] boys will develop a urinary tract infection. Only 1 in 1,000 circumcised boys will. “While that’s a tenfold reduction, you have to keep in mind that the risk was only 1% to begin with,” says Dr. Andrew Freedman, pediatric urologist at Cedars-Sinai Medical Center. Proper hygiene can prevent most infections.

When considering potential benefits, context matters more than an isolated statistic. For example:

The downside of letting the child make the decision later is that adult circumcision is more expensive, painful and extensive. During an infant circumcision, practitioners numb the site with local anesthesia, then attach a bell-shaped clamp to the foreskin and excise the skin over the clamp. The clamp helps prevent bleeding. In adults, the procedure involves two incisions, above and below the glans (tip of the penis), stitches and a longer recovery. The cost is about 10 times that of a newborn procedure.

Let’s ignore the rights of the individual for the moment. I don’t, but the hypothetical does, so I’ll stick with it. The cost is about 10 times that of a newborn procedure. So what? As a fact on its own, it means nothing. How likely is it that an intact male will need circumcision in his lifetime? If it’s less than 10%, and it is, then a basic cost-benefit analysis shows that we will spend less overall by circumcising only those males who medically require circumcision. The “ten times more expensive” meme is worthless upon minimal inspection.

Dr. Freedman seems to understand this:

“The HIV data is the most compelling to date that circumcision can help prevent the transmission of the virus in male-female sex,” Freedman says. “While this is important to sub-Saharan Africa, the question is how many infant boys need to be circumcised in the United States to prevent one case of HIV transmission 25 years from now? Factoring in even the rare complication that can occur with circumcision may render this study insignificant.”

No kidding. Aside from not being able to predict who (or if) circumcision will help prevent HIV, we can also not predict who will suffer a complication. I seriously doubt the few children who suffer a significant mutilation of the penis care that most circumcisions are “successful”. Nor do I suspect the few boys who die from circumcision care about the general outcome. Of course, this should matter now, even before reducing a child to his (unknown) place in the statistical herd.

But he might not get it:

If parents do opt for the procedure, Freedman advises that they do it when the baby is a newborn, have someone trained and experienced perform the procedure, and use pain control. “The older a child gets, the less benefit there is, and the greater the risk,” he says. “I would ask parents of an older child to strongly reconsider if the only reason they’re doing this is cosmetic.”

The parents of a newborn who choose circumcision for cosmetic reasons? Those are somehow okay? Again, the individual – the patient – matters. When he is healthy, every other outside opinion is meaningless to the consideration of his body.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Male Circumcision and HIV.

Delicate Decision: Post 1 of 4

Point one:

Dr. Peter Kilmarx, chief of epidemiology in the CDC’s division of HIV/AIDS prevention, says the CDC is looking at how the findings apply here. “The early opinion from the consultants — and not the position of the CDC, which involves a peer review process and public comment — is that, given all the previous data on circumcision plus the recent HIV African studies, the medical benefits of male infant circumcision outweigh the risks and that any financial burden barring parents from making this decision should be lifted,” he said.

Nationalizing health care will no more end routine infant male circumcision in America than the elimination of Medicaid funding has ended it in the states where Medicaid no longer pays for the unnecessary procedure. There is a political constituency that strongly supports imposing this on children. Until the universal principle that each individual owns his or her body is codified into law for males the way the Female Genital Mutilation Act now protects female minors, medically unnecessary circumcision will continue. And the state will pay for it when parents can’t (or won’t). Any protection of the individual based on entrenching an existing, or establishing a new, collective will fail.

Here’s a half-point in which I doubt Kilmarx understands the missing half:

“The procedure is so ancient, and steeped in cultures, I’m not surprised that the rate of adult circumcision in civilized countries doesn’t track with medical evidence,” Kilmarx says. “But as scientists, we don’t solely rely on what other countries do as a guideline.”

But as Americans, we don’t (mustn’t) solely rely on what science tells us as a guideline. Ethics matters. The rights of the individual matter, particularly the healthy individual. There is a hierarchy for decision-making concerning surgery on children. Kilmarx, among many, does not start at the beginning (i.e. medical need). That leads to mistakes, as clearly shown by the million-plus unnecessary infant circumcisions performed every year in America.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Circumcision and HIV.