The Seven Deadly Sins Diet

Sure, I know we’re all supposed to be acting like grown-ups these days – bucking up, buckling down, toughening up, pulling up our socks, straightening our ties – being more sober than we’ve ever been. And I know a lean, mean look, buffed up like Michelle Obama’s arms, much better suits these tougher times than a, shall we say, softer, silhouette.

Call me a self-indulgent whiner, but I still say losing weight or getting in shape is hard, and I still say hard stuff is, you know, tough. That’s why I had a warm, fuzzy blast to the past – you remember, the good old days when we still thought we could get something for…

The Primary Care Conundrum

Ask any health care wonk and they’ll tell you that within the larger health care crisis is a primary care crisis. There is more and more demand for primary care physicians – the person you probably call your “family doctor” – but America’s medical schools are producing fewer of them.

Why? Well in a word, money.

It’s not actually medical school that’s the problem. It’s what happens next. A newly graduated physician, carrying a big chunk of debt used to pay for medical school tuition, gets to chose their residency and, as such, decides what type of doctor to become.

In the U.S. we let medical students choose what to do. Not being dummies, most of them notice that diagnostic radiologists and orthopedic surgeons make three times what primary care doctors make, and choose their career path accordingly. Why the vast difference in compensation? Doing something to a patient – fixing a broken hip, reading an x-ray – has always been better rewarded more than talking to them about their high blood pressure or their son’s excema.

And while the taxpayer has subsidised teaching hospital residency slots to the tune of a more than $100 billion over the last two decades, the government doesn’t limit the number of those slots by specialty type. Most sensible countries do because they know that the more specialists there are the more specialty care gets done. And specialty care is very expensive. Which is the main reason we spend so much more on health care here than in other countries. In 1965, primary care doctors made up 50 percent of physcians; the other half were specialists. Today, about 70 per cent of America’s doctors have become specialists. Most other countries have the reverse ratio.

There were two major attempts to redress the imbalance in the 1990s. First, managed care… 

Healthcare Politics Trumps Good Policy

Time will tell if President Obama managed to hit the “reset” button with his Wednesday evening speech to Congress on healthcare. But as long as the American public firmly divided into three camps – those who want free healthcare at any cost, those who want none of it and those who are utterly confused by the whole idea – the process will remain unpopular.

Soaring oratory and grand gestures will not turn former Alaska Gov. Sarah Palin or Congressman Joe Wilson to acolytes of government-run healthcare. The “tea-baggers” will never ask for a cube of his sugar. The President, if he is to succeed, must accept this and build a thick skin. And to win the healthcare debate, Obama must convert the confused. Because they are based on good politics and not good policy, even without the so-called “misinformation” by his opponents, the president’s positions on healthcare are confusing enough, all by themselves.

Obama made a fairly bold assertion as he framed the health care debate saying that “our health care problem is our deficit problem.” The logic that follows, is that the status quo costs the government more than the “reform” Obama proposes. That assertion raises several unanswered questions which is where the confusion begins.

If “our health care problem is our deficit problem” why does the healthcare “solution” require a “tax increase” to succeed? That sounds as though “taxes” are the President’s budget solution and “healthcare reform” is just a vehicle to raise them.

If there is a “trigger” to prompt the creation of a public healthcare option – a government-run system – why not make the “trigger” the realization of enough savings from healthcare reform to pay for the public option? Now that would signal a genuine commitment to making our healthcare solution a deficit solution!

If “our health care problem is our deficit problem” then why would the reforms proposed by the White House…

Price is Right? Ask Your Cell Phone

Cash-strapped Italian consumers can now use text messages to tell them if the price is right. Euro-pinching shoppers thumb in product names — from pasta to produce and parmesan cheese — and a text message speeds back with the average retail price for North, Central and Southern Italy. Called “SMS Consumatori” (SMS consumers), the three-year program, organized by the Agriculture Ministry, is free to users.

Italians, like Americans, have been feeling the pinch of rising food costs. Inflation in the Bel Paese is at an 11-year high; a recent pasta strike is just one sign of the discontent.

Falling Out

Ask any health care wonk and they’ll tell you that within the larger health care crisis is a primary care crisis. There is more and more demand for primary care physicians – the person you probably call your “family doctor” – but America’s medical schools are producing fewer of them.

Why? Well in a word, money.

It’s not actually medical school that’s the problem. It’s what happens next. A newly graduated physician, carrying a big chunk of debt used to pay for medical school tuition, gets…

The Church and Prop 8: Losing by Winning

In spite of this week’s setback in the California courts, legal approval for same-sex marriage is building steam. The domino theory many right wingers and religious conservatives worried about when Massachusetts turned in favor of same sex marriage five years ago is becoming reality.

Besides the Bay State, same-sex marriage is now law in Vermont, Iowa, Maine, and Connecticut. New Hampshire and New York are likely the next tiles to fall, and supporters have promised to continue the fight both in California and federal court. No doubt the momentum will build and more states will tilt in the direction of the prevailing political wind.

Yawn.

That’s not to belittle anyone for whom legal recognition of a unified relationship is an important matter. I yawn because I fail to see why this is even an issue anymore.

A year ago, while gay marriage made its way before the people of California, I addressed the church’s political stand on gay marriage, writing about the evangelical community’s failure to conduct themselves in a biblical manner. That failure was – and is – symptomatic of how the church has lost its way. We cheer a legal victory upholding a state ban on same-sex marriage but, blinded by that win, we lose sight of the eternal picture, pushing away tens of thousands of people we have been called to love.

As an evangelical, I understand the reason behind all the hand-wringing and brow-furrowing. For me, the Bible is clear on the issue – homosexuality is sin. But here’s a memo to my fellow believers: so are many other behaviors that we’ve winked at over the years without the same level of consternation. Divorce, for example. Current statistics suggest that marriages within the evangelical church fail just as often as they do among non-believers. Sex outside the institution of marriage…

Fighting What You Eat: The Diet Cong

I have a client, a wealthy woman in her 60s, who has celiac disease. This means gluten – a primary protein in anything involving wheat flour as well as a few other foods – makes her ill by disrupting her intestine’s ability to process not just gluten but anything she eats. It’s a serious disease although its effects are mild in some people. I cater three or four dinner parties for her every summer and those meals must not only be gluten-free but indistinguishably gluten free. In other words, it should never occur to anyone eating it – even a nutritionist – that the meal specifically avoids bread, pasta, couscous (a form of pasta), cakes, and similar dishes. She has good cause for being…

Goa: Paradise Lost?

On 18th February, a young British schoolgirl, named Scarlett Keeling, was found dead on a beach in Goa, a western Indian state extremely popular with foreigners, especially those on shoestring budgets looking for sun and sand.

What, at first, was hurriedly passed off as a case of drowning due to inebriation later turned out, at the insistent calls for further investigation by her mother, Fiona MacKeown, to be rape and murder.

The unfortunate incident made headlines, both in India and abroad, pretty much displacing stories of Madeleine McCann, the young girl abducted in Portugal in the British tabloids. Suddenly, Goa – the perfect holiday haven, that attracts millions of foreign tourists each year, a majority of them British – is not being talked about for its sandy beaches, great food, or for its quaint churches, but for all that is wrong – sex, drugs, rave parties and mafia connections – with this seemingly perfect tourist spot.

The Goa of today is very different from its hippy days of the 1960s, it now attracts all kinds of tourists, including gap year students. But Scarlett Keeling was one of the millions of young men and women looking for cheap accommodation and wild partying who end up in Goa. Scarlett, according to police reports was no stranger to this scene, even at 15. In her diary she is said to have written, in graphic detail, all about sex and the hallucinogenic drugs that she took even when back home in Britain – before leaving on the six-month trip to India.

The day Scarlett was killed, she had been partying alone with local men till the wee hours of the morning, high on a cocktail of drugs. This doesn’t, of course, condone what happened, but, the fact that she was a minor and alone did lead many to wonder what her mother was thinking. She had decided to leave Scarlett by herself in Goa in the “care” of a local tour guide without any money or a mobile phone, while the rest of the family – the mother, her boyfriend and six other children – toured adjoining Indian states. MacKeown has denied…

The Same Old Song

Music is supposed to be the language of peace and brotherhood, a force that can bring the world together in harmony. But is it any freer from politics as anything else in our lives?

Just look at the 2008 Eurovision Song Contest. The musical competition has taken place since 1956, produced under the auspices of the European Broadcasting Union (EBU). The event is broadcast in 43 countries; the residents of each country call in to vote for the entry of any country other than their own. The EBU is a global association of national broadcasters; it has nothing to do with the European Union, which is why there were entries from Israel and Russia.

Iraq’s Murky Battle for Basra

DUBAI — Has Moqtada al-Sadr blinked? Or has Iraqi Prime Minister Nouri al-Maliki? Teasing out what’s going on behind yesterday’s cease-fire is like reading tea leaves in a hurricane. The pieces move very quickly.

But it looks like this yet another negotiated settlement that al-Sadr excels at. The questions now are why did this happen, why did it stop and what does it mean for Iraq’s future?

Some background: On Sunday, the so-called “firebrand” cleric — who is currently in Iran — ordered his Mahdi Army fighters off the streets in Basra and Baghdad and called on Maliki to stop raids against his followers. He also called for the release of his men from Iraqi prisons and an amnesty.

Maliki welcomed this offer, in no small part because the Mahdi Army was poised to trounce government forces in Basra, Iraq’s second largest city and heart of the country’s economy. (Ninety percent or so of Iraq’s revenues derive from the oil pumped through pipelines running through Basra.)

To get the stand-down, two of Maliki’s men, Ali al-Adeeb, a member of Maliki’s Da’wa Party, and Hadi al-Ameri, the head of the Badr Organization in Iraq, traveled to Qom to broker the cease-fire with al-Sadr — along with the help of the head of Iran’s Qods Force. So much for countering Iranian influence in Iraq.

With this truce offer, al-Sadr has short-circuited President George W. Bush’s fantasized-about final showdown with an old nemesis. But it’s not like it wasn’t predictable. Al-Sadr is very, very good at getting into scraps with the powers-that-be and then talking out an inconclusive end to the fighting that leaves nothing resolved. He did it in 2004 — twice! — and in 2006. Each time, the Americans and their Iraqi allies proclaim victory only to have to beat up on the Mahdi Army again some time later. And each time al-Sadr comes out looking better to his supporters and wavering Shi’ites who are looking for alternatives to the ISCI.

This time, he appears strong and statesmanlike. Maliki, by way of contrast, looks weak. After a week…