A Dose of Christmas Humbug

Today's Boston Globe reads, "Health Win in Hand." You can almost feel the exclamation point coming off the page. It follows with the caution, "Hurdles Ahead." Noting that the healthcare bill still faces the challenge of reconciling the two substantively different bills passed by both houses of Congress, not to mention Constitutional challenges and whatever other dirty tricks the Senate Republicans can muster between now and the passage of the reconciled bill, the Globe has a side article usefully informing its readers that this bill may still not become law because the coalition supporting the bill is so fragile it may come apart during the usually perfunctory reconciliation phase. That said, assuming that no 11th hour roadblocks are raised, universal health care is going to become law in the US. Our President has put a happy face on things, saying he got "95 percent of what I want."

On this Christmas Day, allow me to honor a ghost of Christmas past (and doing so as a virtually-atheist Jew, no less) by saying...HUMBUG!

Paul Krugman--not normally a man predisposed to cheery pronouncements just for the sake of feeling good--writes in the NYT that the bill, despite a number of flaws, really is a major accomplishment and will lead to improvement in the lives of Americans in the coming years. But he does provide an analysis of why so many people are so unhappy:

So why are so many people complaining? First, there’s the crazy right, the tea party and death panel people — a lunatic fringe that is no longer a fringe but has moved into the heart of the Republican Party. In the past, there was a general understanding, a sort of implicit clause in the rules of American politics, that major parties would at least pretend to distance themselves from irrational extremists. But those rules are no longer operative. No, Virginia, at this point there is no sanity clause...Finally, there has been opposition from some progressives who are unhappy with the bill’s limitations. Some would settle for nothing less than a full, Medicare-type, single-payer system. Others had their hearts set on the creation of a public option to compete with private insurers. And there are complaints that the subsidies are inadequate, that many families will still have trouble paying for medical care...Unlike the tea partiers and the humbuggers, disappointed progressives have valid complaints. But those complaints don’t add up to a reason to reject the bill. Yes, it’s a hackneyed phrase, but politics is the art of the possible. [my emphasis]

So what's a disappointed progressive to do?

Let me go out on a limb here--very, very far out on a limb--and suggest that maybe the nutso wing of the Republican party (which is now the de-facto leadership of the Republican party) has the right strategy, and maybe it is time for progressives to take a page from their playbook. The phrase that's been bandied about over the past year in relation to the tea-partiers is that they demand of their representatives that they "pass a political litmus test" demonstrating a level of ideological purity. We saw this most clearly in evidence in the New York 23rd Congressional race this November, where so-called "liberal" Republican Dede Scozzafava was abandoned by the Republican base in favor of 3rd-party candidate Douglas Hoffman, allowing Democrat Bill Owens to win in an overwhelmingly Republican district. The conventional wisdom of that election was that the far right had become so crazy that they would rather be out of power than have an electable candidate who wasn't absolutely ideologically pure. My own sense is that the Tea-Party choice, Hoffman, very nearly won the election (he lost by just over 3,000 votes out of 140,000 cast), and almost certainly would have won had he had an additional few months to gain momentum.

So while the strategy of demanding ideological purity failed the far right on the political equivalent of a broken play, I suspect it will pay long-term dividends. Even in marginal districts, potential Republican party candidates are going to be very careful not to run afoul of this very determined, apparently reasonably well-organized group. Yes, in the short run they may have some setbacks as they had in the NY 23rd. But next year I am willing to bet that Owens will be out and he will be replaced by someone approved of by "the base," maybe Hoffman himself.

Might it not be time to demand this from Democrats? Particularly Democrats running for Senate seats? Or even President of the United States? I am not suggesting that an ideological litmus test need to be applied to every single issue that faces us. But demanding support for the Public Option (which, after all, was the compromise position that progressives had decided to live with instead of a Medicare-For-All, single-payer system that would represent real change) would have been a starting point.

Anyway, perhaps Krugman is right and the reasons to be unhappy with the bill are not reasons enough to walk away from it. But I do note that Krugman's view is not universal among progressives, and I'm quite sympathetic to their viewpoint. Here is a great summary in an editorial for CNN online by the mightily courageous Congressional representative from the NY 28th district, Louise Slaughter. She has one line, nicely summarizing the critical difference between the House and Senate versions of the health care bill, that captures it all for me: "I do not want to subsidize the private insurance market; the whole point of creating a government option is to bring prices down." I have yet to hear anything from the leadership of the Democratic party that lucid. Perhaps it is time to think about withholding our support from leaders who do not speak or act as clearly as Congresswoman Slaughter.

--br

Sarah Palin's Personality Disorder Problem

Evidence of the overall cheapness of American political dialogue can be found in the news surrounding Sarah Palin--not in her announcement that she would be resigning her office, but rather in Todd Purdum's Vanity Fair article that may have contributed to the timing of her announcement. Purdum's article is for the most part a rehash of insider gossip about the tensions between McCain's advisors and Governor Palin during the campaign, and is remarkable only for the candor with which some of the political staffers spoke.

Among the unremarkable features of the article includes a little medical soliloquy, and it's unremarkable because we've seen this happen before in national political discussions. Purdum wrote:

More than once in my travels in Alaska, people brought up, without prompting, the question of Palin’s extravagant self-regard. Several told me, independently of one another, that they had consulted the definition of “narcissistic personality disorder” in the Diagnostic and Statistical Manual of Mental Disorders—“a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy”—and thought it fit her perfectly. When Trig was born, Palin wrote an e-mail letter to friends and relatives, describing the belated news of her pregnancy and detailing Trig’s condition; she wrote the e-mail not in her own name but in God’s, and signed it “Trig’s Creator, Your Heavenly Father.”

There it is--Purdum, who is in theory a journalist, includes accusations that Sarah Palin has Narcissistic Personality Disorder because "several people told" him, and apparently they read the Diagnostic and Statistical Manual for Mental Disorders (in the biz called simply the "DSM") and it looked to them like it fit. Within days of the article's release, TV and radio personalities as well as various websites began trumpeting the Governor's "diagnosis" basically assuming it was factually true; for instance, a Yahoo! news bit can be found here, while Salon's War Room (Billy is normally a fan) discussed it here.

This is prattling nonsense of the worst sort, with armchair diagnosis passing for professional opinion, and then repeated again and again as if it were fact. As if to substantiate his own claim, Purdum includes a lil' note from Palin on the birth of her child Trig, noting that it was signed "Your Heavenly Father." Is it a touch odd for Palin to sign the note thus? From my perspective, yes, but I'm an agnostic east-coast Jew so I'm not so sure whether or not this is just a cultural thing and perhaps passes for normal and heartwarming among Christians in Alaska. Does it indicate that Palin thinks--as the placement of this story in this particular paragraph suggests--that she is the Heavenly Father, or speaks directly for him? That seems like such a stretch to me that Purdum appears guilty of the worst kind of guilt-by-innuendo journalism that marks so much of political reportage these days.

For what it's worth, here is the current DSM definition of Narcississtic Personality Disorder:

The symptoms of narcissistic personality disorder revolve around a pattern of grandiosity, need for admiration, and sense of entitlement. Often individuals feel overly important and will exaggerate achievements and will accept, and often demand, praise and admiration despite worthy achievements. They may be overwhelmed with fantasies involving unlimited success, power, love, or beauty and feel that they can only be understood by others who are, like them, superior in some aspect of life.

There is a sense of entitlement, of being more deserving than others based solely on their superiority. These symptoms, however, are a result of an underlying sense of inferiority and are often seen as overcompensation. Because of this, they are often envious and even angry of others who have more, receive more respect or attention, or otherwise steal away the spotlight.

This, though, doesn't describe the features which distinguish personality disorders as a whole from the unflattering qualities that they represent. DSM elaborates on this, noting that to be diagnosed with a personality disorder, the following criteria must be met:

-Symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder.

-The history of symptoms can be traced back to adolescence or at least early adulthood.
-The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life.
-Symptoms are seen in at least two of the following areas:
Thoughts (ways of looking at the world, thinking about self or others, and interacting)
Emotions (appropriateness, intensity, and range of emotional functioning)
Interpersonal Functioning (relationships and interpersonal skills)
Impulse Control

Could this be a description of Sarah Palin? At absolute best, maybe. Since I have not known her for years, and I have not been involved in her life to the extent that I can assess whether her vanity has caused "significant distress or negative consequences in different aspects of [her] life," I don't feel remotely qualified to answer, and I suspect the same is true of the very people that Purdum relies on for his juicy tidbit. That said, I have yet to read an account of her that indicates that she acted megalomaniacally in her "Sarah Barracuda" days in high school so that we could establish this diagnosis, since this pattern of grandiosity must be present since no later than early adulthood. So I suspect this is a totally bogus "diagnosis."

Could Governor Palin be vain, vindictive, grandiose, have a sense of entitlement, and demand praise and admiration? Certainly--and I think there's plenty of evidence to indicate that at least some of these adjectives apply to her. But that doesn't give her the diagnosis of Narcissistic Personality Disorder. And Vanity Fair's Purdum (to say nothing of his editors), in blithely repeating these assertions from unnamed sources who almost definitely are not mental health professionals, attaches a clinical tag to her troubles. (Indeed, when considering this list of personal attributes and applying them to other politicians, President Obama's Chief of Staff Rahm Emmanuel has a reputation for being profoundly vindictive; one can find more than a whiff of vindictiveness in this story about how the White House is offended by one lefty Democratic congressman's willingness to call out the administration on what he believed was a lousy energy bill. Do they all have personality disorders as well?)

Liberal readers may recall that the shoe was on the other foot not too long ago, when then Senate Majority Leader and potential Presidential candidate (and, lest we not forget, actual physician) Bill Frist took to the Senate floor to pronounce his diagnosis that Terri Schiavo was not in a persistent vegetative state. At the time, the howls of indignation came from many corners, and rightly so: Frist was so far out of bounds as to deserve censure from his state medical ethics board in my opinion.

In Palin's case this is no less true. Nobody but appropriately qualified professionals should be bandying about diagnoses. Sarah Palin does not have a personality disorder; she does, however, have a personality disorder problem--the problem of snarky and shallow journalists shoving this kind of bilge on what appears to be an uncritical public.

I find Sarah Palin the politician contemptible in any number of ways. My principal objections to her is that she appears to be not merely uninformed but incurious, and she also appears to revel in anti-intellectualism. But I don't claim to know anything about Sarah Palin the person. From a distance I see a woman who made it to the position of Governor by her early forties--no mean feat, that--and has a family who appear to love her, whatever issues they may have (as all families do). I am perfectly willing to condemn any number of stands that she has taken since she has risen to political prominence. I am fearful of the prospect of a President Palin, although this happily seems to be increasingly unlikely. But I am not willing to go along with the idea that its okay for journalists to lazily repeat assertions of her supposed personality disorder.
--br