Diatribes of Jay

This blog has essays on public policy. It shuns ideology and applies facts, logic and math to social problems. It has a subject-matter index, a list of recent posts, and permalinks at the ends of posts. Comments are moderated and may take time to appear.

27 June 2021

What Whites Get from Reparations


For brief descriptions of and links to recent posts, click here. For an inverse-chronological list with links to all posts after January 23, 2017, click here. For a subject-matter index to posts before that date, click here.

Sometimes the best questions come from skeptics. In response to a recent post of mine on Reparations, a commenter asked such a question. What do white people get from Reparations paid to Black descendants of slaves to compensate them for systematic oppression of themselves and their ancestors over four centuries? The commentator (mohistory2) implied that whites get little, and that that’s why Reparations will never fly.

The short answer is that white people gain, too, because neither life nor democracy is a zero sum game. When people who’ve been kept down and out for centuries rise, everyone gains from the new wealth, new possibilities and new enthusiasm created. Workers and progressives, in particular, gain from new allies.

When people fight among themselves for scraps, their lot gets harder. That’s what American workers have been doing ever since organized labor started getting sucker-punched with so-called “right to work” laws, globalization and rampant exploitation of the poor and undocumented.

That’s the essence of it. The rich and powerful and the billionaires have been pitting various groups of workers against each other to keep them down for the entire history of this nation. Oppression of Black people, before and after slavery, has been by far the worst example. But it’s not the only one: consider eleven million, undocumented hard-working Hispanic laborers, each of whom can be deported with a phone call to ICE. What kind of rights have they?

Make the oppressed better off, and the rising tide raises all boats. (And no, this is NOT like trickle-down; it’s bottom up, not top down.) Let’s look at a few specific ways:

1. Worker solidarity. Why are workers in today’s US essentially in revolt? Why did they vote in droves for the Demagogue, who did virtually nothing to advance their real interests? Why are their wages, their working conditions, their ability to unionize and bargain collectively, their social safety net, and their prospects for the American Dream relentlessly slipping away?

The reason is simple. Although workers outnumber bosses by orders of magnitude, they don’t stick together. They fight among themselves and divide by class, race, ethnic group, type of work and even irrelevant things like abortion and guns.

Through their chief organ of propaganda and oppression—the Republican Party—the bosses relentlessly foster and foment this division. They feed on the petty resentments and jealousies that create it. That’s what keeps them on top.

Don’t take my word for it. Take the word of Professor Howard Zinn, who wrote the must-read book on US history, called A People’s History of the United States. In it, he describes how bosses and their political lackeys systematically provoked inter-tribal conflict among workers at two key turning points in American history: the Progressive Movement of the late nineteenth century and the beginnings of eventually successful labor organizing in the early twentieth.

Bosses fomented division and resentment among every ethnic group they could excite. They pit Polish and Greek immigrants against Italians, Jews and longer-resident native workers in big cities like Chicago and New York.

But the really big idea was the Black-White divide. The Great Migration of Black workers to the industrial North and Midwest was in full swing. Reconstruction was history, and Jim Crow and white terror had set in with a vengeance throughout the South.

So as Black people fled the South in the hope of improving their lives, Northern bosses and their pols convinced various groups of white workers that Black people were out the get their jobs. The resulting division and resentment held our national labor movement and unionization back decades. The only thing that eventually overcome them was the extreme economic suffering of the Great Depression and later our entry into World War II.

During the past forty years, the same division and resentment has fostered and promoted globalization, the so-called “right to work” movement in the South, and the failure to update minimum wages. All of these things have crushed workers and their families since the 1970s, right into our new twenty-first century. The recent failure of the unionization campaign at an Amazon warehouse in Alabama and the massive ongoing exploitation of gig workers generally are just parts of the trend.

In unity there is strength. That was the mantra of the labor-union movement in the first half of the twentieth century. It was hugely successful in building the American middle class until the right-to-work movement, the Black-white divide and eventually globalization broke it down. In order for that movement to rise again, the first order of business must be to heal the Black-white divide among workers. (Globalization is already on the ropes due to things like supply-chain unreliability, the efficiency of distributed production, and growing nationalization in industry worldwide.) Support for Reparations will help immensely, both by showing solidarity and by giving underprivileged Black workers the wherewithal to summon, organize and finance solidarity, and to hold the line.

2. A Massive, Durable Economic Stimulus. If Reparations go the way I’ve recommended, there won’t be any uniform, one-size-fits-all payment to every descendant of slaves. No one will be using Reparations money to buy a Tesla or take a sea cruise.

Every recipient will have to apply for Reparations individually and present a “personal business plan.” The plan might be anything that will improve lives and circumstances. It could be something like attending an Ivy League college that otherwise would be financially out of reach, moving out of the ghetto, starting a business, caring for sick child, sending kids to private school, or starting a nonprofit movement to improve the lives of descendants of slaves generally. But each grant recipient would have to stick to his or her plan to keep the money coming.

All this money will directly stimulate the general economy. It will be spent quickly, not saved or hoarded, to make the lives of recipients better. It will thus constitute a huge, ongoing stimulus for the general economy, including white-owned schools, shops and businesses.

If it works, the stimulus would not be a one-time thing. The primary purpose of each grant would be to help each recipient move into and stay in the middle class. If successful, that raise in economic status would make each recipient a permanent contributor to the general economy, at a higher level than before. To give just one small example, if you are white and own an upscale restaurant, you could expect to see many more Black people able to afford your meals regularly.

3. A Stronger Social Safety Net for Everyone. A century ago, there was no Social Security, Medicare, Medicaid, or anything like welfare. On average, people died in their mid-fifties or earlier. We all live much easier, longer and more carefree lives today because we have a “safety-net” system that takes care of us when we are out of work, sick, retired, or disabled. Those of us on Medicare, for example, don’t have to be rich to afford the modern medical miracles that extend life and make it more pleasant. The Covid-19 pandemic, still in progress, showed us all how much we can suffer—even die—when our social safety net fails us.

Oligarchs and billionaires don’t need a social safety net. Even during the pandemic, they could retreat to their mansions in the country or abroad. They could have Covid-tested and masked doctors and nurses test and treat them at home. They could manage to get vaccinated by hook or by crook, including using their billions to jump the line.

The rest of us, however, need that safety net. And who among us needs it most? Those who have been oppressed, neglected, deprived, kept in ignorance and poverty and discriminated against for most of our history. Black people.

That means, if you want to strengthen the safety net, get things like higher wages, more generous unemployment pay, better and more free or low-cost medical service, family leave and more generous sick pay, then Black people are among your most reliable and effective social and political allies. They need it the most and they will, if they can, push it the most. And they and their ancestors have been at it for longer than just about anyone else.

The problem is that many Black people don’t have the time, money, know-how or leisure to organize and work to strengthen our safety net because they are constantly struggling to just survive. Give Black people a better chance to work, vote and plan for the common good, and they will do just that. The beneficiaries will be not just Black people, but all of us. If you want a more just, equal and fair society, then empowered Black people will be your most enthusiastic allies, whatever your own ethnicity.

4. Fielding All of the Team. Black people in our country are not just a tiny group. The are about one-eighth of us—some forty million people. Not all of them are descendants of slaves, but most of them are. So when we marginalize and neglect them and their talents, as we have throughout most of our history, we are keeping one-eighth of our team off the economic field.

Think about that for a minute. Whatever team sport you play now, or when you were young, think about how it would have fared if you had had to remove one-eighth of your players from the field at random. How much harder would winning have been?

That’s what we Americans have done for over four centuries. We’ve marginalized one-eighth of our people. We’ve neglected and misused their native talents by giving them inferior education, substandard food and housing, inadequate environmental protection, substandard financing and medical care, and few chances for promotion, not to mention incarcerating them at excessive rates. We’ve left a good part of one-eighth of our talent in the dugout.

Reparations are designed to help fix that. They’re designed to give descendants of slaves a chance to develop and use their full native talents, with as much education, opportunity, encouragement and nurturing as anyone else. If you don’t know what that means for winning economically for all of us, then you’ve never played on a team before.

5. Making Positive Change. So far, all these key points have little or nothing to do with politics. They’re mostly basic economics or common sense. But if you’re a white progressive or white Democrat, there’s yet another advantage to supporting Black people with Reparations.

Black people reportedly vote 80%-90% Democratic. Many need our safety net just to survive and avoid police brutality. By and large, they don’t have the luxury of voting on single issues like abortion, gun rights or enhancing the power and the reach of muscular Christianity.

The trouble is, a lot of Black people don’t register or don’t vote today. Their marginalized status has made it hard for them to see the benefit of politics. Many have become cynical and apathetic.

Getting out the vote can help. Stacey Abrams proved that by flipping Georgia. But so can Reparations. When marginalized poor and destitute people get a chance to move into the middle class, they start to think more seriously about voting and political organizing, if only to protect the gains they’ve made.

Reparations can accelerate this process, encouraging millions more Black voters to participate regularly in politics, as well as labor organizing. If you’re a white progressive or Democrat, they will become new and well-motivated allies. If you’re a white worker, they will walk the picket lines with you.

6. Decreasing Crime. Crime is a reliable product of poverty, neglect and hopelessness. Cure the underlying ills, and crime plummets.

This I know from personal experience. For eleven years I lived in a fully integrated middle-class neighborhood in Akron, OH. Working crazy hours, I would come home after trips to find FedEx packages sitting on my front porch. Sometimes I came home so tired that, the next morning, I found my keys in the outside lock of my front door. I never lost anything and never had any trouble from neighbors, all but one of whom (a poor white family) were delights.

The key to this happy story is the two words “middle class.” People of that description have too good lives and too much at stake to run this risk of crime, especially the nasty, violent kind. Bring the mass of poor Black people into the middle class, and you will see crime involving Black people plummet as never before.

That’s what Reparations will do. That’s what they are intended to so, no more, no less: bring the long-neglected one-eighth of us up to same standards that the rest of us enjoy, no more, no less.

Conclusion. So no, Reparations are not just a giveaway to Black people. They are not just a means of finally fixing our original sin. They are investments in our nation and our collective future. They are investments that are long overdue. But now, at long last, the time seems to be right.

Reparations will bring many Black people who’ve never felt fully a part of our system into powerful participation in our economy, our society, and our politics. Having their full participation will benefit all of us immensely, whether we’re white, Black, brown, red or yellow.

Black people have always banked on us coming to our senses. And recently they have saved us when we almost lost our way. I will go to my grave believing that Rep. Jim Clyburn of South Carolina saved us (almost singlehandedly) from submitting to the Demagogue and losing our democracy forever. He did so by getting South Carolina to bring Joe Biden’s primary campaign back from near death, with a huge turnout of Black voters.

The best reason for whites to support Reparations is that it’s the right thing to do. And the chance for all of us to work together to achieve these ends might yet blunt the selfish credo of Ronald Reagan: “It’s your money.” It could stop our slide toward an each-for-his-own society, which in two generations has driven us into our appalling and unprecedented state of general decline.

If we Americans continue to fight each other over scraps, our destiny will be dismal. We’ll be no more secure than the ethnically fractured Afghan government in the face of a united Taliban, or a disunited Europe, with Britain fleeing, as it faces the Russian juggernaut. Granting Reparations and fixing our biggest and most longstanding divide can help avoid the same fate, for all of us, whites included.

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20 June 2021

Juneteenth and Reparations


For brief descriptions of and links to recent posts, click here. For an inverse-chronological list with links to all posts after January 23, 2017, click here. For a subject-matter index to posts before that date, click here.

A day late. A few trillion dollars short. This essay mirrors our four-century-long refusal to face the consequences of our original sin and fix them.

Recognizing Juneteenth as a national holiday is similar. It’s right and maybe even necessary. But it’s an easy, feel-good measure that costs nothing and changes little. The long, dark shadow of slavery, Jim Crow, segregation, and discrimination is hardly a shade lighter.

Over nine years ago, I assessed the chances of something like Nazi Germany happening here. I wrote it was “probably no more than 20%.” But that was before the Demagogue rode his Devil’s Elevator down into Hell and took us with him.

The January 6 Insurrection, his hundred-some lackeys in Congress—not to mention some 75 million mean and deluded voters—now put the probability much higher, somewhere near 50%. We have never come so closing to losing our democracy and our freedom, and we could yet come closer. We could easily tip over the edge.

Think about that. A flip of the coin, and we could lose our freedom and our heritage, just like that.

All the hypocritical but beautiful words of Jefferson, Madison and our other Founders down the drain. All the striving for “a more perfect Union.” Just another routine tyrant, like Putin, Erdoğan or Xi, strutting his stuff, making his threats, batting good people about the heads and shoulders like an alpha ape on the savannah, or jailing and poisoning them as if they were Aleksei Navalny. It damn well could happen here.

But why? What’s the force that drove us so close to the edge? While recovering from surgery, I’m reading President Obama’s latest book, A Promised Land. Perhaps inadvertently, it gave me a clue.

Obama is not just a brilliant thinker, strategist and a quintessentially good man. He’s by far, overall, the best president I was ever able to vote for. (I was too young to vote for JFK, who saved the world, or for Ike, who built the Interstates and warned us of the military industrial complex but failed to stop Joe McCarthy.) Obama’s also a genius, literary as well as strategic. Who else could describe an elderly nun, who gave him a crucifix that he kept for a good-luck charm, having a face “lined like a peach pit”?

So how in God’s name did his successor end up being the Demagogue?

It’s not really “hate.” How many white voters actually hate, fear and despise Black people the way white supremacists do? If it were really 75 million, we’d be hearing the jackboots stomping down every street in America right now. People like me, even in our mid-seventies, would be refugees from a failed state. Hitler started out with a far smaller proportion than that, and (thank God) we’re not there yet.

It’s much more like national stupidity, compounded into custom and eventually policy. It’s a case of massive, consistent, self-compounding national neglect.

It’s as simple as otherwise brilliant people, including our Founders, thinking they could create and maintain a great nation—a democracy yet!—while systematically keeping whole classes of people down. The direct line of compounding stupidity leads from Jefferson’s and Madison’s lifelong maintenance of slaves, to Mitch McConnell’s and Rush Limbaugh’s attempts to distract the public’s attention from the Crash of 2008 by convincing voters that Barack Obama was and is not “one of us.” In fact, he was and is among the best of us. (Joe Biden, we can hope, may have an even more effective presidency. But if he does, it will be because of Obama’s strategic vision, including his making Biden his VP.)

We call ourselves a “democracy.” But what other “democracy” has a legislature anything like our Senate? There our ten least-populous states, with a total of 2.9% of our population, can outvote the most populous nine, with 51%. What other democracy has an Electoral College that has given us five popular minority presidents, two in this new twenty-first century alone? What other democracy has anything like our filibuster, which has become a routine minority veto in our already-rigged Senate? And what other democracy has a clause in its written constitution, decreeing for all time that, without every state’s consent, the rigging of our Senate will only get worse, without any limit, as a result of inevitable demographic change?

Every single one of these infelicities arose from a single source. Our slave-holding Founders wanted to preserve their lives of agrarian, aristocratic privilege as far ahead as the eye could see. They designed our entire governmental structure, including our bicameral legislature, for that purpose. While writing brilliant words of praise for democracy and against monarchy, they had created a system even more oppressive than the landed feudalism their forebears had left behind in Britain and in Europe. They were not mere hypocrites; they were geniuses of hypocrisy.

So how do we fix it? How do we correct their errors and restore and improve what de Tocqueville optimistically called “Democracy in America.” What can we do practically and now to cure the continuing and compounding consequences of our original sin?

We could have another constitutional convention. But what small state would willingly surrender its disproportionate share of power in the Senate and the Electoral College? We could, I suppose, have another civil war. But rolling the dice of bloodshed that way, again, could be catastrophic, especially in the nuclear age. We could have an organized economic boycott, in which the states with real economic power force the little tyrant-states to their knees. But that might just lead to civil war.

In my view, there are only two realistic and practical possibilities to cure our nation’s congenital structural defects. The first is a second secession, this time not by the slave states or their successors, but by the big, powerful states fed up with being ruled by selfish, imprudent, backward demagogues. Over eight years ago, I wrote an essay analyzing how the secession process might work out if the backward states seceded. Much the same analysis applies the other way around: both sides might well end up better off, more content, and more successful on their own terms.

But neither secession nor a group boycott is likely to happen. The simplest expedient offers the most direct path and the least unintended consequences. We can simply get out the vote.

The last presidential election was the most heavily attended in over a century. Yet at the end of the day, only two-thirds of eligible voters cast ballots. One out of three didn’t.

Nevertheless, we got the right result. The Demagogue went down to defeat. But think how much harder it might have been to foment the January 6 Insurrection and maintain the Big Lie of a stolen election if the other one-third had also voted.

The case is much clearer at the primary-election level. Our Congress must admit demented, perpetually angry bullies like Jim Jordan, and over-the-top nutcases like Marjorie Taylor Greene because, on average, only one-third of eligible voters cast ballots in primary elections. In gerrymandered safe districts, true believers, whipped up to a frenzy by the likes of Rush, Fox and Facebook, control who goes to Congress. But what happens if the other two-out-of-three eligible voters actually start to vote in primary elections?

That’s why I think Stacey Abrams fully deserves the Nobel Peace Prize for which she’s reportedly been nominated. I hope she gets it. Her “solution” may not be as quick and decisive as civil war or secession, but its process is far more peaceful, constructive, communitarian, and ultimately democratic. We can fix America by building communities of voters who reject the demagogues, their conspiracy theories and simplistic mantras and will work to rebuild our Founders’ nation upon less hypocritical and far more egalitarian lines.

But how to get out the vote? The reason for the dismal turnout, even in general presidential elections, is that a lot of us have given up hope. Abrams turned the tide in Georgia by extraordinary community organizing, but there aren’t enough with her talent and brilliance to go around.

So what do we do? The trick, I think, is to offer incentives to people who’ve been left behind and so have become cynical and apathetic. That’s why it’s so important for everyone—especially white pols—to start talking seriously about Reparations, as I did in this 2019 essay.

Reparations are right way to atone for, and the best way to fix, the continuing consequences of four centuries of racial oppression. They are the fastest way to raise those who have been unfairly laid low, and to give them a stake and an incentive to participate fully in political action, including voting.

Don’t get me wrong. I’m not a wild-eyed idealist. I understand that Reparations may never happen. Even if they do, they may turn out to be the same kind of tokenism as the too-small, one-size-fits-all reparations for the Japanese Internment. They may be as symbolic as making Juneteenth a national holiday in a nation still burdened by customs, traditions, segregated conditions, and even (still) some laws rigged against Black people.

But the point is not the intrinsically unknowable end game. The point is the effort. When serious white people start talking seriously about Reparations, they will raise hope. Hope motivates voting. If Obama’s presidency demonstrated anything conclusively, it’s the power of hope.

The more people vote, the better democracy we have, and the fewer nutcases, conspiracy artists and flim-flammers. Getting out the vote is not just the fix most likely to succeed. It’s also the cheapest, quickest and least disruptive. And talking seriously about Reparations—even if you think they’re quixotic—is a good way to raise hope and motivate voting.

Pols and their self-appointed political consultants spend far too much time worrying about how the demagogues and propagandists are going to motivate a few percentage points of undecided white people, for example, by claiming (ridiculously) that the street fires in Portland after George Floyd’s police murder are coming next to their small towns. They worry far too little about the one-in-three people who didn’t vote in even the recent make-or-break presidential election, or the two in three who don’t vote in most federal primaries.

This neglect may have experimental origins, once identified by Albert Einstein. Scientists, including political scientists, often drill where the drilling is easiest. And it’s not easy to “survey” and poll people who remain on the margins of society, especially if their self-marginalization is due to cynicism and apathy. But isn’t the potential reward worth the effort?

First trained as a physicist, I’ve always been a numbers guy. The proportion of our population that is Black is about one out of eight of us. The ancient Romans used “decimation”—the killing of one out of ten—to subdue whole tribes and foreign nations. If we elevate the big part of the eighth of us who’ve lost hope, what changes could we not make?

So let’s everyone— especially non-Black people—start talking seriously about Reparations. They are the fastest and most direct way to cure the continuing and continuously compounding consequences of our original sin. Then let’s see how many forgotten voters arise, breathe in hope, and take an interest. What the hell have we got to lose?

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08 June 2021

A Giveaway to Big Pharma


For brief descriptions of and links to recent posts, click here. For an inverse-chronological list with links to all posts after January 23, 2017, click here. For a subject-matter index to posts before that date, click here.

If you seek evidence of our political leaders abandoning science to serve our Oligarchs and the public’s wishful thinking, you need look no further than the FDA’s approval of a new drug for Alzheimer’s disease.

The new drug is made by Biogen, Inc. It has the generic name Aducanumab and the trade-name Aduhelm. The FDA just granted it accelerated approval, subject to a requirement for additional trials, which, according to the New York Times, could take years.

Before we start following the money and wishful thinking, let’s explore four key facts about this new drug. First, the primary reason for its accelerated approval was its ability to reduce the famous amyloid plaques in the brains of Alzheimer’s patients. As an FDA doctor wrote on the agency’s website, the “FDA has determined that there is substantial evidence that Aduhelm reduces amyloid beta plaques in the brain and that the reduction . . . is reasonably likely to predict important benefits to patients.” (emphasis added.) In other words, there was no solid proof, just hope.

In fact, the FDA’s own scientific advisory committee recommended against approving this drug. One of its members took the extraordinary step of publishing, with another expert co-author, an op-ed piece in the New York Times explaining why. As the Times also reported separately, “Prominent experts, including the F.D.A.’s independent advisory committee and a professional society representing geriatricians and other health care providers for older adults, urged the agency not to approve the drug.”

The second important thing to understand is the role of the famous amyloid beta plaques in the disease itself. Science simply doesn’t know what that role is. The plaques appear reliably in the brains of Alzheimer’s patients and appear to get denser and more tangled the worse the disease. But whether they are the cause of the disease, or whether they are just a highly visible chemical symptom, is simply unknown.

Amyloid plaques are not like the fatty plaques in coronary arteries that signal heart disease. The adverse effects of those plaques is simple, mechanical and obvious: they block the flow of blood. But the brain and its neurons are far more complex than blood vessels. There is no medical analogy between the two types of plaques, apart from the verbal coincidence of using the same English word to describe them. For all science knows now, reducing amyloid plaques in Alzheimer’s patients might do as little good for symptoms as reducing the fat around a heart patient’s midriff without reducing the plaques in his coronary arteries.

That sad fact is that science knows little about the microbiology and genetics of Alzheimer’s disease. We do know it tends to run in families, especially early Alzheimer’s. But science has identified neither the precise genetic pathway nor the microbiological mechanism(s) of the disease. There may be several. Humans’ natural blood-brain barrier makes its hard to study brain function in live patients, let alone at a microbiological/chemical level. And studying the progression of such a complex disease by autopsy is obviously not easy.

So instead of running down the basic science, i.e., microbiology, most industrial research has been chasing the “holy grail” of reducing the plaques. It has just assumed that the plaques are the cause, without researching in depth or knowing the truth. All this comes at time when decades of basic microbiological/genetic research allowed two industrial companies (Pfizer and Moderna) to develop outstandingly effective vaccines against Covid-19 in less than a year.

The third thing to know about Aduhelm is that it’s not the first drug able to reduce the plaques. As the New York Times explained, “Over more than two decades of clinical trials, many amyloid-reducing drugs failed to address symptoms, a history that, some experts say, made it especially important that aducanumab’s data be convincing.” (emphasis added). Approving Aduhelm under this circumstance seems to fit Albert Einstein’s definition of insanity: doing the same thing over and over again and expecting different results. What we need is aggressive funding of basic research to understand what causes Alzheimer’s, what genes promote it and how.

The final thing to understand about Aduhelm is its side effects. In two Phase 3 clinical trials, only one—with a higher dose—showed measurable improvement in symptoms. The higher dose “could delay cognitive decline by 22 percent or about four months over 18 months.” But in that trial an astonishing forty percent (that’s two fifths) of patients showed brain swelling and/or bleeding, which can often be detected only by expensive MRIs. (Only 6% of patients had severe enough symptoms to force them to quit the trials.) In contrast, the reported incidence of severe side effects (over 104 °F fever) after the second shot of Pfizer’s Covid-19 vaccine was two out of 2098 + 1660, or 0.05% [Search for “Systemic Reactions”].

I’m an ex-scientist (Ph.D., physics, 1971 UCSD) and a world-class hypochondriac. My mother died of Alzheimer’s, so I probably have at least some of the genes. I’m almost 76 and could be starting to develop the disease. Would I take Aduhelm based on this information? Absolutely not. In fact, I probably won’t take any Alzheimer’s drug until someone proves a cause and effect relationship between what it does and Alzheimer’s. The precise role of amyloid beta plaques is still unproven and mostly unknown; holy grails, I believe, are for religion, not science.

So why the hasty approval? To answer that question, we must leave the realm of science and follow the money and the wishful thinking. According to the New York Times, Biogen intends to charge $56,000 per patient per year for Aduhelm. There are about six million patients in the US and an estimated 30 million worldwide. If a mere ten percent of them take the drug, that’s $33.6 billion in annual revenue for Biogen, just inside the US. Worldwide, it’s $168 billion annually. Most of the domestic haul would probably come from Medicare, i.e., the US government. In comparison, the US government reportedly spent approximately $2.5 billion to develop and buy doses of the Moderna Covid vaccine, and $1.95 billion to buy doses of the Pfizer Covid vaccine, whose development was privately financed.

This huge expense is for a drug that reduces plaques never proven to cause Alzheimer’s, whose effect on symptoms is ambiguous and uncertain, and which causes serious side effects in 40% of those who take it. But that’s not all. The MRIs needed to monitor those side effects are expensive and will provide a bonanza for diagnostic imaging companies, whether or not related to Biogen. So perhaps the best argument for approval is that it’s a private stimulus bill for Biogen and the diagnostic companies that do Alzheimer’s-related brain imaging and test memory and cognitive function.

But that’s still not all. There are also so-called “patient advocacy groups” that pushed hard for approval of Aduhelm. The expert op-ed author who advocated not approving the drug yet and the New York Times both mentioned them, without much information about them.

It’s an unfortunate truth about our society that virtually everything has become political. But activists don’t do scientific or medical research; most of them don’t have the training, let alone the specific knowledge.

So it’s OK for activists to push for experts to do the work and for the government to fund it. That’s in fact what most AIDS activists did back in the day. Quite rightly, they pushed back against the Reagan Administration’s refusal to even mention the disease, or to fund research into it, apparently because most of the people suffering and dying were gay.

But it’s quite another thing for activists to push for approval or marketing of a particular alleged cure when the experts are skeptical or opposed. Then politicians’ favor is little more than pandering. Pandering can come back to bite everyone, including patients, if preliminary warnings of ineffectiveness and/or dangerous side effects prove prescient. Imagine how shamed our FDA will be if, five years or so down the road, real understanding of Alzheimer’s disease produces a preventative as effective as today’s Covid vaccines.

There are no shortcuts in science. We all know how unreasonably impatient and demanding we Americans have become. The question now is how much our leaders will indulge unreasonable demands and lack of patience and discipline, to the undeserved enrichment of private corporations, the detriment of credulous patients, and the ultimate degradation of proper scientific research. Accelerated approval of Aduhelm is a step in the wrong direction and mark of shame for the still-young Biden regime.

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05 June 2021

A Small Step toward Sanity


For brief descriptions of and links to recent posts, click here. For an inverse-chronological list with links to all posts after January 23, 2017, click here. For a subject-matter index to posts before that date, click here.

    “Those whom the gods wish to destroy they first make mad.”ancient proverb, often attributed to Euripides
Facebook’s decision to bar The Demagogue from its platform for at least two more years is all over the news. Although he used Internet platforms to promulgate numerous lies, Facebook’s decision to ban him rested primarily on the Big Lie that the 2020 presidential election was “stolen.” That Big Lie helped foment the January 6 Capitol Insurrection, an act of collective violence unique in American history.

Now the Lie and its consequences have motivated the Demagogue’s two-year ban from Facebook and permanent ban from Twitter. As usual, the chattering heads will natter, confusing the issue with a torrent of sound and fury. But the outlines of these decisions’ rightness—indeed necessity—are simple and clear.

First, let’s look at the law. The law of the United States imposes little restraint on politicians lying, especially on the Internet through private firms like Facebook.

The First Amendment imposes no restraint on the speech of private parties and firms at all. Quite the contrary: it prohibits any branch of government from restricting their speech. “Congress” it says, “shall make no law . . . abridging the freedom of speech, or of the press . . . .” (emphasis added). It restricts government, not people or private firms.

Our Supreme Court extended the Amendment’s prohibition to state governments under the Fourteenth Amendment, which guarantees basic rights. But nothing in either amendment prohibits private individuals or private companies from restricting speech.

Our Supreme Court has made this clear in numerous precedents. No First Amendment challenge to censorship (or anything else) can even begin without proof of “state action,” i.e., a restrictive law, regulation or act of federal, state or local government. So our First Amendment leaves Facebook, Twitter, Fox and the rest free to censor, restrict, and distort speech, and indeed to lie at will, as long as they are not doing so under the auspices of or on behalf of government.

Insofar as private speech is concerned, the First and Fourteenth Amendments cut the other way. Under many Supreme Court decisions, private business corporations are “persons,” entitled to legal protection from governments’ interference with their speech. The infamous Citizens United decision was only the last in a long line of precedents making this point.

There are exceptions, but they are limited and narrowly construed. Like people, private corporations can’t engage in false advertising or trade libel that harms consumers and competitors. They can’t defame people or firms in ways that harm them, and they can’t incite violence and mayhem. Other laws limit the ways that certain corporations (mostly banks and securities issuers and brokers) have to disclose certain information, avoid lies, and keep customers’ information confidential.

But these exceptions are narrow, detailed, and specific. There is no general legal rule that restricts speech by private corporations, any more than speech by individuals. The First and Fourteenth Amendments see to that, because they keep government, i.e., “state action” from enforcing any such restriction. So Facebook, like you and me, can propagate pretty much anything it wants about politics and public affairs, subject only to laws against defamation, i.e., libel (written) and slander (oral).

Enter Section 230(c)(1) of the Communications Decency Act of 1996. This one-sentence “midnight amendment” to a law on another subject I’ve analyzed in several essays (See this one [search for “230”] for a summary and this one for a possible amendment). I won’t repeat the analysis here, just the result. For Internet platforms like Facebook, this law erases all liability for defamation based on things that others post on their platforms.

So Facebook cannot be legally liable for defamation in promulgating the Big Lie. Facebook can’t be liable whether the Demagogue posts the Big Lie himself, or when any one of this 71 million followers does. Facebook can’t be liable when Russian, Chinese or Iranian spooks repost it, with twists of their own. Facebook can’t be liable when any Internet troll, anywhere in the world, reposts it with his or her own variations.

In other words, Facebook is legally home free. It’s secure under the First Amendment and the midnight amendment, from any liability for defamation for propagating what may be the most consequential political lie in American history over what is undoubtedly the most powerful megaphone in human history, reaching about one-third of our the human species.

That’s why Facebook’s own decision to ban the Demagogue temporarily for his Big Lie was so consequential and so necessary. Without it, there would be no legal restraint on the Big Lie whatsoever. (The Demagogue himself is probably immune from civil liability under the doctrine of sovereign immunity. See this post at “sovereign.”)

Sure, injured parties could sue the originators of the Big Lie for defamation, as some voting-machine companies already have sued the Demagogue and others. But the practical difficulties of suing the other millions of propagators of the lie—many unknown, concealed, hiding or outside our nation’s jurisdiction—make any such effort ineffective. The cat will already have long leapt out of the bag.

When a lie causes personal injury or property damage, as in the January 6 Insurrection, injured parties might sue under general tort law, which the midnight amendment does not address. (I discuss this possibility in two other posts, here and here.) But a recovery of this sort requires proof of physical injury and causation, which would be difficult for all but the rarest of lies. And any recovery of damages will come only after years of litigation. By then, the damage to truth in the public mind will have been done and fixed in concrete.

The so-far theoretical possibility of legal liability for this rare sort of personal injury and/or property damage may have been a factor in Facebook’s decision to treat political speakers no differently than others in applying its platform’s rules. But infrequent real, physical injuries to people and property are hardly the most consequential harm of Facebook’s immunity. The greater harm is injury to truth, even loss of the concept of truth as an important social value.

Democracies need truth to survive. Because their people make their key decisions, the people must have access to the truth. If they are led to believe lies, Euripides’ observation comes into play. Decisions get made in a manner out of contact with reality, a psychological euphemism for insanity.

Authoritarian governments don’t need truth. At least they don’t need their people to know it. Their massive spying and intelligence organs can give the leaders all the truth they need. Then their propaganda organs can persuade the people to follow orders by any means necessary, including a convenient fabric of lies. If there is resistance, coercion and ultimately liquidation can do the rest. This is the course that Vladimir Putin is taking with Alexei Navalny, and Belarus’ dictator Lukashenko is following with the hapless hijacked native journalist Roman Protasevich.

There is little question which system is more “efficient” in putting truth to work. A dictatorship requires a smaller number of truth seekers (mostly known as “spies,” not “journalists”), and a much smaller circle of recipients and decision makers. And authoritarian control by decree, coercion, imprisonment, torture and murder takes less time than slowly and painfully persuading the masses.

Yet journalists in free countries perform much the same work as spies and intelligence analysts in both free and unfree ones. They collect facts and information. They interview people. They collect and analyze documents. They put what they collect together and line up the dots, using their accumulated experience, knowledge and understanding of human nature. Then they analyze and report, as clearly and succinctly as they can, making clear what is known and what is uncertain.

Under effective leadership, both spies and journalists are free to use their best judgment and report honestly. The only difference is that their audience is much smaller in unfree lands, and there is a personal risk there for being too honest.

Two recent revolutions in reporting have vastly complicated this picture. The first was the advent of mass electronic communication, first TV, then cable.

This consequential change in presentation shifted from a written and analytic “cool” medium, to the hot, emotional and reactive medium of video. More consequentially, it gave rise in free nations to profit-making mega-corporations, whose profit and executive salaries depend on the breadth of their audiences. This development, in turn, led directly to “news as entertainment” and to Fox. It also led to capture of the media by profit-hungry ideologues, who saw how to shape government and indeed their whole societies to their own profit-seeking ideologies.

The second revolution, which is only now gaining force, is far more consequential. The advent of “many-to-many” Internet platforms like Facebook and Twitter let anyone, anywhere pretend to be a journalist, regardless of training, professionalism, honesty, or level of commitment to accuracy and objectivity. Not just The Demagogue, but every foreign spook and troll, now has access to the global population directly, including most Americans. The once-able corps of “middlemen,” i.e., trained professionals, is mostly gone.

In this world there are no standards or rules, only anarchy and chaos. In fact, our First Amendment precludes government from creating such rules. It’s a canon of our Constitution and our “American way of life” that government cannot serve as arbiter of truth.

So truth, honesty and accurate analysis depend on things like Facebook’s platform rules, as embodied in its “click here” contract with users. Facebook—a private corporation controlled by a single man, Mark Zuckerberg—now essentially writes many of the rules for collecting, analyzing and reporting intelligence for the supposed rulers of the USA, its people.

At the moment, there are few, if any, other rules and standards for those tasks, let alone on private propaganda organs like Fox. The disciplined journalistic professionalism of Walter Cronkite and his peers is gone with the wind, at least outside of the so-called “mainstream” media.

Today the overwhelming majority of actual “reporters” in our video-Internet system have little or no contact with the ethics and standards taught in today’s journalism schools. Everything is becoming ad-hoc, audience-driven and attention-centric. That means ever more sensationalism and ever more entertainment as news. Even articles in the New York Times and the Washington Post are becoming more like short stories, told chronologically around the experiences of one or more individuals, rather than analytically with a summary lead and its logical exposition.

Under these circumstances, Facebook’s “truth committee” of outside experts is a small but positive step away from chaos and insanity. So is its decision to hold politicians to the same rules as other users. Its policy up to now—sort of a private-sector New York Times v. Sullivan [search for “Sullivan”]—gave politicians too much incentive to fabricate and to lie. That’s the last thing today’s pols need.

But make no mistake about it. The struggle to impose the disciplines of truth, accuracy and recognition of uncertainty on private electronic media, including the Internet, is just beginning. Our First Amendment doesn’t help; instead, it prevents government from writing or enforcing any rules.

With government constitutionally sidelined, the people, too, can’t act, at least not through government means. So the private sector must fill the gap. Our oligarchs and corporations must rise to the challenge, the more so as they are increasingly taking over traditional governmental functions in general.

So the fundamentals of democracy and its very viability are at stake. If our democracy degenerates into a system in which the oligarchs and elite are in the know and they delude the people by the most efficient and effective means possible, their rule will become indistinguishable from totalitarianism. Public access to good information is the key to avoiding this dismal outcome.

In historical perspective, we are about where democracy was in the early 1700s. We have tried to “democratize” information in a system without rules, but the oligarchs and pols have figured out how to control that system. They are becoming an aristocracy of a new sort, manipulating information accessible to the masses for their own ends.

History tells us what happens when such a system grows out of control. The French Revolution was one of the bloodiest and most excessive in history. And if the oligarchs succeed with subtlety and guile, we or our children or grandchildren may have only Orwell’s world to look forward to as an alternative.

True, the members of Facebook’s “truth committee” are not elected. True, they are in every sense members of the “elite.” But they have training and values far beyond mere profit or Zuckerberg’s infamous lust to “move fast and break things.” That’s a good start. Now the task is for Zuckerberg and Jack Dorsey (Twitter’s CEO) to make sure their private decisions on liars and propagandists are as collective, open, transparent, accessible, and sensible as possible.

The First Amendment precludes government from requiring fidelity to truth or any sort of discipline in finding it. The people have no practical way of acting, except through government. So the private sector must step in, in loco patriae (in place of the homeland). If there is a vacuum of rules and discipline, the worst sorts will step in and fill it. That’s the Demagogue’s message to the rest of us, loud and clear.

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