When Your Classmate is Disturbed

In the wake of the deeply troubling killing spree by Jared Lee Loughner in Arizona Sunday, we're being subjected to pious homilies against "inciteful rhetoric." I don't doubt the sincerity of most of the folks connecting these dots, even though I do question their rationality.

To describe quickly and looslely, the notion is that crosshair graphics and the use of the common language of competition and combat contributes in a very substantial way to violent actions, especially by mentally unstable individuals.

I don't buy it. That is to say, I think any such language is a feeble spit into the ocean of human motivation. Your mileage may vary. If it does, then maybe you think altered individual motivations can result from curbing aggressive, mean-spirited, and angry political talk. Even if so,  you have to ask yourself whether you think such a substantive change is even remotely likely.

What troubles me is this: the pissing contest about the relationship between so-called inciteful political rhetoric and violent individual actions has sucked up all the bandwidth. The result is the loss of a legitimate opportunity for a broad spectrum of Americans to focus in a meaningful way on how to recognize truly serious mental disturbance and to respond usefully. Here's Dr Helen with a useful takeaway:

My point is that as long as schools and society simultaneously place the rights of the mentally ill above other citizens while refusing the mentally ill the help that they may desperately need, we will continue to see mass killings like the one in Arizona. People will seemed dazed and ask "why?" until they forget and another horrible killing takes place.

Many of us understand that it's sort of politically incorrect not to have the utmost respect for the rights of the mentally ill, and that bureaucracies will, by law, enforce that perspective. I think we need to do better than that. When the classroom environment suffers and the disturbed person in question is really not benefitting, we owe it to all concerned to ask what we're achieving.

It's extremely important to note that the vast majority of folks who have some mental issue represent no threat at all. Among the ranks of those who have mental disorders, most are invisible and highly functioning members of society: our friends, family, and colleagues. They might be obsessive-compulsive, or suffer from chronic depression or one of its analogues. They may have had a serious breakdown as the result of a cascade of unfortunate and highly stressful circumstances, and then bounced back. Many of them stronger and less brittle for the experience, believe it or not.

But there are some number of folks who suffer from fairly serious mental disturbances, and who are prone to deteriorate quickly if they are unmonitored and untreated. Or treated and monitored in a haphazard or threadbare fashion, which is quite sadly the rule and not the exception. Even among these ranks of folks who have periodic psychotic episodes, there's usually no general threat to public safety even if interacting in public with such folks can be painful and disturbing.

The point here is that we would probably all benefit from increased awareness that uninstitutionalized folks who have serious mental issues do periodically deteriorate and suffer psychotic breaks, and when the deterioration starts, these folks need assessment and treatment. The worst of all possible worlds is for bucks to be passed and asses to be covered.

Ideally, Pima CC and other schools should not simply suspend such a student on the condition of getting a psych eval. They should do their best to make sure that eval and treatment occurs. Classmates of disturbed individuals should at the very least make a calm expression of concern as an official written statement to school administrators. And schools should have an expedited process for this.

We won't fix episodes like this by toning down how we talk about politics. But we could mitigate the frequency and severity of such episodes if we beef up both individuals' understanding of serious mental illness and the cultural framework for ensuring appropriate treatment. If we can do that instead of obsessing about inciteful rhetoric, the lives lost in Arizona will not have have been entirely in vain.

Jefferson Not a Fan of Fetishists Either

My take on the recent trend of constitution worship is this: our constitution deserves the utmost respect and reverence. So long as we don't turn that into a fetish. [BTW, that term had already sprung independently to mind before I saw Alex Altman's rant at Time.] Turns out someone much wiser than me agrees. Here's Thomas Jefferson:

Some men look at constitutions with sanctimonious reverence, and deem them like the ark of the covenant, too sacred to be touched. They ascribe to the men of the preceding age a wisdom more than human, and suppose what they did to be beyond amendment..."But I know also, that laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths disclosed, and manners and opinions change with the change of circumstances, institutions must advance also, and keep pace with the times. 

None of us ought to give an inch when a precious opponent wraps himself in a very simple and convenient version of what he says the constitution means. We're all stuck keeping pace with the times. And that means that when the constitution is broad and vague, it's up to all the folks involved in our constitutional processes to make a good faith effort to figure out how it applies.

Like it or not, the constitution is not a cookbook. Protecting and extending the magnificent ideals embodied in our constitution into our future is a much more difficult and serious matter than "Two cups of liberty, a teaspoon of free speech, 3 tablespoons of the right to bear arms. 4 cups of equal protection.... ."

We're all responsible for doing the hard work. grasping the details, appreciating the fine balances needed when ideals conflict, and moving forward as best we can. This was made quite obvious to me as a child in school. It's not rocket science. But even though it's clear and obvious, it's not easy. Tough shit.

As Mark Twain Spins

Even though I'm a career publishing professional, I've spent a lot of time complaining that copyright laws are too long, that creative works deserve no longer a protection than patented items. I love to say something like this:

You can spend 40 years in your basement and emerge with a cure for cancer, and you only get exclusive profit rights for 17 years. But if you get drunk and scribble a jilted love song about your high school sweetheart, that's protected for a century. Where's the justice in that?

Was thinking about it earlier today, in fact. So it's with some considerable amusement that I submit exhibit A in the case for longer copyright protections:

Huckleberry Finn published with the word "nigger" removed.

Word fail. And the last bit of hope fades that we'll ever be saved from people who JUST. DON'T GET. IT. In fact, I don't think I can come up with another author who would be more pissed and amused by this.

UPDATE: I followed one of the links and took a poll asking whether or not sanitizing Huckleberry Finn is justified. 93% of people say "Yes, the word is offensive and children should not be exposed to it." Comic if you think, tragic if you feel.

When Do Bad Individual Choices Cost Everyone More Money?

This thread is being started for the express purpose of continuing to pursue an interesting area of inquiry that a balky Donklephant is hindering here. I'll use a comment of my own as a point of departure:

What’s your basis for believing that society bears a higher overall financial cost for obesity?

Since it limits lifespan, there’s plenty of reason to believe that a taxpaying and bill-paying society benefits financially from letting people made bad health choices and die sooner. That thins the herd, and preserves sparse resources for things like medicare and social security. Thereby financially benefitting those who make the allegedly wiser health choices.

I wish I had simply said "there's reason to speculate that." An error of enthusiasm, one that I would not expect to get clobbered on if I were talking with folks committed to good-faith inquiry.

This post will almost certainly be revised to add more stuff later. But I look forward to hearing from folks as soon as they have time and feel like it.

UPDATE: I'll try my best to summarize my lines of thought and some of the relevant questions that I wonder about on this issue.

At base, we're talking about what personal failures might legitimately justify paternalistic intervention by, say the government, or maybe an insurance company. That's a very broad and fundamental question. And obviously, even though lots of us don't like the idea, we know that it has been happening for a long time in areas of broad cultural agreement (you go to jail for your habit of violence, you may pay higher insurance rates for a poor driving record, and so on).

What we also know is that such intervention is slowly but surely seeping into areas where there isn't nearly as broad a cultural agreement on right and wrong and fairness of penalty.

Miscellaneous random questions and concerns, numbered for ease of reference:

1. How far down that road do we want to keep going?

2. When do me mistake petty resentment for moral rectitude?

3. Are we counting everything? If not, what is the basis for counting within a more limited domain?

4. Do all people who make bad health choices incur higher medical costs that are subsidized by folks who make "good" choice? Or Only some. If only some, which ones?

5. What is the difference in average "end of life" costs for a "good chooser" versus a "bad chooser?"

6. How much more, annually, does it cost taxpayers in social security costs for every additional year of lifespan?

7. In general, do good health efforts undertaken by employers and health insurers increase or decrease total healthcare costs? Which ones?

8. Which cost figures should we use when we try to perform such calculus? For example, if the list price of an MRI is, I dunno, $900 but insurers only pay $590, how should we do the math?

8. Should good health efforts be pursued further only on the basis of cost savings, or should they be pursued simply as a matter of moral rectitude?

That's probably more than enough. I should be upfront, that my basic bias here is a visceral reluctance to go much further down a road where more and more of our private human behavior is scrutinized, judged, and affixed with a dollar figure of penalty or reward. It seems like a fools errand, like it will lead to a more unpleasant, more exhausting world where our real choices are ever more constrained. I see a sort of a statist business-government beast that won't actually deliver healthier happier more prosperous people, but will still crawl up our arses at every opportunity.

Right Where The Rubber Meets the Road

In the healthcare debate, here's where the rubber is going to meet the road. Right here:

Randall Shepherd, a 36-year-old father of three who needs a new heart after childhood battles with rheumatic fever, is one of 98 Arizonans no longer eligible for state-paid transplants after Governor Jan Brewer and the Legislature eliminated funding.

Shepherd, a plumber from Mesa who no longer can work, said he was next on the list to receive a heart of his size and blood type when the transplant program was eliminated Oct. 1, cutting him off from the $600,000 procedure. Now, “I wouldn’t even be notified,” he said in a telephone interview, his breathing labored.

The Republican governor’s elimination of transplants to save $800,000 toward a $3 billion budget deficit makes Arizona the only state to do so in the past two years, according to a report from the Henry J. Kaiser Family Foundation, a nonprofit health-care researcher in Menlo Park, California.

I don't pretend to have the answers here. But I know the question: are we going to let sick unfortunate Americans die?

Complain, Don't Act

Recent developments suggest a few favorite tea party congressfolk are adopting a strategy of Complain, Don't Act.

 From Politico, Appropriations Panel Loses Its Luster

Rep. Michele Bachmann (R-Minn.) was asked to be an appropriator and said thanks, but no thanks. Rep. Steve King (R-Iowa), a tea party favorite, turned down a shot at Appropriations, which controls all discretionary spending. So did conservatives like Lynn Westmoreland (R-Ga.) and Jim Jordan (R-Ohio), an ambitious newcomer who will lead the influential Republican Study Committee.

Indeed, the Appropriations Committee just doesn’t seem to be the plum assignment it once was, and the line is short for new recruits to join a panel where the longtime focus on bringing home earmarks and other goodies will shift to finding $100 billion in spending cuts. Even conservative reformers who do get assigned to the committee are likely to be stymied once their appropriations bills reach the floor and get amended to death, then potentially earmarked into oblivion by a Democratic Senate.

These are exactly the sorts of signals we need from new Republican congressfolk to finally convince Americans to support independent candidates who might listen to the people, figure out what they want, and then actually try to follow through.

This reminds me of the Seinfeld episode where Jerry patiently explains to the car rental rep that it's the holding of the reservation that matters. "Anyone can just take 'em!" Same goes for the complaints of the people. Anyone can just take our complaints and then rant them back at us. It's the addressing of the complaints that matters.

Palin Jumps Shark

For months I have been telling both Palin-despising liberals and Palin-adoring conservatives that Sara Palin is not going to run for President. "She's happy and comfortable in the roles she's carved out as a sideline cheerleader, "I've told everyone. "She has no interest in actually playing in the big game."

Well, now Palin has a reality show. It's some sort of an infomercial for her, and for Alaska.

With this action, I declare that Palin has officially jumped the shark. She's maybe a list or two above Kathy Griffin, but that's it. Do we need a clearer signal to tell us that she's not running? I say no. But I also note that this doesn't  mean that she's through playing coy. It's in the interest of prolonging her appeal to display how serious she is about her important work. So this show could well be the most explicit signal that she's not running, at least for the next 6 months.

I warn you all to stay away from such soul-sucking fare as Palin's show. But if you must watch, keep an eye out for moments where Palin name drops smart people in a sad attempt to signal that she has more than a feeble grasp of a complicated issue that smart people right serious books about. I can't bring myself to keep watch for it myself, but it's a safe bet to happen.