I work as a nuclear medicine technologist in a medium-sized imaging clinic, and every day long-term patients come in to get various scans and procedures for their continuing care.  Yesterday, for instance, I had 2 patients indicative of much of the long-term care patients: 78-82 y.o. men, conscious, w/ dementia, no verbal communication, and a laundry list of medical problems: severely contracted, diabetes mellitus, osteomyelitis of lower extremities, CAD, history of stroke, PVD, PEG tubes, wound vacs, MRSA, etc.

 

Not only would these patients never get "better," but their quality of life would never get much better.  On top of that, they had no family to speak of--only as legal representatives.  The family in these cases usually consists of a niece or nephew or cousin or another somewhat distant relation.  The directive is usually the same: keep them alive for as long as possible (as long as we aren't paying for it).

 

The nuc med doctor takes a very cynical but practical view that these are the patients that are using the most money from the system and have very little positive output to society other than as medicare/Medicaid recipients.  This, he says, is the primary motivator to keep cycling these patients through the system: to keep them alive (with family consent) so the various organizations can keep their lights on.

 

He's cynical, for sure, but he has a right to be: his own daughter was in a terrible car accident many years ago, right after graduating from a medical university as an MD, and now she is bedridden for life, and worse, unable to communicate.  She requires 24-hour medical supervision, and this does not come cheap.  The good doctor would have retired years ago if he didn't have to pay for her care out of his pocket.

 

His point is simple: if people paid for the long-term care of their family members instead of leaving it to the state, they would be forced to make the difficult decisions about life or death eventually.  As it stands, for all the fears we have of the state making the difficult decisions about our elderly and infirm, the default position is to keep them alive for as long as possible without regard to their quality of life.

 

We are near the point at which we must, as a society, be able to talk about dying, death and quality of life of our loved ones--as well as relatives we barely know who happen to fall into our legal custody.  As a culture, we will avoid this conversation at all costs.  The real costs are the quality of life of the relative and the monetary costs that the rest of us must bear.

 

The short of it is that both patients I had yesterday deserve a deep evaluation of their quality of life-to-cost of care.  However, we are still like children when it comes to this topic, unable to face the tough questions so long as we can pass the costs on to someone else.  The people who lose from this failure are those whose health stands a chance of improving, yet cannot afford healthcare, patients who suffer their lives away alone in bed, and everyone of us as taxpayers.

Since the advent of the "War on Terror" the abuse of prisoners has only been rivaled by the abuse of language.  Just as top-down notions of "terrorism" mean little more than "homicidal foreigner," "enemy combatant" is anyone who might now or someday be considered a threat, and being a "patriot" means letting your government do whatever it takes to protect our freedom from the enemies--even if that mean taking our freedoms away.
Whether we accept it or reject it, I think this black-means-white Orwellianism makes us all a little crazy one way or another.

This is not an attempt at armchair war strategy, but a theory that our persistence in spreading democracy is an easily rationalized one that becomes twisted into an excuse to levy our influence in the region.  Although that's not exactly a controversial opinion on this site, it occurred that resistance to the notion of federal authority is not only a recurring theme in Afghanistan in general and Waziristan in particular, where a mix of tribal law, Pushtunwali, and Sharia rule, but also in the right-leaning Tea Party movement (or their kinkier name, the Teabaggers).
Both groups want to be able to wrap their hands around the neck of any federal authority more powerful than the meter maids.  (Although in this country, the right recently re-embraced that concept after having put it to the side for the last 8 years in the name of liberty and freedom for some.)  Both groups rally around a religious conservatism that informs every aspect of life, including the male-dominated household, eye-for-an-eye retribution, and draconian measures against consensual adult homosexuality.  
Now, before anyone accuses me of making hyperbolic comparisons, let's really take it to the next level with some clarifications of how these groups differ:
First and foremost, child buggery is not an acceptable aspect of the Teabagger culture.  Fair enough.  (Yes, this one is ripe for commentary, but not my purpose.)
Second, I have a hunch that the rugged individualism of the Waziris carries a little more weight than our 10-cylinder-H3 driving, mall-shopping asses can imagine.
Third, I've never been in a mosque, but I'd be willing to bet there are no flags of Israel on the walls--unlike the MANY evangelical churches I've attended in the last 10 years which, without exception, display the Israeli flag somewhere in the church.  (Again, ripe for comment, but not the purpose here.)
In regard to war as a solution, it's not clear to me whether the tribal leaders of Waziristan believe violence can solve everything, and it would be facile and shallow to assume that the opinions of the inhabitants of that 5000 sq mile landscape (with a population of roughly 650,000 people) are in unison on any one issue.  However, if living in Houston has taught me one thing it's that the evangelical right in America have a strong and nearly unified belief that US military power can solve all the problems of the world.
Violence is most certainly the answer to some questions.  Agreed.  But no scenario of violence seems to bring about a sustainable solution in this case.  
In some important ways, our own countrymen are more ideologically twisted than the fanatics we are told want to take our women out of schools and put burqas on them, create a global caliphate, arrange unwanted marriages for political purposes and punish adultery with stoning and otherwise turn back the clock of scientific progress to roughly 900 AD.  
It's silly that these two groups should stand against each other when in fact, they both largely agree on the issues that appear to divide them.  As we attempt to force-feed American-style representative democracy around them, the Teabaggers squirm to free ourselves from this out-of-control federal monster.  And we are the civilized ones.  

I love to watch professional journalists insist that the only kind of judge they want on the SCOTUS is a "strict constitutionalist"--who empties all past experience the moment they put on the black robe and reaches directly into the pure meaning of our Constitution.  This notion of a strict constitutionalist supposedly stands in opposition to the constitution as a "living document" interpreted by a "shootin'-from-the-hip (terrorist sympathizer) constitutionalist" or an "empathy (non-Caucasian male) constitutionalist" or whatever implication has the most potential to spoil an appointment.

When Marilyn Monroe met Einstein, she famously joked that if they had children, they would have her looks and his brains.<br>"What if they have my looks and your brains?" he responded.<br>This seems to be a close analogue to the experience/judgement question of the two campaigns: Obama has good judgement if not that much experience, and Biden certainly has a wealth of experience on many fronts.  The combination of them only seems to reinforce each other.<br>My fear is the McCain campaign, by default, carries the judgement of McCain ... and the experience of McCain, and Palin as a lure to disgruntled democratic women who aren't paying attention.  I wonder if the possibility exists for Palin to inform the judgement of McCain--not that her judgement is anything to commend--I don't know much about her accomplishments.  Not likely anyway one looks at it.  <br>

Why do we accept war-economy monopolies as if we are fighting "the good fight" all over again?  Why do we seem to fall for the same shite over and over again?
A solution to detangling the propaganda lies in the simple framework used for so long it has a Latin name: cui bono?  Who benefits?  or Follow the money (and you will see the most cynical conspiracy theorists outside of David Icke might actually be right).
Recently ExxonMobil posted the most profitable quarter in world history at $11.7 billion (beating their previous most profitable quarter and world record by $100 million).  Now, coupled with the very real gasoline price crunch, how is it these things are somehow unrelated?  In any other industry in the world, if the prices increase by several hundred percent while the company in question rakes in record-breaking profits, there would be a bloody revolution.  
Imagine, for instance that it now costs $1000 to get your drivers license renewed, and that the DMV announced record profits the next quarter.  I'd bet there would be some civil disobedience in response.
Yet, in this particular case, we are told repeatedly that "market forces" dictate prices, and the helpless oil oligopolies are merely playing their role in getting the consumer a product at a reasonable cost--and accidentally making record profits--while US lives are being lost in the heart (or liver) of the oil producing nations.  
As anyone who's ever heard the WuTang Clan can attest, this world is about making money.  If the most powerful people in the world are not using their power to accumulate wealth, then they are either insane or dead.  And yet, it is a kind of blasphemy to believe that US politicians (of one's own party) would use their clout to purposefully profit.  
It is my uncontroversial contention that we could significantly improve our republic if we could collectively pull our heads out of our asses when it comes to the most pressing issues of our time and simply follow the money.  War requires us to trash our guarded concepts of supply and demand in favor of no-bid contracts, and no-cost-is-too-high-for (insert ideological-fear-mongering fluff).  
But this isn't just about our wars, it's about every decision made to spend money, or to remove or institute protections to a particular business niche.  It has everything to do ANWR and coastal drilling bans as well as the mechanisms that allowed slanted hiring practices in the DOJ and the undisclosed roll call of oil lobbyists and executives who set energy policy with VP Cheney in 2001.  
How it is that our current administration never had a substantive conflict of interest case brought against them is bewildering.  Yet this pattern will continue "as fiercely as if it had never happened before" if we cannot see our own power structure for what it is.

Just to be clear, I've never met Mr. Thompson, but I felt he always seemed more sincere as his character on t.v. than in live debates or when he says "my name is Fred Thompson, and I approve this message."  But now Fred has his own domain at Townhall.com, and he's made it a point to keep in touch with everyone on their mailing list.
You can hear the ghost of Rudi Guiliani echoing his favorite mantra in the background.
Here are some highlights from his first piece in a continuing series with TH:

Primaries and elections sometimes do not turn out the way we might like.... [but] the principles we fight for are timeless.

...increasingly these values are under assault. In foreign affairs, our political opponents ignore our progress in Iraq and want to return America to isolationism. Economically, they call for dramatic tax hikes and increased government spending. Judicially, they support activist judges who strive to make the law rather than interpret it....Each month, I will be giving the "Closing Argument" on what I see as the pressing issue before us. I hope that these pieces and Townhall may inspire a national dialogue on the fundamental principles that define conservatism today. 

...The world changed forever on September 11, 2001 yet so many politicians and academics what us to bury our heads in the sand, ignore the enemy ? motivated by fanaticism, martyrdom -- and wish ourselves back to September 10th. 

To anyone interested in the reality of propaganda, especially right-wing radio, pay attention to the spin coming off http://barackswhitelies.com.  
As a addict of propaganda of all sorts, I find sites (and radio shows) like this of central importance in predicting the sway of right-wing attack modes.  The basic attacks are not unpredictable, but the specific manifestations require specific responses, and the more precisely these attacks can be predicted, the less impact they can have.  For instance, his basic stance on Obama's Iraqi policy to remove troops is to question the wisdom of pulling troops out of "the world's largest reserve of oil," betrays a central devastating failing of right-wing war propaganda.  
Now, we all know Saudi Arabia is the world's largest reserve of oil, but his appeal brings the salient (but mostly unspoken) issue of Iraqi occupation clearly into the realm of debate.  The point is that the issues we call "obvious" but are forever outside the bounds of debate, like the Iraq war was for control of oil resources, can be fully realized and can be fully digested by these "fringe" pundits without the incessant filtering of MSM.
If the Iraqi invasion was framed in terms of oil to begin with, it would never have happened because even the average conservative American can do a cost-benefit calculation on his/her son's blood for oil.  Without this framing, replaced instead by the shining ideals of "freedom" and "liberation," the majority of Americans are lead without much difficulty.
A suggestion: embrace fanatical right-wingers.  Free speech will win.

This afternoon on "Your World with Neil Cavuto" (5/14/08), Mr. Cavuto, in his own fair and balanced way, presented the will of the people (29%) who say Senator Clinton should run as an independent in the upcoming election.
Unfortunately, I was unable to catch the description of the sample population from which the 29% were drawn.
He bounced this notion off Karl Rove who also (unsurprisingly) thought it would be a fair expression of the will of the people.  
Admittedly, I watch Fox News because I am addicted to propaganda: I have a masochistic love for serious b.s., and Neil Cavuto is, pound-for-pound, one of the heaviest sellers in the market.  
My point may not be completely original, but this piece highlights the reactionary stance of serious Republican strategists at the moment.  They have a vested interest in driving the wedge between the democratic field.  In fact, they are depending on defections to McCain and loss of support of the inevitable nominee in order to stand a chance in the GE.  
Now, many sites have apparently solid predictions for McCain in the Fall with only a slightly closer race with Obama in the Democratic slot.  However, most of these predictions are based largely on the voter registration numbers from the 2004 GE.  These numbers (most likely) do not accurately represent the current voter registration numbers as we have all been witness to the massive voter turnouts in this unprecedented primary season.
I have yet to find a good set of numbers to make a solid case of this point, and yes, this is conjecture from me, but it appears that the Republican strategists have this same feeling about things and are looking for anything that resembles a wedge to divide and conquer the Democratic nominee in the Fall.  Nader was the key in 2000.  In 2004, Americans, still scared of their own shadows, changed party affiliation in large numbers to the Republicans, and hence voter registration totals came closer to even than in many decades.  
This season, the clear Republican strategy will be to tout Clinton's name, virtues, true grit, character, and all the other "electability" issues to the tune of calling her true followers to either stay home, demand her name on a joint ticket or vote R.  
I want to be clear that Senator Clinton is not my first choice, but policy-wise, she and Senator Obama are hardly distinguishable.  Indeed, a good case could be made that her policies are better than his.  But the point is that we must, for the sake of the future of this country, for the sake of the vibrancy of the middle class, the backbone of the nation, stay united as a party.
We Democrats could take a lesson or two from the Republicans in this regard: no matter what child-murdering charlatan they nominate, they band together and avoid infighting until their old white guy takes office.  Be on guard for those whose aim is to divide this party: they do not have your or my interests in mind.