Why We Are Stuck With the Sequester

A month ago, it was clear that voters would blame Republicans if Congress went ahead with the for the so-called “Sequester”—some $85 billion in automatic government-wide spending cuts.

I thought this meant that Republicans would be forced to back down, call off the Sequester, and accept the fact that if we want to reduce the deficit, we’ll need to raise some taxes while also cutting spending.

I was wrong. The sequester took effect March 1 and Republicans aren’t budging.

The public does, in fact, blame the GOP for the budget stalemate that has led to the sequester:  a recent CNN poll shows that shows that only 38 percent say they have a “favorable view ”of the Republican Party, versus 54 percent who view it unfavorably.

                                  Why Republicans Aren’t Worried

Yet House Republicans are not terribly concerned about what voters think. This is because, back in 2010, they succeeded in re-drawing election district lines in many swing states in a way that creates “safe districts” for Republicans—districts where they have a solid majority. They feel untouchable.  At the same time the new boundaries pack as many Democrats as possible into as few districts is possible.

This is a major reason why Democrats didn’t win a  House majority in 2012, even as their congressional candidates drew about 1.4 million more votes than Republicans nationwide, according to data compiled by Bloomberg News. And, Bloomberg notes, the redistricting “will hinder the Democrats from regaining control of the chamber in 2014.”

District lines are re-drawn once a decade, right after the U.S. census is taken. The last census took place in 2010, and that year Democrats saw massive losses at the polls. As a result, the GOP controlled state government in key states, including Wisconsin, Michigan, Ohio, Indiana, and Pennsylvania. This gave Republicans the power to draw congressional district lines. They seized that chance, aggressively “gerrymandering” so as to protect Republican incumbents while isolating Democrats. The fact Democrats are concentrated in urban areas made their task easier. Nevertheless, creative cartography led to some crazy designs. For instance, Bloomberg points out, “Michigan’s 14th congressional district looks like a jagged letter ’S’ lying on its side.”

 

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The Lost Arts of Listening, Touching, Seeing . . . The Depersonalization of Medicine

As Clifton Meador’s observes in “Unheard Hearts,” these days most doctors rarely listen to a patient’s heart.

 “Physicians do carry stethoscopes and it certainly is a badge that shows they are a physician, but the sad thing is a large percentage of them don’t know how to use it and use it improperly when they do,” says Michael Criley, professor emeritus of medicine and radiological sciences and the University of California, Los Angeles’ David Geffen School of Medicine.

In a recent interview with Cardiovascular Business, Criley explains: “When two-dimensional echocardiography became available in the mid-1970s it could have, and should have, provided a noninvasive way of seeing what the heart chambers and valves were doing when extra sounds or murmurs were created, but instead replaced bedside auscultation [listening to the heart].

Reading what Criley had to say, and thinking about Meador’s piece, it struck me that this is all part of what some call “the depersonalization of medicine.”

By and large, 21st century doctors do not lay hands on their patients. As psychiatry resident Christine Montross pointed out in a New York Times op-ed: a few years ago:  ”Today’s doctors rarely do thorough physical exams.” Instead, they rely on “diagnostic tests and imaging studies.”

Meanwhile, in medical schools, Montross  reveals, “virtual gross anatomy” lets students avoid the “messy” business of dissecting a real body. “This is a mistake,” says Montross.

                                    Listening to the Heart                        

Criley’s theory that the stethoscope has become little more than a badge of honor is based on a study of physicians’ cardiac examinations.. . Criley was the lead author on a study that investigated these exams, published in the the December 2010 issue of Clinical Cardiology. Continue reading

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