Monday, July 20, 2009

Critical Issues in Healthcare

Today I filled out the Future of America's Healthcare Survey from John McCain's Country First PAC. To some extent, it had the usual flaw of such surveys - a limited range of responses that made it easier to give a response in line with the organization's biases. But there were also places where one could step off the marked path and write one's own brief responses, including this open-ended final question: Please list, in order of importance, the four health issues you consider most critical. As an economist who works in the field of injury epidemiology, I am not unfamiliar with some of the problems of our healthcare system. So I took my time to come up with four critical healthcare issues. Here I will share my responses and expand upon them. (This will be an atypical blog post for me - more stream-of-consciousness, without my usual images, links, and obsessive editing.)

1. The system is rigged to favor the insured over the uninsured.

Unless you have the good fortune to live in Maryland, here is how hospitals determine how much you owe them: The hospital issues a bill for about twice what it actually spent to treat you. If you have insurance, your insurer then negotiates down the amount it actually pays to a more reasonable level. So the amount that is collected by the hospital depends primarily on the relative market power of the hospital and the payer. If the payer is the government (e.g., Medicaid) it has tremendous clout and can sometimes even force the hospital to treat patients at a loss. If you don't have insurance, on the other hand, you are stuck paying way more than you should.

If you've studied industrial organization, you will recognize that the system I have described here is not a competitive market. In a state of competition, by definition, everyone would pay the same price for the same service. What we have here, rather, is bilateral oligopoly. In the state of Maryland, we have cost controls to keep hospitals and insurers from playing this game. The result of this regulation, ironically, simulates a competitive market more closely than the free-for-all in other states. But maintaining such regulations is difficult. New York formerly had a similar cost-control regime, but it broke down when hospitals found they could get around the restriction on charges per day by increasing the length of stay of inpatients. Before the system was abandoned, New York had average lengths of stay that were (as I recall) roughly 25% higher than anywhere else.

It seems to be the consensus of pundits and policymakers that the solution to the problem of rising healthcare costs is simply to mandate that everyone be insured. This is like saying that the solution to the threat of lawsuits is to require everyone to keep a lawyer on retainer. Or the solution to the threat of armed robbery is to require everyone to carry a firearm at all times in public. In short, if there is going to be an arms race, everyone should be armed. The big winners, obviously, will be those who make and sell arms - in this case, the insurers.

While this approach might protect individuals from the threat of outrageous medical bills, it will not reduce medical costs overall. In fact, far from reducing the amount our society spends on healthcare, it would inevitably increase it. By making healthcare less expensive to individuals, it will encourage them to consume more healthcare. Greater demand will increase the price of healthcare. If these costs are not borne by individuals in the form of higher insurance premiums, they will have to take the form of reduced profits for hospitals and insurers . . . or increased subsidies from the government.

My opinion in short: Health insurance is the problem, not the solution. Making health insurance, as we now know it, universal will make our healthcare problems worse, not better.

2. Hospitals and doctors use secrecy to prevent evaluation and comparison shopping.

Hospitals and doctors fear competition. It is as if every hospital secretly fears that it is not as good as its peers, so it does its best to keep anyone from getting enough data to evaluate it. Researchers like me who do get access to the necessary data are generally forbidden from using it for this purpose. Doctors, meanwhile, have professional restrictions on advertising. This makes it difficult for potential healthcare consumers to discover where they can get the best treatment for the lowest price. This, in turn, makes a competitive market in healthcare impossible.

3. Too much reliance on drugs for treatment, rather than nutrition (including supplements) and exercise.

Our healthcare system has a drug dependence problem. Doctors have become so impressed with the power of medicines that many have come to see their primary role as prescribing medicine. Some doctors avoid career tracks, like the emergency room, where they would see a lot of patients whose problems cannot be treated with drugs. The pharmaceutical companies have encouraged this approach to doctoring for obvious reasons. And Americans, who like to think there is a quick, easy solution to any problem, can be persuaded to subscribe to this ideology without much arm-twisting.

The best solution to many health problems is prevention - cultivating healthy habits so that one does not get sick in the first place. But good health is not in the interest of drug companies and the doctors who prescribe drugs. They would rather see us contract chronic conditions (e.g., obesity, diabetes, arthritis) that require treatment for life with the medicines that only they can sell us.

In recent years there have been repeated efforts by drug companies and the Congressmen they control to prohibit most vitamins and other nutritional supplements. They make the specious argument that supplements are drugs and should be regulated like drugs. They have even extended this argument to some foods, reasoning that if health claims are made for a food (e.g., drinking milk will reduce the likelihood of osteoporosis), that makes it a drug. But since food, vitamins, etc. cannot be patented like synthetic drugs, no one would have an economic incentive to put them through the expensive trials that drugs have to go through.

4. Too many resources are wasted on useless and expensive end-of-life care.

I have been thinking about this one for a long time. It was my back-up dissertation topic. But since my adviser liked my primary topic (bureaucracy), I never pursued it. Currently, more than one-fourth of Medicare payments go to treating the terminally ill. In part, this results from a culture that is in denial about death and simply refuses to accept its reality. We either need strict controls on end-of-life care or a cultural revolution that encourages us to prepare for the inevitability of death.

There are other topics I could have covered if I were not limited to four issues. The next on my list would have been the threat of lawsuits, which raises the price of malpractice insurance and forces doctors to perform extra tests. Another issue, which I touched on above in 3, is the generally unhealthy lifestyles of most Americans today. In particular, the marketing arm of the food industry encourages us to consume way too much food and drink with too little nutritional content.

Fortunately, Senator McCain only asked me to list issues - he did not ask me to propose solutions. I really do not like any of the options that are politically realistic - especially the default option, the status quo.

However, I think there might be a confluence of developments on the horizon that will make a single-payer healthcare system inevitable. As we learn more about the genetic basis of illnesses and genetic testing becomes more widely available and more economical, individuals might soon be able to have fairly certain knowledge of the conditions for which they are at risk. At the same time, a growing obsession with privacy of medical information will make it impossible for insurers to see their clients' genetic information. If I have 100% knowledge of my genetic information and my insurance company has 0% knowledge of same, the information asymmetry will destroy the viability of private insurance.

What will happen when the government runs the healthcare system? It certainly will not be all bad. Many administrative costs will disappear and others will be slashed. The government will acquire an interest in keeping its citizens healthy in order to keep costs down, and this will end its too-cozy relationship with Big Pharma. We will actually have national conversations about some cultural issues that should be decided by the democratic process rather than by the market.

On the other hand, there will be obvious problems, as well. In addition to the usual problems of government bureaucracy, we will suffer the consequences of monopsony - a market with a single buyer. Those on the other side of the market - doctors, hospitals, makers of medical devices and drugs - will find their incomes squeezed. As a result, some hospitals will go out of business, and fewer young Americans will choose medical careers, and fewer new drugs will be developed. The US might lose its status as the world's leader in the development of new medical technology. The most expensive and innovative forms of care might be prohibited as too expensive. And matters of appropriate treatment and payment levels will become political questions, fought over every four years by special interests who could become powerful players in our political system. Every disease-of-the-month organization will try to get special treatment for its members/victims, which could easily eat up any cost savings if their entreaties receive positive responses.

Conclusion. The problems with our healthcare system are complex. Too complex, in fact, to be alleviated by any political quick fix. Any program that is rushed through Congress hastily on a single-party basis will make things worse, not better. This is not an emergency and should not be treated like one. But neither should we remain complacent about the growing costs of healthcare. The current system will not fall apart next year, but it might in ten years.

Addendum. One of my correspondents reminded me of an issue I forgot to mention. I tend to favor abolishing the tax exemption for employer-provided health insurance - and for most other fringe benefits, for that matter. One could argue that health insurance is a public good, and that it is reasonable for the government to subsidize it. But the logical conclusion of that argument is that the government should subsidize all private health insurance, not just that provided through employers.

There is also the matter of insurance for catastrophic health events. I think it might be best for the government to provide such insurance for all Americans. Such events are rare, but when they occur they can wipe out a family's finances, even if they have insurance. They can be so expensive that insurance companies will try to dump such policyholders or resist paying on their policies. If the government were to cover these rare events, it would level the playing field for insurance companies to compete in the non-catastrophic insurance market.

Yesterday, the New York Post published this piece by Robert A. Book and Robert E. Moffit of the Heritage Foundation. They conclude that the plan now being discussed in Congress would break most of President Obama's campaign promises about health insurance.

Wednesday, July 8, 2009

Homosexuality Reading List

In recent weeks I have received a barrage of interesting articles on homosexuality and related issues such as same-sex marriage. As a possible explanation of why so much anti-gay material is now finding its way around the intellectual marketplace of the internet, I would hypothesize that, in the wake of the pro-gay blitzkrieg we have seen in the past three years in the media and the courts, the conservative counter-reaction is finally getting organized. I harbor no illusion that these arguments will be seriously entertained by the mainstream media or the government in the age of Barack Obama and his buddy Gene Robinson, but that tide could turn quickly.

In "What About the Children?", Canadian writer Tom McFeely discusses the disadvantages faced by children raised in homosexual households. The article's hook was the new position statement of the American College of Pediatricians, which reversed a 2002 endorsement of same-sex parenting: "Given the current body of research, the American College of Pediatricians believes it is inappropriate, potentially hazardous to children, and dangerously irresponsible to change the age-old prohibition on homosexual parenting, whether by adoption, foster care, or by reproductive manipulation. This position is rooted in the best available science."

The mission of the National Association for Research & Therapy of Homosexuality (NARTH) is to "uphold the rights of individuals with unwanted homosexual attraction to receive effective psychological care and the right of professionals to offer that care." LifeSiteNews covered NARTH's publication of a study that examined over a century of professional and scientific literature, which refutes the claims of some factions of the American Psychological Association, who assert that homosexuality is immutable and that attempts to treat it therapeutically are harmful. Blogger David Virtue interviewed Dr. Joseph Nicolosi, the head of NARTH, at the Sex and the City Conference in London. According to Nicolosi, "the three great pioneers of psychoanalysis, Freud, Jung, and Adler, all saw homosexuality as disordered." In his practice, Nicolosi finds that most of his patients experience significant diminishment of same-sex attractions. Those who do not improve are mostly the ones who are not motivated – teen-agers dragged in by their parents, or husbands pressured into treatment by their wives or pastors.

Dennis Prager, a Jewish theologian and radio talk show host, makes the bold assertion, "When Judaism demanded that all sexual activity be channeled into marriage, it changed the world. The Torah's prohibition of non-marital sex quite simply made the creation of Western civilization possible." His article, "Judaism's Sexual Revolution: Why Judaism Rejected Homosexuality," supports his thesis persuasively. Prager shows us how radically Judaism departed from the sexual practices of its pagan neighbors. The Jewish condemnation of non-marital sex was, no doubt, a key motivation for the ancient hatred of the Jews. (It should be noted that Prager, in passing, also repeats the Jewish view that male celibacy is a sin: a man who is unmarried is incomplete.)

In "Answering Advocates of Gay Marriage," Canadian scholars Katherine Young and Paul Nathanson enumerate 20 different claims (not all of them consistent) made by advocates of same-sex marriage, and they systematically demolish them. They begin by assuring readers that they are not opposed to gay persons or gay relationships, but only to gay marriage. They describe their approach as comparative and dialogical: "One of us is a man, the other a woman; one is Jewish, the other Gentile; one is gay, the other straight; one specializes in Western civilization, the other in Eastern civilization; and so on. As a result of our collaboration, we have been able to gather a great deal of evidence, both historical and cross-cultural, to support our answers to the claims made by advocates of gay marriage." They argue against the shallow, individualistic understandings of sex and marriage implicit in most current discussions. Instead, they argue that heterosexual bonding is fundamental to civilization, and that it must be deliberately fostered by a supportive culture. In particular, they argue that culture and its institutions must bind men to their families, lest men become a toxic force with no stake in their society. Their own country, unfortunately, ignored their wisdom, proceeding with the "massive human experiment" of same-sex marriage.

Finally, British journalist Melanie Phillips reports that the Conservative Party is expected to unveil a new policy to shore up marriage. It will be based on a report, expected to be released this month, which recommends "a sweeping overhaul of the law to strengthen marriage, including moves to make divorce more difficult and promote marriage preparation classes and 'family relationship centres', as well as tax breaks for married couples." Phillips laments that the Tories cannot see that their support for marriage will ultimately be undermined by their support for gay rights.

After reading all of the above articles and pondering them, I conclude that Western society's current thrust for the abolition of heterosexuality as a norm grows out of a larger underlying problem: Our society is already corrupted with the ideology foisted on us by Baby Boomers, which tells us that the world exists for the immediate pleasure of competent adult individuals, and anything that interferes with this in any way is unacceptable. We have no debt to the past, no obligation to the future; no stake in the culture we inherit and pass on; no responsibility for weaker members of our society, including children (except, perhaps, those we "choose"). The gay rights lobby is so immersed in this self-indulgent, individualistic ideology that it cannot imagine a contrary reality. But this does not distinguish it from most other special interest groups of 21st century America.

We will never reverse the onslaught of gay rights – or, more generally, "rights" associated with sexual identity – if we do not reform our society's entire view of sex and marriage. Barring the once-in-a-millennium true leader, this will not happen through the political process. We can no longer count on a self-serving mainstream media to confront us with hard questions and harder answers. For the most part, the academic world has insulated itself from reality by wrapping itself in ideology. Only a religious revival is likely to save our civilization from being consumed by a culture of self-indulgence. Otherwise, we can start reading Brave New World as a roadmap of the near future (though I think Huxley was rather optimistic).

Saturday, April 11, 2009

Give Me This Stranger

Today, which is Good Friday on the Gregorian calendar, my Byzantine Catholic e-friend Dan sent me this YouTube video of the hymn “Give me this stranger.” It is Byzantine chant sung in Arabic, and it’s about 10 minutes long. It’s not very impressive visually – just a series of very slow pans over icons of Christ’s burial – but the music is otherworldly.

This hymn is sung on the night of Great and Holy Friday at the end of the Lamentation service, which commemorates Christ’s burial. It is sung from the point of view of my patron saint, Joseph of Arimathea. Many of the hymns on Holy Friday mention St. Joseph, but this is one of only two that are sung from his point of view. (Interestingly, both of these are in tone 5, as opposed to the hymns about him, which tend to be in tones 2 and 6.) An English translation of the hymn follows.


Seeing that the sun had hidden its rays and the veil of the Temple had been rent at the death of the Saviour, Joseph did approach Pilate and did plead with him crying and saying,

Give me this stranger, who from his youth hath wandered like a stranger.

Give me this stranger, whom his kinsmen killed in hatred like a stranger.

Give me this stranger at whom I wonder, beholding him as a guest of death.

Give me this stranger who knoweth how to take in the poor and strangers.

Give me this stranger whom the Jews in envy estranged from the world.

Give me this stranger that I may bury him in a tomb, who being a stranger hath no place whereon to lay his head.

Give me this stranger, to whom his Mother, beholding him dead, shouted crying, “O my Son and my God, even though my vitals be wounded, and my heart burns, as I behold thee dead, yet trusting in thy Resurrection, I magnify thee.”

In these words the honorable Joseph pleaded with Pilate, took the Saviour’s body, and with fear wrapped it in linen and balm, placing thee in a new tomb, O thou who grantest to all everlasting life and the great mercy.

Friday, April 10, 2009

Byzantine Chant

In the 18 months since I was chrismated into the Orthodox Church, my main ministry has been chanting at Matins, which I do nearly every Sunday. Matins begins at 8:15 on most Sundays, and 8:00 on certain feasts. That it could get a night owl like me out of bed that early on a weekend should be sufficient proof of how much I have come to love chanting.

When I was an Anglo-Catholic, my liturgical involvement took the form of serving as an acolyte. I served at both Low and Solemn Masses, as well as Evensong & Benediction. I especially enjoyed my five years serving for Fr. Anderson at Morning Prayer and Low Mass on Thursdays. After working together for so long, each of us knew what the other was going to do, and our choreography became automatic, so that I could actually pray during Mass instead of always thinking about what I had to do next.

In my various liturgical roles, I was not only serving the church but also educating myself on the details of the liturgy. While I gained a respectable degree of expertise on the Mass, there were always others with more knowledge (and bigger libraries) than I on that subject. But eventually, thanks in large part to my exposure to Benedictine monastic life, I think I became the parish’s resident expert on the Daily Office.

At Holy Cross, lay liturgical roles at the altar are reserved, for the most part, to subdeacons and teen-age boys, so it looked like I would have to learn Byzantine worship standing with the congregation. When Doug, one of the protopsaltis (lead chanters) began offering occasional classes in Byzantine chant on Sundays after coffee hour, I attended. Since I have always found my voice frustratingly inadequate, I did not imagine that I would actually be able to chant in services, but I thought this would be a chance to begin my education on the Byzantine services of Vespers and Matins. Not much later, the other protopsalti, Emily, took over the job of training the new chanters. We would meet to practice for two hours on Saturday afternoons before Vespers. At first we focused on learning the standard pieces that are sung every Sunday, as well as on learning the eight Byzantine tones. Emily recorded and uploaded several of the hymns, as well as a short introduction to each of the tones consisting of the apichima (a short mnemonic to help the chanter bring the tone to mind quickly), a sample hymn in the tone, and the Resurrectional Troparion of the tone. I learned to chant by playing these pieces over and over and singing along with them. Eventually, the time came when I was scheduled to chant at Sunday Matins.

My very first time, I was the only chanter who arrived on time. When Deacon Mark came out of the sanctuary to ask if I could get the service started by myself until the other chanters arrived, I could only say no. (Ever since then, I have judged my progress, in part, by asking how far into the service I could get if I had to do it solo.) The first few times, I would just be assigned to read psalms and other parts that are simply read, and otherwise sing only the parts that were sung in unison by everyone. But it wasn’t long before we newbies started to take our turns on the kathismata and the anabathmoi, two types of hymns that are free chanted every Sunday.

In free chanting, one is given a text, along with a number from 1 to 8 representing the tone in which the words are to be sung. Each Byzantine tone has its own characteristic patterns built on one of the four scales. The chanter sings the words, matching them to the patterns of the tone, essentially composing a musical setting for the words spontaneously within the strictures of the tone. If you really know the tone and can get it into your head, free chanting is not as hard as it sounds. If you don’t know the tone or can’t call it to mind, however, it is impossible to do right. Free chanting is much easier when you are following someone else who has just chanted something in the same tone. Another thing that makes free chanting easier is that each Sunday is assigned one of the eight tones, and most of the pieces that are free chanted will usually be in the tone of the week. Therefore, we could focus on one tone each week.

Not everything is free chanted. For most of the hymns there are settings written in Western musical notation. Some chanters prefer to rely on these, while others prefer to free chant. Free chanting comes easier to me. However, free chanting only works for solo pieces. Hymns that are to be sung by everyone require written music to keep everyone together. I learn the frequently sung pieces by ear and then use the written music as a reminder. Otherwise, I try to follow those who read music better than I.


About a year ago, on Lazarus Saturday, a crew from the PBS program Religion & Ethics NewsWeekly came to interview Emily about Byzantine chant and to film Matins and the Liturgy. That segment, edited down to under three minutes, will finally air this weekend. It became available on-line today.

Only James chants with Emily in the segment. I was still too green to chant on TV (in the big game you play your stars, not your rookies), so you’ll only see the back of my head in the congregation (I’m the one obstructing your view of the icon of Christ). Now, a year later, I get to chant with Emily and James all the time – like tomorrow at Matins of Lazarus Saturday.

For those who want to read more, here are some links:

Byzantine Chant – an article from OrthodoxWiki.
Byzantine Chant – an article from the Holy Cross Website.
Tone Three – Emily’s reminiscence about chanting in Greek on Christmas Eve.
Makin’ the Big Time – Emily’s blog post on the TV segment.

Thursday, February 12, 2009

Thoughts on Evolution

On the occasion of the 200th birthday of Charles Darwin, today I went through some of the old messages in my e-mail folder labeled Evolution. It consists mostly of discussions over the past decade with a circle of old friends from the Wesley Foundation at the University of Illinois, mostly on evolution and related topics such as human nature and philosophy of science, with occasional forays into discussions of homosexuality, the Star Wars and Lord of the Rings movies, and ancient Greek drama. I came across a lot of interesting stuff, some of which I remembered and some of which I had forgotten. I was looking for one message in particular. In 2005, when the subject of Intelligent Design was in the news, Diane Rehm devoted an hour of her radio talk show to ID. Unfortunately, the episode was hastily arranged so as to strike while the topic was hot, and she settled for second-string guests who were not really experts on evolution or ID. Both guests exhausted their knowledge of the subject before the program was half over. It was the most disappointing episode I have ever heard, and perhaps the only time I have heard Diane obviously frustrated with her guests. In my e-mail to her afterwards I wrote, "I think I could have argued both sides better than either of your guests!" I then wrote down some of my own thoughts on the creation-evolution debate that I thought might have made inspired a more interesting program. The essay that follows here is built up from that old e-mail.


I have accepted the truth of biological evolution by natural selection for as long as I can remember. I can't recall ever hearing about evolution in science class in my rural K-8 elementary school – I just picked it up on my own through my extensive reading, and it seemed to make sense. In the sixth grade I did my science fair exhibit on evolution, and as a result I suffered a brief wave of persecution – a rare opportunity for my classmates to pose as more pious than me. Obviously, I do not find evolution to be in conflict with Christianity or with divine creation of the world.

Terminology

Evolution and creation are sometimes framed as competing theories of "the origin of life," but this is a mistake. While creation is certainly about the origin of life, evolution is not. Evolution offers an explanation of how life developed and diversified into different species, but it says nothing about where the first life came from. For this reason, evolution and creation are not exactly symmetrical, competing theories – they don't cover quite the same ground. The specific aspect/theory of creation that might be seen as the counterpart of evolution is "special creation" – the notion that every species is directly created by God as a separate and distinct creation. This is what is usually meant by creationism. But obviously one can believe in God's role as the ultimate source of creation without endorsing this theory.

Like creation, the term evolution also requires some narrowing. In the broadest sense, it simply refers to the accretion of changes in forms of life over the generations. Even some self-described creationists concede the reality of microevolution – small changes within a species in response to changes in its environment – but they deny the possibility that such evolution can lead to the development of new species. Before Darwin, evolutionary theorists already believed that existing species had evolved from earlier species, but they proposed many different mechanisms by which this evolution might have occurred. Jean-Baptiste Lamarck famously proposed that parents could pass on acquired traits to their offspring. But today when we say evolution, the default meaning is the development of new species through evolution by natural selection, as proposed by Charles Darwin 150 years ago in The Origin of Species.

In the Classroom

Opponents of evolution often talk in terms of presenting "alternatives" to evolution. But there is no real alternative to evolution. This is not to say that there never can be and never will be any alternative. Nor is it to say that evolution is ready to be enshrined as a final and complete law of nature. It is only to say that there is currently no alternative on the table. Evolution has vanquished the competing theories and no new theory has yet risen to challenge it.

Some have proposed Intelligent Design as an alternative to evolution. But ID is unable to explain the thing that evolution explains – the origin of species. ID does not constitute a stand-alone alternative to evolution, but, rather, a critique of evolution. By pointing to possibly anomalous data that evolution (allegedly) cannot explain, ID demands a re-thinking of the theory of evolution as currently understood.

Some advocates of evolution freak out at the very mention of Intelligent Design. But in doing so they betray themselves as proponents of science qua ideology, not science qua science. They would be more Darwinist than Darwin himself!

You see, the principle on which ID rests was introduced by none other than . . . Charles Darwin. In Chapter 6 of The Origin of Species, Darwin himself proposed a number of possible critiques of evolution. ID is, essentially, a highly developed form of one of these critiques. Darwin admitted that it is difficult to see how "organs of extreme perfection and complication," such as the eye, could have come about by natural selection, but he tried to answer this objection. Modern ID theorists have run with this critique, producing the idea of "irreducible complexity." Evolutionary biologists, in turn, have answered the critique. That is how science works.

I think this suggests one approach to the controversy over teaching Intelligent Design in the classroom. While ID cannot reasonably be taught as an alternative to evolution (because it does not actually propose a concrete alternative mechanism for the origin of species), it could be introduced as one of a number of critiques that evolutionary biology must address if evolution by natural selection is to be established as a law of nature. If Darwin himself could raise such questions, I don't see why a biology teacher should be prohibited from doing so. Working through Chapter 6 of The Origin of Species might make for an interesting high school biology lecture.

I think the fact that evolution currently faces no competion makes it especially important to raise such questions. Evolution is a strong enough theory to withstand all such questions, so I see no danger of leaving students with the impression that evolution has been refuted. Rather, such questioning would serve as an example of the scientific approach to knowledge, showing budding scientists that it not unthinkable to question even the best established of scientific theories. This should help to dispel any tendency to think of scientific theories as unquestionable dogmata.

Evolution and the Incarnation

In a stereotypical creationist-vs.-atheist debate, I have no one to root for. Both sides have already lost me before the debate even begins. Once the debate is joined, it looks like they disagree on every single point, and that is how they are usually perceived. To me, however, it seems that they agree with each other on the central premise that underlies the debate: in the provocative form attributed to Richard Dawkins, "If Darwin's cosmology was right, then theology is senseless babble." And creationists like Phillip Johnson accept the premise and join the debate on those terms. This all-or-nothing proposition, for those who accept it, validates both the conflict and the energy they expend on it.

When combatants on both sides find a rare proposition they can agree on, one is tempted to let it pass without further examination. But this premise is both illogical and heretical. It assumes that God's only purpose is to serve as a causal explanation of phenomena in the physical universe, and that if a completely natural explanation can be found for every phenomenon then we can dispense with God as redundant and dismiss the supernatural entirely. This argument might be compatible with a Deistic "God of the gaps," but it cannot be reconciled with the God of orthodox Christianity. We believe that Jesus was both fully divine and fully human – that these two natures dwelt in him without contradiction. From this orthodox Christian understanding of the Incarnation, it follows that the supernatural is not excluded by the natural; rather, the supernatural manifests itself in and through the natural. Therefore, even if science were somehow to demonstrate the truth of an entirely materialistic explanation of the universe, it could not exclude the existence or activity of God.

Therefore, from an orthodox Christian point of view, a debate premised on the mutual exclusivity of the natural and the supernatural is flawed from the outset.

Interesting Links

Here are a few interesting bits I came across in my Evolution folder.

"Special Creation" on the Left

Science vs. Norse Mythology

God and evolution: the state of the question

Expelled: No Intelligence Allowed

A classification of possible routes of Darwinian evolution

For Sociobiology

Augustine's Origin of Species

Genesis and Creation: Towards a Debate

Wednesday, February 4, 2009

Charitable Solicitations Revisited

Back in March I gave a preliminary report on charitable solicitations I received in 2008. At that point, my solicitations were running 3% behind 2001, the last time I conducted such a study. But by the end of the year, 2008 had topped 2001. Last year I received 864 solicitations (2 more than in 2001), plus 123 newsletters or magazines, from 214 different charitable organizations. (That does not count thank-you letters and tax receipts that were sent by the charities I actually donated to.) The biggest single month was October, when I received 103 solicitations – that's an average of 3.8 every time I opened my mailbox!

One major difference between the two years is that 2008 was an election year. I received 40 solicitations that I categorized as political, of which 33 were from political parties or candidates. In 2001 I received only 13 politically oriented solicitations.

The category with the biggest drop was Roman Catholic religious orders. In 2001, 31 orders sent me 80 solicitations (with 22 coming from a single order!). In 2008, just 9 orders sent me 11 solicitations. In late 2000 I purchased a rosary from a monastery, and I think the monks must have shared my address with everyone in the Catholic Church. Most of them probably lost track of me after I moved in 2003 and 2004.

The two worst offenders were Human Rights Watch and WETA, each of which sent me 19 solicitations. I had not donated to either in 2007, so I'm not sure what they hoped to accomplish by flooding my mailbox.

At the other extreme, two local charities that I have donated to consistently over the past decade did not contact me at all last year. In the past I have even made special efforts to restore contact with them after I moved, but it seems they just aren't very good at keeping their databases up to date.

Friday, January 23, 2009

A Day on the Mall

Yesterday I traveled downtown to the National Mall. My primary mission was to attend the 36th annual March for Life. A secondary mission was to take a few photos with my guest, Flat Ajay. I got off the train at the Archives-Navy Memorial Metro Station around 11 AM, and the march was not scheduled to begin until noon, so I took a short detour through one of my favorite places in Washington, the National Gallery of Art. On the lower level I found a room with a few pieces of sculpture, including stained glass, on the theme of the Annunciation. Since no one else was around, I decided that would be an appropriate place for a quick prayer. Then I pulled Flat Ajay out of my backpack and posed him for his first photo, with the 15th-century marble sculpture Kneeling Angel, by Giovanni Antonio Amadeo.

I suppose this would be a good place to explain why I'm taking photos of a construction-paper image of a kid. In the children's book Flat Stanley, a boy who is accidentally flattened takes advantage of his state to be mailed in an envelope to friends in other places. Inspired by this tale, children create flat images of themselves and mail them around the country, where their hosts take them to interesting places and record their adventures. Flat Ajay is the alter ego of a third-grader in California.

Then I headed for the mall, looking to meet up with some other folks from my parish who were planning to attend. The march was to begin around 4th Street, at the Capitol end of the mall, and proceed around the Capitol to the Supreme Court. I walked back and forth across the mall, looking for some of my fellow Orthodox Christians, but I only spotted one priest. Finally, on my third pass, I found a big ORTHODOX CHRISTIANS FOR LIFE banner with an image of Christ blessing the children.

As you can see from the picture, it was a beautiful, sunny day - the first nice day, in fact, after a couple of frigid weeks! Christian pop music was playing from the loudspeakers on the stage as the crowd grew and grew. I read one estimate that about a quarter of a million people attended - about one-seventh the size of the crowd that had gathered two days earlier to see Barack Obama sworn in as the 44th President of the United States. If you out-click the photo above to full size, you'll see that some of the apparatus from the inauguration, including five big historic U.S. flags, are still in place at the Capitol.

Another Orthodox banner featured an icon of the Visitation. The ByzanTeens (Byzantine Catholic youth, I presume) had a similar banner based on the same icon. It shows Our Lady greeting her cousin Elizabeth, with their sons in their wombs made visible (Luke 1:44).

The event began with introductions by the founder and the organizer and a prayer. Then more than a dozen members of Congress spoke. And then the speaker all the Orthodox had been waiting for - Metropolitan Jonah, the new primate of the Orthodox Church in America. Then a few more speakers. The most rousing speaker was a black minister, who decried abortion as genocide against his people. And while most of the participants were Christians of various sorts, one of the speakers and many of the marchers were Orthodox Jews, who had come down from New York for the day.

By the time the speakers had all finished and the actual march could begin, it was 2:15. We got off to a slow, crowded, and disorganized start, with a lot of stopping and waiting.

I was with a group of fellow Holy Cross parishioners, mostly students from St. John's College. Finally, we started moving forward. But within a few minutes I had lost site of everyone I knew. I could still see one Orthodox sign, but it was moving farther and farther ahead, and I was surrounded by people who were practically standing still. It took me a few minutes to realize that I had become surrounded by a knot of Catholics who thought it was more important to keep their group together than to keep up with the march. I took to the sidewalk to circumvent the crowd and eventually spotted the Orthodox banners, but the crowd was so thick there that I could not get any closer.

I finally caught up with the other Orthodox marchers at the southwest corner of the intersection of 1st and Constitution, NE, where they had stopped for prayers led by Metropolitan Jonah. (In this picture you can see the flag that flies in front of the Supreme Court, just to the left of the Guardian Angel banner.)


(In this last photo you can see Metropolitan Jonah, in the white headgear, just under the left edge of the big banner.) To complete the Orthodox participation in the march we all lined up to receive the Metropolitan's blessing, along with an icon card to commemorate the event. Then I continued on down the street past the Supreme Court.

I walked all the way around the Capitol. I hoped to pose for a Flat Ajay photo in front of the Capitol, but I soon realized that would be more difficult than I had anticipated. They were still tearing down the inauguration stage, so I could not get as close as I had hoped. The best I could do was across the street, from the Ulysses S. Grant memorial statue.

You can see that by this point they had removed two of the five flags from the front of the Capitol. On my way back to the metro station, I passed by the Canadian embassy, which was displaying a banner welcoming our new President.


I walked back to the metro station tired after several hours on my feet. Fortunately, being Orthodox gives me a lot of practice at being on my feet . . .

Friday, December 5, 2008

The Legacy of Patriarch Alexy II

Alexy II, Patriarch of Moscow and All Russia, died this morning at age 79, after leading the Russian Orthodox Church for 18 years.

Some of you know that I have always had reservations about Patriarch Alexy because of his KGB ties, which were instrumental in his rise to power. Given his background, it was only natural that he would become entangled with Russian nationalism and with the government of Vladimir Putin, himself a former KGB officer. In recent years, however, I have been impressed by the patriarch’s strong opposition to some of the more extreme manifestations of Russian nationalism. In putting down the monarchist faction pushing for the canonization of Ivan the Terrible and Rasputin, for example, Alexy asked rhetorically, “What believer would want to stay in a church that equally venerates murderers and martyrs, lechers and saints?” And earlier this year, rather than serve as an apologist for Russian aggression against Georgia, he issued a heartfelt call to both sides: “Stop! Don’t let more blood shed! Don’t let today’s conflict boil over! Show wisdom and courage: come to the negotiating table to respect the traditions, outlook, and hopes of the Georgian and Ossetian people.”

But those who are more interested in international ecclesiastical politics than in governmental politics will remember Patriarch Alexy more for his rivalry with the Ecumenical Patriarchate, his blocking of better relations with the Vatican under the late John Paul II, and his clinging to Moscow’s dominance over the Orthodox Church in the former Soviet republics that gained their independence during his tenure as patriarch. I was delighted to find that everything I might say on these topics has already been said better than I could say it in this brilliant analysis from Catholic World News, which considers Patriarch Alexy’s legacy and the future of the Russian Orthodox Church, particularly with regard to Moscow’s relations with Rome and Constantinople. The article concludes:

If a new Russian Orthodox Patriarch adopted a friendlier attitude toward Rome – or even toward Constantinople, for that matter – his leadership could produce enormous strides toward the goal of Christian unity. But in order to take those strides, the Russian leader would need to question his Church’s strong identification with the forces of Russian nationalism. And simply by raising such questions, he might endanger the current ties between the Moscow patriarchate and the Russian political leadership. The new Patriarch, whoever he may be, will face challenges every bit as difficult as the ones that faced the late Alexei II.

Addendum: My friend Alphonse pointed me to another analysis of Patriarch Alexy’s legacy – this one from Radio Free Europe/Radio Liberty – which takes a broader perspective than just ecclesiastical politics.

Friday, November 21, 2008

Book Meme

James Gibson of Sanctus tagged me with the book meme. I am supposed to pick up the nearest book, turn to page 123, find the fifth sentence, and post the three sentences afterward. For me this will not be as straightforward as one might hope . . .

The nearest book – right at my elbow, since I consult it so often – is Detailed Diagnoses and Procedures, National Hospital Discharge Survey, 1991. Even though it is falling apart, I use its list of ICD-9-CM diagnosis codes, which is laid out in a user-friendly way for quick reference. Page 123 is the second page of a 24-page table. It doesn’t even have five actual sentences on the page. The next closest book is the Ultimate World Pocket Atlas. Page 123 shows the eastern half of the Pacific Ocean, along with North and South America – again no sentences. The next closest book is The Book of Common Prayer (1979). Page 123 contains five collects for Evening Prayer II. Skipping titles and Amens and counting each collect as a sentence brings us to the next page, where we find . . . more collects:

A Collect for Protection
O God, the life of all who live, the light of the faithful, the strength of those who labor, and the repose of the dead: We thank you for the blessings of the day that is past, and humbly ask for your protection through the coming night. Bring us in safety to the morning hours; through him who died and rose again for us, your Son our Savior Jesus Christ. Amen.

A Collect for the Presence of Christ
Lord Jesus, stay with us, for evening is at hand and the day is past; be our companion in the way, kindle our hearts, and awaken hope, that we may know you as you are revealed in Scripture and the breaking of bread. Grant this for the sake of your love. Amen.


I wish I had landed on a Rite 1 page. Even as my eyes were reading the Rite 2 words, my lips were saying the Rite 1 versions that I recited hundreds of times during my years as an Anglo-Catholic.

Wednesday, October 29, 2008

The Media and the Messiah

Of late, it has often been practically a full-time job to keep up with reading (and occasionally forwarding) my anti-Obama e-mail. While the mainstream American media intently avert their eyes – and ours – from the flaws of their messiah, those who have bothered to look have found a history of out-of-the-mainstream Leftist politics; close ties to terrorists, criminals, and Islamists; and a pattern of deceit, manipulation, and cover-ups. He also maintains a longstanding relationship with ACORN, which, among other crimes, extorted banks into making subprime loans (Obama actually served as an attorney for ACORN on one such case) and is currently being prosecuted for voter registration fraud in several states. (A friend personally witnessed ACORN reps paying under-age teens to fill out multiple voter registrations earlier this month.) In addition, despite his attempts to straddle the fence between pro-life and pro-choice positions, he has the most extreme pro-abortion record of any political candidate in American history. But even if you want to discount these sensationalistic-sounding allegations, it is not hard to find damning indictments in what is commonly known about Barack Obama.

Senator Obama’s campaign rhetoric would have us believe that he is moderate and post-partisan – a new kind of politician for a new era. The media have refused to challenge this attractive image, giving Obama an unprecedented free pass. But the truth is easy enough to discover. Barack Obama spent his formative years in politics as a loyal cog in the Daley machine. He learned to play power politics in the manner that Chicago Democrats are known for. One might excuse him, since he did not invent that system and could not realistically have challenged it. But in doing so one would be conceding that Obama’s record is one of politics-as-usual, not “change”; and one of service as a Democratic Party yes-man, not an independent-thinking leader. His record and his rhetoric are entirely at odds. Which are we to believe?

Those who would believe in the sincerity of candidate Obama’s promises must face the fact that he has already broken his first campaign promise: he pledged to participate in public financing of his presidential campaign if his opponent did. Obama weaseled out of his pledge and his sycophants in the media made excuses for him.

The domestic media’s pro-Obama bias has become so flagrant that it is even drawing attention overseas. The OSCE, which is sending observers to monitor the U.S. elections next week, has issued a preliminary report that concludes favoritism in the major media gives Obama a “hidden advantage.” Meanwhile, Melanie Phillips of the UK’s Spectator exposed Obama’s longstanding close ties to communists, racists, and other extremists, as well as the refusal of the U.S. media to investigate the candidates’ background, in two recent articles.

One American journalist, ashamed of his profession, blames short-sighted, self-interested editors for the media bias:

In other words, you are facing career catastrophe – and desperate times call for desperate measures. Even if you have to risk everything on a single Hail Mary play. Even if you have to compromise the principles that got you here. After all, newspapers and network news are doomed anyway – all that counts is keeping them on life support until you can retire.

And then the opportunity presents itself: an attractive young candidate whose politics likely matches yours, but more important, he offers the prospect of a transformed Washington with the power to fix everything that has gone wrong in your career. With luck, this monolithic, single-party government will crush the alternative media via a revived Fairness Doctrine, re-invigorate unions by getting rid of secret votes, and just maybe, be beholden to people like you in the traditional media for getting it there.

And besides, you tell yourself, it’s all for the good of the country . . .
While I believe there is probably truth both in this explanation and in the problem of “liberal media bias,” let me propose an alternative hypothesis just for fun: the media are scripting the story of Barack Obama according to the celebrity template – build him up and tear him down. They resist any attempt to examine the celebrity’s shortcomings at this stage of the story because they know that the first act must end in triumph. Obama must win the election and perhaps even move into the White House before negative information can be entertained. The media have invested too much in this narrative to risk endangering the dramatic impact with a premature scandal. But, should Obama become President, I predict that before the end of his first term someone in the media will break away from the pack and launch the scandal storyline. That’s just what the media do to celebrities.

And that’s what usually happens to messiahs, as well. In fact, there are great similarities between the messiah storyline and the celebrity storyline – that’s the whole premise of Jesus Christ, Superstar.

I will leave you with this Tleilaxu epigram from Frank Herbert’s 1969 novel, Dune Messiah:

Here lies a toppled god –
His fall was not a small one.
We did but build his pedestal,
A narrow and a tall one.