Blogito, Ergo Sum - 28 November 2008

The surprising news made headlines in December 2002. Generic pills for high blood pressure, which had been in use since the 1950s and cost only pennies a day, worked better than newer drugs that were up to 20 times as expensive.

The findings, from one of the biggest clinical trials ever organized by the federal government, promised to save the nation billions of dollars in treating the tens of millions of Americans with hypertension — even if the conclusions did seem to threaten pharmaceutical giants like Pfizer that were making big money on blockbuster hypertension drugs.

Six years later, though, the use of the inexpensive pills, called diuretics, is far smaller than some of the trial’s organizers had hoped. ...

The aftereffects of the study show how hard it is to change medical practice, even after a government-sanctioned trial costing $130 million produced what appeared to be solid evidence. ...

“The pharmaceutical industry ganged up and attacked, discredited the findings,” Dr. Furberg said. He eventually resigned in frustration as chairman of the study’s steering committee, the expert group that continues to oversee analysis of data from the trial. One member of that committee received more than $200,000 from Pfizer, largely in speaking fees, the year after the Allhat results were released.

As far as I've been able to tell from my experiences in life, "follow the money" always applies.

I've been through several blood pressure drugs in my lifetime and I've finally found one that works for me without any allergies, candesartan, marketed (down here, at least) as Blopress Plus, meaning it includes a diuretic with it, so I'm reluctant to make any changes even though I'd love to get rid of the expensive drug. My last couple of allergic reactions to different blood pressure drugs was on the scary side. And, yes, it's manufactured by Pfizer.

On the other hand, I also know that a lot of my blood pressure problems are, and have always been, associated with my weight. I should weigh 173, according to every chart and schedule in the entire world, calculated every way from go, BMI and NYL (insurance), but I'm constantly fighting to get below 200 lbs and only occasionally succeeding. Right now I'm under perfect control, 120/74 the other day, but I'm also just above the 200 mark. I'm hoping that if I ever do get to 173 on my present diet that I can first cut my candesartan in half and then eliminate it entirely, as well as the diuretic.

I don't know for sure because I haven't seen 173 since I was a teen-ager, but I'm currently well-motivated on the Atkins diet and I've got high hopes this time.

A Land Rush in Wyoming Spurred by Wind Power

By FELICITY BARRINGER

Residents are forming associations to bargain with developers looking to buy land rights for wind farms.

India’s Suspicion of Pakistan Clouds U.S. Strategy in Region

By JANE PERLEZ

The attacks seem likely to sour Indian-Pakistani relations and hamper, at least for now, U.S. goals for reconciliation in the region.

Come on, now, admit it honestly...have you ever wondered what kind of world it would be if all of the Arabs, Pakistanis, Palestinians and Iranians lived on another planet?

What's that? Why stop there? Ah, yes, that's the problem, isn't it. But I'll bet you still wondered, didn't you...

Paul Krugman answers the question "why didn't we see this financial crisis coming?" but not mine:

One answer to these questions is that nobody likes a party pooper. While the housing bubble was still inflating, lenders were making lots of money issuing mortgages to anyone who walked in the door; investment banks were making even more money repackaging those mortgages into shiny new securities; and money managers who booked big paper profits by buying those securities with borrowed funds looked like geniuses, and were paid accordingly. Who wanted to hear from dismal economists warning that the whole thing was, in effect, a giant Ponzi scheme?

My question is: why aren't the people who made all this money the people who are losing it back today? It seems to me that THIS is the big problem...the winners only win, they don't pay off when they lose. That's not a gamble, that's a good business plan. Any CEO who wouldn't follow this plan is incompetent.

...because we’re all so worried about the current crisis, it’s hard to focus on the longer-term issues — on reining in our out-of-control financial system, so as to prevent or at least limit the next crisis. Yet the experience of the last decade suggests that we should be worrying about financial reform, above all regulating the “shadow banking system” at the heart of the current mess, sooner rather than later.

Ah...a lack of regulation on the shadow banking system. That should be right up the Democrat's alley, shouldn't it? What's that? Barney Frank prevented the regulation of Fannie and Freddie? I mean, who knew? He's still right up there in front these days, puffing out his chest proudly. So is Rep Jefferson and Rep Murtha, the unindicted co-conspirator. Yeah, we can trust them.

The truth about Obama's worldview was hidden in plain sight in his most politically consequential foreign policy speech. Antiwar Democrats cheered Obama for addressing a rally against the Iraq war in Chicago's Federal Plaza on Oct. 2, 2002. His opposition to the war was a major asset in his nomination struggle with Clinton.

Obama did indeed denounce the impending war as "dumb," "rash" and "based not on reason but on passion." But in retrospect, the speech may be most notable for other things Obama said that separated him from some in his antiwar audience.

Not once but five times did Obama declare, "I don't oppose all wars." The first several paragraphs of the speech were devoted to the wars that Obama thought were justified: the Civil War, World War II -- in which, he said, "that arsenal of democracy . . . triumphed over evil" -- and the battle against terrorism after the attacks of Sept. 11. "I would willingly take up arms myself to prevent such tragedy from happening again," he said.

The thrust of his argument against the Iraq invasion was a classic realist's critique of a war he denounced as "ideological." It would, he said, "require a U.S. occupation of undetermined length, at undetermined cost, with undetermined consequences." It also would "fan the flames of the Middle East" and "strengthen the recruitment arm of al-Qaeda."

They just came up short when they stopped there. Because while all of that is true, it is neither complete nor the end of the story.

Like it or not, we are in an ideological war; militant (at the least) Islam against the Western world. Remember the old chant? "We’re here; we're queer; and we're IN YOUR FACE!" Well, that's the jihadists in a nutshell. Soft talk and diplomacy have no effect on this kind of thinking, because there is only one thing that they really want and we cannot afford to offer it to them: total victory.

We still don't want to face up to that unpalatable fact, but it's not going away.

The war did fan the flames in the Middle East and recruit for al-Qaeda, but victory has doused a lot of those flames (Khadaffi, most notably) and uncounted thousands of al-Qaedans have been killed. More importantly, al-Qaeda lost "face" in Iraq by losing, as well as making enemies of the Iraq Sunni, in particular, their fellow religionists. Iraq turned out to be a disaster for al-Qaeda, and most importantly the loss of Baghdad! You cannot believe how central Baghdad is to their desire to restore the Caliphate. Winning in lots of other places doesn't make up for losing there.

A democratic government in Iraq is a pearl beyond price, and it's vital that we preserve and protect it. Obama is said to be intelligent, so perhaps now what he is elected he will be able to forget past rhetoric and look fully at the situation he faces.

Imagine what the world would be like if Iran was as fully democratic as Iraq, for instance, and not ruled by religious fanatics. They aren't crazy, don't get me wrong, but they ARE fanatics. Politicians negotiate; fanatics do not. Politicians are always willing to pragmatically settle for part now, hoping for the rest later; fanatics are not.

It is also a step backwards into a time which no longer exists. GHWB decided to end the first phase of the Gulf War after the magical round number of 100 hours had been attained, as if it were some kind of board game, and Powell went along with that foolishness because few Americans had been killed at that time and that sounded good to them. I think it's childish to make military decisions because of round numbers on a clock.

GHWB and Powell settled for a negotiated cease-fire which left the loser, Saddam, with entirely too much power. If there was a lesson to be learned from Vietnam, that was certainly it: do not make that mistake again. Cease-fires inevitably and invariably are breached. Name just one which has lasted. Are you going to tell me that GHWB and Scowcroft and Powell were too dumb to know that? Innocent or conceited enough to believe that theirs would be the world's first one which worked?

GHWB fought half a war, deferring the other half for the future while little realizing he was setting the table for his own son. Bill Clinton spent his entire 8 years banging the drum about what a bad man Saddam was and how his regime had to be overthrown and replaced by a democratic government. His entire administration supported him on that. So did a majority in Congress. But Clinton did not do anything about Saddam.

Most interesting of all, a lot of Bush haters seem to have no idea about what the Clinton administration had said all that time.

Well, it's a crazy old world, and you never know when it's your time to die, or how:

NEW YORK -- A worker died after being trampled by a throng of unruly shoppers when a suburban Wal-Mart opened for the holiday sales rush Friday, authorities said. ...

A police statement said shortly after 5 a.m., a throng of shoppers "physically broke down the doors, knocking (the worker) to the ground." Police also said a 28-year-old pregnant woman was taken to a hospital for observation and three other shoppers suffered minor injuries and were also taken to hospitals.

Nice people in New York I hope they had security cameras trained on the door.

...let's not forget any differences between Mr. Obama and Bill Clinton -- since no matter how many promises to the contrary, he will be co-secretary of state.

Speaking of Bill, Mr. Obama famously noted during the primary that it was time to move beyond the Clinton era. Instead, he's dragging that baggage back into the White House living room. The Obama team is combing through the hundreds of thousands of donors to Mr. Clinton's foundation. Those papers surely contain compromising conflicts. There was good reason the Clintons have always refused to make that information public.

Mr. Obama can now sit on those documents, renege on his pledges to be one of the most "transparent" presidencies in history, and endure the rightful outrage that will follow. Or he can release them, and guarantee a feeding frenzy. Either option will prove an unpleasant side story to his more pressing policy concerns. And that's just the immediate issue. There are also the 1990s Clinton documents, which remain under wraps at the Clinton library, but not forever.

Having made the grand gesture, Mr. Obama can now only get rid of Mrs. Clinton at risk of another party rift. The president-elect now owns Mrs. Clinton's past, and future, behavior. That could turn out to be some deal.

The people who promise transparency are the ones who mean it the least. Because they can afford it the least.