Thursday, May 2, 2013

Wonky Wankers

Oh, no! A randomized controlled trial reveals that when poor people get medical insurance because they won a lottery, they don't instantaneously shed their ravaged, neglected bodies and become pictures of robust good health overnight. The wonkosphere is going nuts. Pseudoliberals worry that the "bombshell" results of an Oregon study on insured and uninsured poor people could put a damper on Obamacare's Medicaid expansion. Republican nihilists are crowing "we told you so" -- you give a bunch of takers gummint health care and they still get sick, so why waste money on them?

No matter that 10,000 lucky ducky Medicaid sweepstakes winners reported feeling a whole hell of a lot better mentally, just knowing they no longer had to pick between going to a doctor and eating. They may feel better, but they still have diabetes, hypertension and high cholesterol. The punditocracy is shocked, shocked that after lifetimes of living on the edge of mortality, the Medicaid study group did not immediately regain its health when accessing health care. These policy experts are not taking into account the continuing poor diets of the poor, that often the only food affordable to them is laden with sugar, salt, fat and chemicals. They're not taking into account the irreversible effects of environmental pollution on people. They're not taking into account the lingering, unaddressed scourge of income disparity. They are of the exceptional American mindset that a pill and a doctor visit should cure everything, overnight.

Zeke Emanuel, former health care advisor to the Obama Administration, calls the study results, published in the New England Journal of Medicine, "disappointing" -- not inconclusive, mind you! --which means they'll have to tinker with "the system." (code, probably, for privatizing it.) This is what happens to physicians when they turn into deficit-obsessed technocratic policy wonks, controlled by numbers instead of focusing on real people.

Slate's Ray Fisman writes:
Now that the clinical results have started to come in, it’s time for liberal media types like myself to eat some humble pie. Today’s New England Journal article presents a set of findings showing that Medicaid had no effect on a set of conditions where you would expect proper health management to make a difference. There are effective treatment protocols for hypertension, cholesterol, and diabetes, yet insurance status had no effect on blood pressure, cholesterol levels, or glycated hemoglobin (a measure of diabetic blood sugar control).
(Liberal media types like Fisman obviously buy into the insta-cure messages spewed over cable by Big Pharma snake oil salesmen.)

Conservatives, of course, are gleefully twisting the study results into their own toxic pretzels. They argue that since expanded Medicaid coverage means more people will finally be diagnosed with disease, it naturally follows that Medicaid actually makes people sick! The Cato Institute's Michael Cannon writes that the Oregon study should throw a huge stop-sign in front of Medicaid expansion:
There is no way to spin these results as anything but a rebuke to those who are pushing states to expand Medicaid. The Obama administration has been trying to convince states to throw more than a trillion additional taxpayer dollars at Medicaid by participating in the expansion, when the best-designed research available cannot find any evidence that it improves the physical health of enrollees.
The study itself is unfortunately behind a paywall. But the lead author does caution about reading too much into it, suggesting we need to take the long view, that other studies show that people's health improves over time when given adequate medical care.

Tell it to the politicians. One side of the duopoly panics and caves, the other side smirks, and the private insurance predators controlling both parties laugh all the way to the bank.


James F Traynor said...

I read the summary and noticed that there was a significant increase in the detection and control of diabetes in the two year period. Over time this alone would, I think, most likely decrease the frequency and severity of effects due to diabetes within the sample. Coupled with the decrease in depression, this alone would seem to justify the program in the long term (longer than two years), but as long as it did not decrease the incidence of ingrown toe nail I would expect it to denigrated by the 1%, their hangers on and representatives in the media.

Fred Drumlevitch said...

Yes, @Karen (and all), what temerity of poor people to "take advantage" of health care when finally available, and not be immediately healed! Next thing I expect from the right wing is for them to assert that any failure of health to immediately improve is a sign that God wants the poor to be sick, and that any attempt to provide adequate health care to the populace is meddling with those divine intentions.

Some local (Arizona) angle to it all, complete with absurd Republican pronouncements:

Denis Neville said...

You are so right, Karen: “They'll be waving this study before the cameras to justify gutting Medicaid the same way they used Rogoff & Reinhart for their austerity crusade. I doubt many of them will even bother reading it.”

Everyone knows that a funeral is cheaper than health care. So fuck off and die.

They just don't care. They just want to slash Medicaid. Doing so will create an even harsher society. That's too bad, but that's the way that their God made the world. Those who have Medicaid now, or hoped to have access to Medicaid under the Affordable Care Act, will be further shafted by Republican state governors.

What kind of society would try to actively disprove the value of caring for the health of its citizens?

"One of the greatest dignities of humankind is that each successive generation is invested in the welfare of each new generation." – Fred Rogers, The World According to Mr. Rogers: Important Things to Remember

Zee said...

"Oh, No!"

Not another single, isolated "study" that is seized upon by one "side" or the other--or even both sides at once--as proof positive that this, that or the other policy is HUGELY WRONG or a WASTE OF TAXPAYER DOLLARS and MUST be changed by 180 degrees if the nation is to be saved!

Honest to God, it's like watching five-year-olds play soccer: everyone just races after the ball with no sense of training and the overall picture.

American policy these days seems to be governed by the results of whatever poll or "study" is published today, in never-ending knee-jerk fashion.

This week it's the JAMA study, and last week it was the paper that purportedly "debunks" the Reinhart-Rogoff study. What will it be next week?

What everyone seems to be overlooking here is the tragedy of some 90,000 Oregonians being eligible for Medicaid, but the state having funding for only 10,000 of the eligible.

And then to hold a "lottery" to select the lucky 10,000! Life has been reduced to a Shirley Jackson short story.

Although 90,000 applications is a lot of applications to sift through, one might have thought that some form of triage might have been performed, instead of relying on random chance.

But better still would have been to have funding for all the needy.

Oh well, I'm sure a lottery was cost-effective.

Denis Neville said...

Predictable statistically illiterates are rising to embrace the Oregon Medicare study data.

Charlie Pierce, “In Which I Throw Up My Hands Because Simply Throwing Up Is Indiscreet,” Megan McArdle “talked to her blender,” – “Glycated hemoglobin! I might as well be one of the adults on Charlie Brown going wawawawawawa . . . and you fell asleep, didn't you?”

“Medical statistics will be our standard of measurement: we will weigh life for life and see where the dead lie thicker, among the workers or among the privileged.” – Rudolf Virchow, 1848

Zee said...


I do believe that Arizona State's Republicans are even nuttier than ours here in New Mexico. (Not that New Mexico's Democrats are any better, in their own distinctive, ethnically partisan ways.)

"Sen. Kelli Ward, R-Lake Havasu City, called the care provided under Medicaid 'substandard,' and said entitlement programs like this 'disincentivize the poor from improving themselves.'"

So, according to this Arizona State Senator, because Medicaid health care is "substandard," [his/her choice of words, not mine], the options should be "improve yourselves or die and leave us alone?"

Whatever happened to Dubya's compassionate conservatism?

Zee said...


An interesting personage, this Rudolf Virchow. His history is food for thought on a number of levels, at least for me.

From Wikipedia this quote from Virchow himself:

“Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution... The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction.”

From the same Wikipedia article,

‘Virchow made himself known as a pronounced democrat in the year of revolutions in Germany (1848). Earlier the same year, the government-employed doctor Virchow was asked to investigate an epidemic of typhus in the poverty-stricken area of Upper Silesia by the Prussian government. His political views are evident in his Report on the Typhus Outbreak of Upper Silesia (1848), where he states the outbreak could not be solved by treating individual patients with drugs or with minor changes in food, housing, or clothing laws, but only through radical action to promote the advancement of an entire population, which could only be achieved by "full and unlimited democracy" and "education, freedom and prosperity". ‘

But perhaps most interesting of all is the “sausage duel” with Bismarck:

“As a cofounder and member of the liberal party (Deutsche Fortschrittspartei) he was a leading political antagonist of Bismarck. He was opposed to Bismarck’s excessive military budget, which angered Bismarck sufficiently to challenge Virchow to a duel in 1865... Of the two versions, one has Virchow declining because he considered dueling an uncivilized way to solve a conflict. The second has passed into legend, but was well documented in the contemporary scientific literature. It has Virchow, having been the challenged and therefore entitled to choose the weapons, selecting two pork sausages, a normal sausage and another one, loaded with Trichinella larvae. His challenger declined the proposition as too risky.”

It always helps to be familiar with one’s weapons.

Zee said...

Rolling on the floor, laughing my ass off!

"Barack Obama has once again dropped all pretenses of being a progressive president by nominating Penny Pritzker—a major campaign contributor with a personal fortune estimated at $1.85 billion and a history of dogging bank regulations—to head the Commerce Department."

Whataguy! Bought and paid for from the start! Just like any good Republican!

Fred Drumlevitch said...


I won't say that "compassionate conservatism" has always been a complete oxymoron, but under Republican politicians at least including and after Reagan, that has been the state of affairs. I will readily admit that many Democrats haven't been much better --- and it's really sobering/disgusting to realize that many contemporary Democrats either outright take positions to the right of Eisenhower and Nixon ones, or perhaps worse, talk decency for the people but cast their votes (and appointments) for a corporate agenda.

And yeah, that Obama nomination of Penny Pritzker to head the Commerce Department certainly falls into that category. As did, among others, his nominations of Jeffrey Immelt, CEO and Chairman of G.E., to the Economic Recovery Advisory Board, and as chairman of the Council on Jobs and Competitiveness. From Wikipedia: "Despite this, in July 2011 Immelt's General Electric announced that it is in the process of relocating its X-ray division from Wisconsin to China.[18][19] Immelt had previously referred to China as GE's 'second home market'.[18]"

@Zee and @Denis:

Thanks for bringing up Rudolf Virchow. Certainly his views on the link of public health to the economic well-being of the populace remain relevant today. But his "sausage duel" proposal to Bismark also seems still useful. Perhaps it could be employed in contemporary budget negotiations!

Kat said...

Excellent point, Zee-- our lurching around from solution" to "solution". Yes, I am in full agreement with Virchow-- it is the inequality (and not even just poverty as problematic as that is.)
Probably you have all read the news about increases in suicide among baby boomers. Predictably, there are calls for more aggressive screening. You need only think about this "solution" for 2 seconds to realize how utterly ridiculous it is. Suicides are on the rise-- and in the past when the rates were lower we had more effective screening?

Denis Neville said...

Karen, excellent comment today @ Krugman, re: the number one crisis in America: unemployment…

“They're economic terrorists. And they have blood on their hands. Our national suicide rate has gone up a shocking 30% in the past decade, in large part because people's lives have been destroyed by the economic mafia, aided and abetted by their political minions and media hacks.”

I am reminded of my favorite character in Graham Greene’s book The Comedians, Dr. Magiot. Standing over the body of a government minister who committed suicide out of fear, Dr. Magiot observes, "Violent deaths are natural deaths here. He died of his environment."

Suicide rates among middle-aged Americans have risen sharply:

Chris Floyd: “four little words that capture the grand, overarching political philosophy of the age: Fuck Off And Die”

Their violent deaths are natural deaths. They died of their environment.

Karen Garcia said...

Thanks, Denis. Forgot to copy and paste on the blog last night. Here it is:

There was, very tellingly, not one question at this week's presidential news conference about the number one crisis in America: unemployment.

The propaganda courtiers of the national media are probably still too hung over from their co-respondents' ball to notice that the entire nation has been hung over for a very long time. When you socialize with the people you're supposed to hold accountable for their failure to address issues affecting real people, you tend to lose sight of the big picture.

Low inflation? Sitting on cash? Meh. It's just what the plutocracy doctor ordered, especially since the cash is coming straight from the public treasury. A new joint study by Campaign for America's Future and the Institute for Tax Studies shows that the CEOs of Pete Peterson's Fix the Debt cabal of pathological hoarders raked in more than $1 billion in taxpayer-funded bonuses last year under the stock option loophole. They call it a performance bonus. It's more like grand theft.

They're the paranoid plutocratic preppers. They're economic terrorists. And they have blood on their hands. Our national suicide rate has gone up a shocking 30% in the past decade, in large part because people's lives have been destroyed by the economic mafia, aided and abetted by their political minions and media hacks.

The only inflation we have to fear is the collective inflated ego of the oligarchs. "Nothing exceeds like excess" -- they say it loud and they say it proud.

Kat said...

Denis-- I loved that line too!

Actually, it's funny you mentioned it because I think a more Graham Greene world view is what we need, don't you think? I think it ties into Zee's point.

James F Traynor said...

A Graham Greene world is what we have. One of my favorite authors.

Miss Sarcasm said...

@Denis, suicide rates up

Did you see this story in the New York Times? Suicide Rates Rise Sharply in U.S.

"Suicide rates among middle-aged Americans have risen sharply in the past decade, prompting concern that a generation of baby boomers who have faced years of economic worry and easy access to prescription painkillers may be particularly vulnerable to self-inflicted harm."

Also on Reuters and the Denver post

Suicide make sense to people who are alone, have no money, no real prospects, and let’s face it, aren’t getting laid anymore. What’s the point of dragging out a bad ending?

A friend and I discussed suicide, the friend thinks taking 10 Tylenol tablets will do it; I say that only wrecks your liver. You need a cyanide pill, like the nazis used.

The other day, sitting in my vehicle in the garage, I thought just running the motor with the door closed is supposed to do it, right?

However there is an alternative for middle-age people, the educated and formerly valued citizens, now cast aside by the F-ING CRIME SPREE that passes for government. We need to form our own mafia, a middle-age mafia and fight back. It may cost your life, but its better than suicide. Why waste your death in a nursing home or hospice?

Justice Brandeis in Olmstead v. United States, 277 U.S. 438 (1928)

"if the government becomes a lawbreaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. To declare that in the administration of the criminal law the end justifies the means—to declare that the government may commit crimes in order to secure the conviction of a private criminal—would bring terrible retribution. Against that pernicious doctrine this court should resolutely set its face."

Will said...

This article Denis linked us to yesterday (?) by Chris Floyd ( ) and Miss Sarcasm's latest comment about suicide rates are 2 of the most honest things I've read in a while. (Those & every single post by Karen, of course.) Thanks, you guys. You make living in this piece-of-shit world almost bearable. Almost.

Have a nice weekend. :)

Stev-o said...

I ditto Will's comment. I must admit that my life in Vermont is perfect for me, but that does not mean I do not care about what happens outside, because in many cases I feel as though VT is in a world to itself. Not that we do not have our problems, we do, but the real world just seems so far away and unreal. Perhaps it is our total immersion in the Natural World - just saying. I so enjoy reading any updates by Karen and of course the comments are always over the top. It is great to know there are people out there who look at things the same way that I do.

James F Traynor said...

Screw suicide. If it comes to that for me, and I very much doubt that will happen, I will, judiciously, make up a list of my own and proceed down it until I am eliminated. I'm all in favor of a useful death.

Kat said...

Yes Stev-O I take your point about immersion in the natural world and Vermont seeming to be a world unto itself.
And yet, in some ways it represents the very worst of capitalism.

Pearl said...

A most interesting series of comments to your latest column, Karen. Instead of talk of suicide for oneself, why not join others in trying to pass regulations allowing doctors or helpers for people who are ill and in pain with no hope of improvement, to have the choice of dying peacefully with assistance and no repercussions.

This is something of interest to me, seeing how members of my family should not have had to needlessly suffer in their final days and at my age I also worry and wonder about how things will end. I have an explicit living will and my son who has my health power of attorney supports my wishes.

It is sad that people who might otherwise live for a while, are taking their lives when things go wrong. There should be more support from their communities, both physically and emotionally to avoid such tragedies.
But of course, the indecency of how the country is being run is the first order of business to expose and attack.

In regard to the mishandled health care system, the controversy about so called 'needless"? (and expensive) tests for women (mammograms, pelvic exams) and men (prostate blood tests, etc.), involves questions as to why they should be cut back with arguments on both sides. I think it leans in favor of the system cutting back on those expenses and letting some people die as a result in order to prevent profits from being cut back instead.

Denis Neville said...

Pearl said...”Instead of talk of suicide for oneself, why not join others…”

According to Kay Redfield Jamison, Night Falls Fast/Understanding Suicide, “Decisions about suicide are not fleeting thoughts that can be willed away in deference to the best interests of others. Suicide wells up from cumulative anguish or is hastened by impulse; however much it may be set in or set off by the outer world, the suicidal mind tends not to mull on the well-being and future of others. If it does, it conceives for them a brighter future…A young chemist, before committing suicide, put it succinctly, ‘The question of suicide and selfishness to close friends and relatives is one that I can’t answer or even give an opinion on. It is obvious, however, that I have pondered it and decided I would hurt them less dead than alive.’”

“Hope now, - not health, nor cheerfulness,
Since they can come and go again,
As often one brief hour witnesses, -
Just hope has gone forever.” - Edward Thomas

Jamison writes, “Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense, and unpalliated. There is no morphine equivalent to ease the acute pain, and death not uncommonly is violent and grisly. The suffering of the suicidal is private and inexpressible, leaving family members, friends, and colleagues to deal with an almost unfathomable kind of loss, as well as guilt. Suicide carries in its aftermath a level of confusion and devastation that is, for the most part, beyond description.”

Shakespeare, writing of the suicide of Mark Antony, said it best: “The breaking of so great a thing should make/ A greater crack: the round world / Should have shook lions into civil streets,/ And citizens to their dens.”

Jamison asks, “Where is the public concern and outrage?” “How little value our society puts on saving the lives of those who are in such despair as to want to end them.”

“Look to the living, love them, and hold on.” – Douglas Dunn, “Disenchantments”

“Night falls fast.
Today is in the past.
Blown from the dark hill hither to my door
Three flakes, then four
Arrive, then many more.”
- Edna St. Vincent Millay

spreadoption said...

A citizen army of the terminally ill.

Think about that.

Put an exclamation point on the end of your life! Take that last stand you've always dreamed of.

New recruits ever available, willing, and eager.

Zee said...

All this talk of suicide is depressing me.

Time to lock up the guns for the night.

Miss Sarcasm said...

@ spreadoption, Take that last stand you've always dreamed of.

While I hear your justified frustration, inviting anarchy (as Justice Brandeis predicted would happen) is not the answer. But someone, or some group, could put an exclamation point on rising suicide rates by creating writing paper for suicide notes, perhaps with a message to Pres. Obama and the rest of our crime spree government.

Zee said...


That was an attempt at levity during the discussion of a dark subject.

No worries here except for the usual concerns about the collapse of American society.

Jay - Ottawa said...

I'm watching a nation commit suicide.

Will said...

"No worries here except for the usual concerns about the collapse of American society."

Thanks for making me spill a little of my morning coffee, Zee. I'm still giggling as I write this. :)

Pearl said...

Denis: the quote you included from Jamison about understanding suicide in response to a sentence of mine was a very dark approach in which the
depressive thoughts of people who felt hopeless enough to end it all did not deal with the possibilities for change. Most people who wish to commit suicide (other than the extremely mentally ill) feel isolated, unsupported and do not know how to get out of their unbearable misery. No matter how dark their thoughts, if they are able to connect with a support system that
has the means to help them deal in other ways with their problems and
reactions it does make a difference. I know this sounds simplistic but I
also know first hand that this is vitally needed to save lives which can become productive.

Of course, as you know from dealing with the health system, such help is not available easily and indeed, psychiatric patients who are able to leave institutional care, have very little support financially, medically or emotionally when they are on their own.

When I made the statement about turning around to assist another area of need, I meant it for some of you who were making comments about depression and suicidal thoughts to perhaps think of supporting another area of great need. There is increasing pressure to make it possible for ill and/or old
people to have support in more than one state for legal and compassionate
ways of allowing this choice to be available as it is in some other
countries. And this is not as complicated a challenge as in those who end their lives needlessly, often at a young age.

Cutting back on the less than ample help for people in emotional trouble in the era of sequesterism is tragic.There is much to do to to bring these facts to the public. A few more health cutbacks to the health care system will begin to percolate some reaction before long and it has already started.

Zee said...


I'm glad that I could give you a good, morning laugh!

Best wishes!

Kat said...

Critics of routine mammogram screenings are up against a lot of powerful interest groups. After all, there is a reason that diagnostic equipment maker GE donates to the Komen foundation.

Kat said...

Here's what I'm talking about as far as needing a more Graham Greene view of the world:
This is from the NYT, a story about an "urban garden evangelist" form south LA:
then, Mr. Finley has been thrust into the unlikely role of pavement-pounding Johnny Appleseed. His talk has received almost 900,000 views on TED’s Web site and his message that edible gardens are the antidote to inner-city health issues, poverty and gang violence (“if you ain’t a gardener, you ain’t gangsta,” he told the crowd) has gone supernova.
I think it's great he's planting community gardens-- and glad that he's including flowers too. And I'm sure residents will appreciate the veggies but those expectations! They need to be dialed back. Why do we think that we have to find a magic bullet to every problem when talking about poverty. We certainly accept "well, this is the best we can do" when it comes to "solutions" to the problem of our criminal banker class.

Zee said...


If you're still following this thread, could you elaborate further on what a "Graham Greene attitude" towards the world would constitute?

I have never read a novel by Graham Greene, though thanks to your--and Denis'--prompting, I am adding that to the library reading list.

And the Wikipedia article about him has also sparked my interest.

Based on what I have read ABOUT him, it sounds as though his outlook might be that there is only so much than anyone can do about this, that or the other social or political "problem," and that tinkering further may well produce negative results that were neither desired nor foreseen, as opposed to the starry-eyed results that were so exuberantly predicted.

Fred Drumlevitch said...

@Kat (and everyone):

Along with @Zee, I too could use some clarification on the "Graham Greene view of the world" statement.

Quite aside from that, while I do think that Mr. Finley should be applauded for his grass-roots initiative and organizational skills, I do hope 1) that he is genuine, that is, that he currently is and will remain committed to community improvement much more than personal aggrandizement and 2) that he and members of his project have sufficiently acquainted themselves with what must be done to eliminate the hazards of urban gardening --- specifically, the frequent presence of hazardous levels of lead and other toxins in urban soil.

Either of those potential issues could make the real lesson "no good deed goes unpunished".

Denis Neville said...

@ Zee and Fred - Graham Greene “attitude towards the world”

From my perspective, having lived and traveled in South America, it is Greene’s understanding of the politics of poverty in Latin America.

Once asked what drew him to Latin America, Greene answered, "In those countries politics have seldom meant a mere alteration between rival electoral parties but have been a matter of life and death."

Greene was on the side of the poor and the oppressed. He understood their suffering and their hope.

Dr. Magiot, my favorite character in Greene’s The Comedians, somehow maintained a faith in a just society in the face of great adversity. Such beliefs reflected Greene’s own faith.

Greene once wrote, “The enemies of the church in Cuba are not the Communist leaders. They are Cardinal Spellman and Bishop Fulton Sheen, those doughty champions of cold war and counter-revolution, churchmen for whom Pope John XXIII seems to have lived in vain."

Greene's characters are protests against injustice.

In The Comedians, Greene writes of the Haitian priest whose words are call for the church to take a stand on behalf of the poor and the oppressed:

“The Church is in the world, it is part of the suffering in the world, and though Christ condemned the disciple who struck off the ear of the high priest's servant, our hearts go out in sympathy to all who are moved to violence by the suffering of others. The Church condemns violence, but it condemns indifference more harshly. Violence can be the expression of love, indifference never. One is an imperfection of charity, the other the perfection of egoism. In the days of fear, doubt and confusion, the simplicity and loyalty of one apostle advocated a political solution. He was wrong, but I would rather be wrong with St. Thomas than right with the cold and the craven. Let us go up to Jerusalem and die with him.”

When once asked if he felt "hounded by God," Greene replied, "I hope so. I hope so. I'm not very conscious of His presence, but I hope that He is still dogging my footsteps."

James F Traynor said...

I don't pretend to be knowledgeable about Greene, at least not in the academic sense, but I have read eight of his novels. And I've ordered "Getting to Know the General". Read bits of this and always wanted to read the original (cost used $2.00 + $3.00 shipping and handling).

Greene was everybody's bête noire, an embarrassing man. An admitted sinner,incorrigible and repentant at the same time. Approved of neither by Bill Buckley or John le Carré. We nor the Russians liked him, denied a US visa. AND, FOR HEAVEN'S SAKE, THE OPIUM!

A better man than me; I don't forgive my enemies.

Kat said...

I would say yes to what you say and yes to Denis too.
I was thinking of two characters from The Comedians-- a married couple who plan to help the Haitians with of all things, a vegetarian center. The narrator looks upon such schemes with a jaundiced eye. How will a vegetarian center help in Haiti when the whole system is rotten? He awaits their disillusionment. At the end of the book he acknowledges that as misguided as they are, they are two of the kindest people he's met. And so, they are not misguided.
Anyway, that's one thing I got out of the book.

Zee said...

Thanks, Kat.

I think that I know a few people like the "vegetarian center" characters myself.