Wednesday assorted links

1. American doctors are too educated.

2. Bloomberg column by me on Trump and ideas.

3. “Academia is a temple of dopamine.”  Link here, by the way I don’t agree with this.  And LambdaSchool.  They teach you skills, and get a small share of your future earnings.

4. My Sept.19 Conversation with Eric Schmidt, in San Francisco, apply for an invite at the link.

5. Lee Ohanian and Hoover have a new blog, California on Your Mind.

6. “Now the Wisconsin Agricultural Tourism Association says Wisconsin has at least 150 “event barns.””  Yet regulation is on the march: “Some wedding websites caution brides to make sure their dream barn venue is safe and won’t be shut down before their big day. There are fears that old barns could collapse under the weight of dancing guests, injuries could be easy (think rusted nails and uneven boards), and fire can spread quickly without proper renovations and safety precautions. They may not be handicapped accessible and may not meet up-to-date building codes.”

Comments

Re: #1

A conclusion that could have been easily arrived at 50 years ago.

Anyway, anytime one see's some observation about faults in the U.S. approach to healthcare, one might as well be observing paint drying on a wall or even continental drift. The U.S. healthcare system has (always) been horrible, and is getting ever more horrible all the time.

I think you could say most of this about “education” in general. People are expected to spend too much time at school and the problem is getting worse and worse.

Yup. Sure. Education, in general, isn't really a problem; like healthcare, however, it's how we carry it out. With available technology tools, education could be far less resource intensive (labor, time, ivy, buildings, and underfunded pension plans).

The various education unions have a white-knuckle death grip on the system do not tolerate any change to the system other than a compensation increase.

Ditto for health care unions and associations

Anyone else notice how child sex abuse sounds like children did something wrong? And who are the men of God? Another inflection: According, Impregnating, Abusing....As Raymond Chandler wrote, the NYTimes is "calling on four million dollars."

But promotions received high service. And concealment is equated with church safety? The NYTIMES does not understand categorical imperative. The grand jury does not understand what facts mean is doing the same the church is by not saying lying. Or perverting evidence. Or distortion. They can't even properly write about investigation.

Zappa informed us as to what we already knew 40+ years ago: "Catholic Girls" off of "Joe's Garage" (1979).

Actually, just about 40 yo. Anyhooo.

It's hard to find knowledgeable people on this subject, but you sound like yyou know what you're talking about!
Thanks

I prefer the terminology "the capital crime of child sex abuse" which makes it clear that the abusers deserve to be hung by the neck until dead.

I do not like the phrase "child sex abuse" I prefer the phrase "the capital crime of child sex abuse".

Or, as others might say, "profound evil".

for the record, one realizes that this comment was basically at the level of the comments from the guy who was recently featured in the Onion for "saying that Nazis are bad"

except for the fact that I support the death penalty for people who rape other people, if they have been proven to have done so beyond a reasonable doubt. How can that be a minority opinion? How cold-hearted do you have to be to say hey let's allow the rapists back out of their cells, someday, to rape again?

You tell me?

OK I will tell you.

Either you care about other people or you do not.

Someone rapes a child, you want them dead. If you want them to live to rape again, you are cold-hearted. There is no "intrinsic dignity" of "human beings" that overrules the desire of a parent to see the rapist of that parent's child hung by the neck until dead.

Thanks for reading, I hope you already knew what I was saying. If you are a decent human being you did.

By the way, please don't argue with me. I am no big fan of Thomas Aquinas (who ate too much) or of Karol Wojtyla (who was smarter than I was in 1974 but who really did not understand the world, but he was right about the death penalty - sometimes it just needs to be applied) but if you argue with me you argue with Thomas Aquinas and Karol Wojtyla, and you will lose that argument.

ok bob.

my name is not bob 90 iq boy

my name is not bob, IYI

thanks for the laughs sarcasm dude.

try again try harder

Go on distorting the theme of Instagram and post your photos day after they've been taking. Days spent listening to the New Pornographers and looking up tatoos on google images. Days spent around stooges wearing Harley Davidson shirts who weeze as you put back another bud light, bud heavy combo.

Proverbs 7, translated into a new idiom!

epheseus 6:5

Ephesians 3:20

in case I am the guy who is being called 90 IQ boy ...

it might be as low as 85, but I think fast

there are lots of six foot tall pitchers, the average six foot tall guy throws 40 miles an hour.

I know what that was like, but I think fast, and can throw a 100 miles an hour. Velocity counts, I hope,

We all are human, we all have guardian angels, we all can say the right thing, sometimes. I have said the wrong thing lots of times, but I always think - Matilda, in the last cantos of the Purgatorio, was everything we want anyone we have ever cared about to be

Unions, and at the root of it all, fee-for-service medicine, which drives up union healthcare costs, pre and post retirement.

The U.S. healthcare system has (always) been horrible, and is getting ever more horrible all the time.

The life expectancy of someone 65 years of age has gone up about 4 years since 1970. The ratio of cancer deaths to new cancer diagnoses has declined from 0.63 to 0.36 in that time. A real horror.

A real horror?

Actually, yes. One would expect far more progress given all the wonderful developments in the life sciences since 1970, as well as portion of GNP going to healthcare going from %6 of GNP in 1970 to %18 of GNP in 2017.

Also, you've totally and completely misused cancer stats. It has everything to do with the mix of cancers, which have differing death rates. In 1970, cancers of a kind that have much higher death rates were far more prevalent.

cancers of a kind that have much higher death rates were far more prevalent.

The sites with a high death rate are as follows: brain, esophagous, pancreas, liver, lung, and ovary. Add to that acute myeloid leukemia. Leaving out skin cancers, these sites accounted for 26% of all cancers diagnosed in 1970. By 2017, the share these sites accounted for plummeted to...25%.

Some cancers are more equal than others.

The ratio of deaths to diagnoses for each site is as follows. The 1970 value is in parentheses:

Esophagous: 0.917 (0.925)
Pancreas: 0.80 (0.97)
Liver: 0.72 (0.98)
Brain: 0.70 (0.66)
Lung: 0.66 (0.91)
Ovary: 0.63 (0.70)

Your thesis doesn't work.

The war is over. Nixon won.

And to the extent that there has been progress in cancer (or whatever else) therapy outcomes, it has absolutely NOTHING to do with the U.S. healthcare service system and its approach and practice. It ONLY has to do with government subsidy of NIH research, without which the private sector pharma and biotech, as well as the healthcare system, would be utterly and completely lost and foundering. So, yes, Nixon did win the war--at least partially.

Keep on spinning. I'll enjoy watching you throw up.

I offer you truth. You offer nothing.

Left to its own devices, the U.S. biotech and pharma would, at least, be good at boner drugs, hair loss solutions, and cold remedies.

Oh, wait, cold remedies aren't quite there. Likewise with extensions treatments.

Oh well.

So, which continent do you travel to to get the best health care?

Africa?
South America?
Asia?
Europe?

Given you have identified the worst, you clearly have identified the better and best.

Please name the best health care systems in the world so we can adopt the health care systems that are at least better, if not the best.

Creating a huge public health system like Singapore would certainly be difficult given the opposition to private deliver with obamacare based on it being "a total government takeover of the entire US health care system."

How "huge" is the city-state of Singapore's public health system? If I recall correctly, you also have a $5,000 deductible, which would be necessary to any prudent system.

Every Canadian middle class and up purchases supplemental insurance so they don't get stuck on a 4-month waiting list for the CT machine with that nagging pain in their abdomen.

That being said, we do appear to be getting less bang for the buck in the US.

Wouldn't some sort of baseline public health care enable more job mobility and entrepeneurship? I'm surprised I haven't seen that angle addressed by Tyler or Alex that I recall.

We tried a version of this in the individual healthcare market. It’s called Obamacare and is a shitshow.

The main issue with the American health system is not that it is private but that it is a heavily subsidized corporatist system: the supply side is bounded above by a very small number of doctors who are essentially a mafia that block entry into the field by enacting these outrageous entry costs, making supply of medical services almost perfectly inelastic while the demand side is heavily subsidized by the government but that doesn't result in increase in equilibrium quantity but only in the increase in prices because supply is perfectly inelastic. Hence the US healthcare equilibrium: super high prices and low quality service.

#1) Shocker!

#1 - US doctors "too educated" but as a counterpoint, the Third World doctors I deal with are sometimes shockingly ignorant. Sure they'll deal with easy stuff but sometimes they come across as stupid. The other day one of them told me of a folk remedy to cure worms (maybe it will work, probably not, I prefer gold standard tested western medicines) and often they come across like rather crude auto mechanics.

Beware of what you wish for. In Tibet the "doctor" was a teenager with rather limited knowledge, though he did know about altitude sickness.

2.
America is now exporting the notions that corruption and intolerance are a perfectly normal part of the executive branch of government, even in the world’s No. 1 economic and military power.

Yes, the FBI and CIA are, I guess, part of the executive branch.

part of the job of the president of the global hegemon, namely America, is to put up with criticism and maintain a brave face nonetheless.

Since when? It's easy to put up with criticism when there is none, ie. BHO, at least when what little there is comes from an ignored part of the citizenry. The present executive has been a dart board for criticism since he entered the competition.

Trump's just another snowflake. The victim-in-chief!

Yes, Hillary, the DNC, the MSM, Hollywood, and the entertainment industry are destroying the reputation of the USA globally, but we are fixing that.

From the article:
"Still, all Americans have to live with these misperceptions, however unfair or incomplete they may be. In other words, part of the job of the president of the global hegemon, namely America, is to put up with criticism and maintain a brave face nonetheless. Trump has been spectacularly bad at that. Furthermore, a lot of these perceptions do ring true, such as the notion that Trump is using the presidency to enrich himself, that he engages in petty bickering, and that he simply is not well-informed about foreign affairs.

It is a truism that ideas have consequences. Nevertheless, we neglect it at our peril. "

I guess when the numbers aren't going your way, i.e. the economy is roaring, then you have to go with vague un- provable mood affiliation talk.

I did catch Trump in a lie. He said I would get tired of winning. That is a lie, I have not.

"Win baby, win." - NFL football team (Raiders) owner.

You tell 'em, hun.

The idea that Trump's tweets have harmed American innovation makes absolutely zero sense. I take issue with his trade policies, for sure, but our loss of global standing due to the perceived increase in corruption in US politics has nothing to do with the vibrancy of our capital economy. Your stupid patent napkin drawing has done more harm to American innovation than Trump's tweets, and you get a lot less press. :)

1. Supply creates its own demand: increase the supply of doctors, and it will increase the demand for doctors. But the price for doctors, not so much. There's two ways to reduce the excessive cost for doctors (health care): reduce the price or reduce the demand (consumption). The former is as easy as setting a lower price price for their services, but is as likely as Donald Trump proposing what he promised during the campaign: cheaper and better health care. The latter (reduced demand) is what Trump is actually delivering. Are doctors overpaid? It depends on whether one needs the services of a doctor. I could argue that Cowen provides a more valuable service than any highly paid specialist doctor, but that's because I don't actually need the specialist's services. When one is sick, no price is too high, whereas when one is learning, even a modest price may seem too high. Since I am making the analogy between doctors and economists, I will make the point that increasing the supply of economists will likely reduce the price of economists, unlike the case with doctors. Sure, in their dreams economists would like to believe that increasing the supply of economists will increase the demand for economists, but my observation is that Say never met an economist.

#2: It's silly to think that polls actually reflect what people think. There's a lot of posturing and virtue signaling in polls. A few years from now we will be able to really measure if Trump's influence in our "standing" (a fuzzy definition in itself) really was that bad. Not to mention that some claims in the article are simply exagerations or purely subjective ("America is now exporting the notions that corruption and intolerance are a perfectly normal part of the executive branch of government,". The way I think Trump might actually damage good ideas is by succeeding. For instance, if his tariffs turn out to have a positive effect (even if short term) that could incite other countries to impose tariffs. But this is nothing new really, we have had price controls before and that was "exported" and later all of it was proven damaging.

Pixies, fairies, unicorns and short-term benefits of an International Trade War. (Especially one impacting intermediate goods.)

You left out the male-friendly lesbian. She’d definitely get to the hundred dollar bill first.

Item 2 maps to my beliefs with some overlap, but leaving aside my greater general concern (I am not so complacent), I will take this up: "a greater emphasis on deregulation"

I for one want to keep all my IQ points, and for the next generation too.

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(16)30275-3/fulltext

Whatever else is going wrong, we are not treating environmental health risks seriously. We should, and before the endocrine-disrupting chemicals catch up with us all.

You can join up with Alex Jones and his anti-gay frog crusade.

Note that the 11 million missing IQ points may not be distributed evenly. They might for instance be clustered among those who don't understand the problem.

Oooo clever.

MDs doing Monte Carlo simulations, huge yikes.

Then doing a Monte Carlo simulation and providing an exact point estimate with faux authority. Huge f’in yikes.

There’s a reason they have not been hired as quants on Wall Street.

Since you clearly can get through the paywall, please provide the data analysis appendix.

Thanks

It is funny just to see you suddenly acknowledge that this is a real study and not Alex Jones with gay frogs.

That alone satisfies my entire argument. There are real questions of health and safety and environmental chemicals and yes we should be looking seriously at the data set.

Is that what Scott Pruitt was doing in his soundproof boot?

And like Alex Jones, you run away at the first sign of numeracy.

I’m sure chemtrails and vaccines are causing the neo holocaust.

“Asking for data is validation of my point” said the idiot. America wept.

At least you keep good company?

#1 Amen. Medical school is too selective too.
My father in-law in Honduras like many in the upper class people he wanted at least one of his children to be an MD. Unless you are an exceptionally good at school family that will probably not happen in the USA. And takes sooooooo long.

And can't we get cheaper people than even LPN's to do things take blood pressure and talk about depression, weight and test blood sugar?

A computerized machine could do all that.

I don't know why (to my observation) pharmacy school still remains a draw. A lot of pharmacy operations will be automated.

All of the Vietnamese youngsters in Southern California are becoming pharmacists. Some of their mothers claim they pull down a quarter million dollars a year, which seems unreasonable.

But under the current regime pharmacists are there to say things to you which you acknowledge and are supposed to reduce everyone else's liability.

Pharmacy seems to be the grad school of choice among cultures that esteem professional certifications for the offspring that couldn't get into medical school.

Like I said, I don't get it. Most end up working ridiculous hours for chain pharmacies and there wouldn't seem to be too many openings for VP of Pharmacists, assuming pharm's even get on management tracks. And the pill-counting and cross-referencing for interactions will be computerized in the near future.

Not long ago the highest paid employee of Hennepin County, Minnesota was a pharmacist, because of extensive overtime.

2. "When I was in Nigeria last year, a cab driver in Lagos cackled to me that 'Now America finally has a Nigerian president!'"
Everybody knows you never go full Friedman.

Let me get this straight. You want me to let my client of 15 years, one of my best friends, die in the jungle alone, for some money and a G5?
Les Grossman: Yes

Since we are into anecdotes, a friend of mine cam back from the UK about a month ago. He was buying something from a street vendor who was Arabic. The vendor noticed my friend American accent and asked about Trump, which led to a 10 min conversation on how the vendor loved Trump . Unexpected to say the least.

+1 I laughed.

#1. The author doesn't even mention the easiest way to shorten medical education which is to make medicine an undergradudate qualification.

In the US, doctors receive 4 years of medical school after 4 years of undergraduate study in an irrelevant area.

In the UK, doctors receive 5 years of medical school straight after high school and then have continued training for their first 2 years after qualification. Doctors in Britain start practicing years sooner, while actually having received more medical education.

Why you would argue for cutting down the medical education rather than the irrelevant undergraduate education is beyond me.

+1

Embrace the power of "and".

http://slatestarcodex.com/2015/06/06/against-tulip-subsidies/ is a great essay and evergreen, but if you are busy skip to section II. If you are super busy, just read this:

In America, aspiring doctors do four years of undergrad in whatever area they want (I did Philosophy), then four more years of medical school, for a total of eight years post-high school education. In Ireland, aspiring doctors go straight from high school to medical school and finish after five years.

I’ve done medicine in both America and Ireland. The doctors in both countries are about equally good. When Irish doctors take the American standardized tests, they usually do pretty well. ... There’s no evidence whatsoever that American doctors gain anything from those three extra years of undergrad.

... that means the total yearly cost of requiring doctors to have undergraduate degrees is $4 billion.

I don't actually know of any country that follows the US model. At least within Europe, pretty sure in every education/health system you go to med school straight after high school. Same goes for law school (though then law school takes 4-5 years vs 3 in the US).

It genuinely makes me wonder, is there a legal requirement that says doctors and lawyers need an additional undergrad degree? Or do law and med schools decide this on their own? Why would US schools be so obsessive about this when the rest of the world doesn't care?

The US "higher education" is not run for the benefit of the student.

It is run for the benefit of the teacher and the administrator.

If they can force you to attend for 4 more useless years, they will. They figure the USA is rich enough that they can get away with it. And so far, they are right. It does not hurt that they funnel billions in donations to one particular American political party.

So sure, we waste the time, money and energy of our doctors.... but think of the upside. Some of our econ profs get to go to Ukraine and comment about the food!

+1

The higher education system in the US is, as the first US astronauts used to call the space program, the "unscrewable pooch". No matter how bad the results are, it just keeps getting more money.

The US military is the other unscrewable pooch. We keep losing wars, they keep getting more money. Trump wants a $100M parade even.

In at least some other advanced economy countries general practitioner medical training is an undergraduate degree. Graduate study is the next stage for becoming a specialist. If someone knows that they want to become a doctor and they have all the necessary attributes and drive what's the point of having them spend four years of which at least two will have nothing to do with medicine directly or indirectly?

2. “Now America finally has a Nigerian president!”

In an odd sort of way foreigners are not upset at Trump contrary to what the NYT and WashPo and CNN would have you believe, and this is why ...People do get tired of America lecturing them about how they should run their domestic affairs... Even if they agree their own government sucks.

#4: San Francisco? Eff that. Make him come to DC.

Better yet, a strip-mall Burmese restaurant, of some sort, in Northern VA.

"1. American doctors are too educated."

Yes. Of course. Everybody knows this and has for a long time. But American doctors will fight changes for the same reason NY Cab companies fight Uber -- the current MDs spent quantities of time and money acquiring their 'physician medallions' and they're not going to tolerate reforms that would diminish their value. And doctors have a lot more status, money and political clout than do cabbies.

#1. Make Doctors Great Again? This fits perfectly with the current federal administration's war on regulations.

#1 has been obvious for forever. The best options would be:

First, get rid of the B.S. requirement. You can take all the pre-med requirements in two years and still have some time for general liberal arts. This easily can shave two years off training.

Second, as mentioned whack M4. It does very little and is of no use to anyone.

Third, completely overhaul the Step exams. You could easily cut down the pre-clinical years if it were not for the obnoxious level of detail tested on the Step exams. Covering named receptors, protein channel types, syndromes with <1/100K incidence, and the random anatomy pimping is pretty worthless. Estimates of time spent on bulk memorization for Step exams are simply insane, they do nothing to help you practice better and everyone talks about how memory purges happen right after the exams. Pretty much all the step exams do these day is feed a Red Queen scenario where ever more time and effort is dumped into relative positioning which embitters medical students (making them more likely to seek higher pay later) and sucking down instructional time.

Fourth, split medicine up. In all honesty a lot of docs simply do not need to study surgery. You will forget most things you learn there and it will not affect your practice all that much. We should follow other disciplines and divide the curriculum so people can specialize sooner.

Fifth, reduce the residency timeline. Far too many residencies last four and five years with little learning gained in the final years. This is not as useful as the other options as these physicians are basically in practice regardless, but you could do a bit better of staffing issues if they were flying solo a year sooner.

Sixth, abolish the monopoly exemptions for the National Resident Matching System and the NBME. Like all monopolies, they extract resources (cash, prestige) from their "consumers" and dramatically increase the costs of medical education. Getting past them makes it nigh unto impossible to actually design rational medical education.

Good suggestions!

>And since Trump took office, America has lost much of its global standing.

Eff yourself. Seriously.

Oh, to go back to the days when the President circumnavigated the globe giving his Apology Tour, and actively derided his own nation on foreign shores, and made it clear that if you wanted to invade your neighbor, that was fine with him. He'd even "have more flexibility after the election" to make it easier for you.

Other countries loved us then! We had such GLOBAL STANDING!

Hah - thanks for the litany of right-wing tropes! Haven't seen any of those before "Apology tour (?)" New one on me. Not!

Did you make that up yourself?

And "eff yourself. Seriously." I'd prefer it comedically!

I vote for Democrats, and the basic underlying point that TPM is making about the shallowness and idiocy of caring about the US’ global standing seems quite right to me. Trump may or may not be a good President (probably won’t be in my opinion) but the global standing of the US doesn’t mean a whole lot. It means pretty much nothing in the Middle East (and meant about that much during Obama’s presidency), it means nothing in Russia or China, it means very little in Europe or Africa. Also, it was always wealth, not freedom, that made liberal democracies attractive to most people (ie the US as the land where the streets are paved with gold). Making the US a place of broadly shared prosperity is so important in promoting democracy that almost everything else is dwarfed in comparison.

I remember saying that once Obama was President, the wars in Iraq and Afghanistan would go better, and Gitmo would be easier to shut down, because all the enemies that Bush had made among our allies would want to deal with Obama.

That was pretty foolish of me. Other countries turn out to be sophisticated actors acting in their own self-interest. "Because Bush" may have been the excuse for not helping out, but in reality they just didn't want to help out, and one Obama came around they just shifted to a different excuse.

I expect that Trump will turn out to have been a poor President when all is said and done, but not because of "global standing." "Global standing" is next to worthless for the country.

This is one of those topics where 9/11 is still relevant. Bush II wasn't particularly loved abroad, but when he got elected he wasn't hated yet either, he was just another American yokel but generally benign.

Then 9/11 happened and almost the entire world was by our side, ready to help and support us. Most either helped with or supported our efforts against the Taliban in Afghanistan. That was a good time for our 'global standing'

But then Bush and the crew fucked it all up invading Iraq. Now almost the entire world turned against us, and I doubt we'd have had much support if another 9/11-type event happened. Iraq really changed things.

Obama came in and the narrative shifted again, he made nice with the world and for the most part the world liked it. If another 9/11 happened on his watch (it did not of course) I feel the support would have been there.

Now it's Trump. What do you think happens if another 9/11 happens on HIS watch? Do we get the international support today? Maybe from Russia...

You’re right that for some reason Obama was loved by many other countries, as was Clinton and JFK, but that’s about it. I vividly recall the reaction in the UK to Nixon, Ford, Carter, Reagan, Bush 1 and 2 — all idiot country bumpkins, not at all like the Oxbridge types that Brits respect. So their reaction to Trump is just the latest iteration of the same snobbery.

It must be hard being a Trump supporter who recoils at the slightest critique of Trump. Considering there is much more critique these days thanks to social media and Trump's own unforced errors, you must an angry ball of miserable butthurt 24/7. Am I right or am I right?

#6 on the event barns is much appreciated. My local classical music outfit has annual summer concerts in a "music barn". The audience and musicians climb up an old airlines stepway to a second story loft. Everything in the building is made out of wood. The audience is mainly over 60. The only exit is the airlines stepway, or a leap from one of the loft's capacious doors.

If that place caught on fire, the conflagration would move quickly and kill many.

My brother is an electrical inspector. Whenever we go out to a restaurant or any other crowded public place, he cheerfully points out the barriers to rapid exit in the case of fire or other emergency.

Many popular urban spots are death traps. But re-purposed barns are fire-trap, death traps.

"But re-purposed barns are fire-trap, death traps."

Meh. I've been to a few barn weddings. In all of those cases, the event space was on the main floor and there were enormous barn doors -- standing wide open during the event -- for egress. In case of a fire, I can't imagine how anybody would have been trapped (I can't say the same for other wedding reception venues I've been in).

I've never seen a story of a fire during a barn wedding, let alone one where people were injured. I have seen, however, stories of ongoing political fights in the rural townships near here over the late-night noise and traffic from event barns, for example:

https://www.mlive.com/news/ann-arbor/index.ssf/2018/03/nixon_farms_petition_lawsuit.html

I suspect safety is a pretext for imposing barriers to entry and limiting competition.

Any Wisconsin wedding, regardless of venue, can turn into a disaster. Those folks take their brown liquor seriously.

#2 It was not an error for Americans to send the world a message that we do not much prefer a skilled liar to a bad one.

#2 Authoritarians have traditionally been the world's darlings. Stalin was as beloved in his day in NYC as he is today in Moscow. Xi is the most popular leader in the world. https://thediplomat.com/2014/12/the-worlds-most-popular-leader-chinas-president-xi/ Ideas have very little to do with it, and even if the US had ideas to export (what might they be? the US is pretty much at the back of the pack when it comes to innovation and creativity) , it would not make much difference. People despise weakness. Trump is weak. He is an anti-authoritarian and has very limited means to fight the ruling class's attempt at a putsch. Obama demonstrated that it is very easy to pander on the global stage and win cheap points by bad-mouthing the United States. It may have gotten him prizes and popularity, but not respect or influence. Trump is unwilling to do so. Judging him by his enemies, he is no doubt the greatest President in US history.

Praise with Purple Prose? Paul Robeson's eulogy for Stalin:

http://www.northstarcompass.org/nsc9804/robeson.htm

2. "When I was in Nigeria last year, a cab driver in Lagos cackled to me that 'Now America finally has a Nigerian president!'
That may not be very fair to the Nigerian President. Even his opponents generally concede Gen. Buhari's personal integrity.

#2, seems confused. If the US exported "ideas" that were in line with how western Europeans like to think about the world then the US's ideas would be more respected.

I agree with the author that medical school should be shortened. However, clinical experience should be lengthened or intensified. Upon graduation the typical graduate of the authors residency program is hardly ready to perform eye surgery at a high level.. A post-residency year in a third world country performing high volume surgery under a good mentor should replace one of the medical school years.

RE: #2 I'm also not too concerned about world opinion. I got back from Ireland a week ago and the reporting there about Trump was pretty badly one sided. The UK is no different. It's like CNN all day. But it's always been that way. The Guardian was still reporting that Bush's National Guard document was true even after Dan Rather got fired for faking it.

As for "and questions about Trump are being promptly and thoroughly investigated. " I think the world should be happy we're investigating the crimes of the previous administration. 6 of three FBI's top people have had to quit or got fired for illegal activities relating to the election. That should show we are serious about running a fair democracy. Most of those over there thought Trump was attacking them in the trade agreement, but had no idea that the EU's tariffs were higher and that we had just agreed to get the tariffs down to 0%.

And no one was a fan of Hillary.

Can you link to that Guardian piece? I found old op-eds saying they were obviously faked, and some that describe what Dan's laughable movie portrayed, but I'm not seeing the recent reporting that takes the memos as true.

No, not recent, but still a month after they were shown to be false.

"and that he simply is not well-informed about foreign affairs."

LOL. How did Tyler not faint during the last administration. Trump has been unusually adept in his foreign policy. FP is not a tea party and no other nation acts like it is except for us. the EU just looks for welfare from us and Russian, China, and the middle east have no respect for a weak president like O.

If countries like Trump too much he's not doing his job.

Entry into the medical professions is restricted and heavily regulated because of prescription drugs. 100 years ago we had correspondence school physicians prescribing opiates. If you want more physicians you have to remove the ability of some physicians to prescribe certain drugs.

Re: "Entry into the medical professions is restricted and heavily regulated because of prescription drugs. 100 years ago we had correspondence school physicians prescribing opiates."

On the verge of some brutal irony.

2) I am blown away by how bad that opinion piece is, mostly because it ignores the effects of media perception. Trumpism isn't being exported to the world, the media's wildly biased opinion of Trump is

Totally off-topic, but the numbering along the right-hand column makes no sense.

"While I'm not a Trump supporter(...)"
The need that people feel to include this preface every time they are about to say something positive about Trump's government reflects the intolerance for different opinions.

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