Proven Wrong About Many of Its Assertions, Is Psychiatry Bullsh*t?

Some psychiatrists view the chemical-imbalance theory as a well-meaning lie.

Photo Credit: Olena Yakobchuk / Shutterstock

In the current issue of the journal Ethical Human Psychology and Psychiatry, Australian dissident psychiatrist Niall McLaren titles his article, “Psychiatry as Bullshit” and makes a case for just that.

The great controversies in psychiatry are no longer about its chemical-imbalance theory of mental illness or its DSM diagnostic system, both of which have now been declared invalid even by the pillars of the psychiatry establishment.

In 2011, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times, stated, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” And in 2013, Thomas Insel, then director of the National Institute of Mental Health, offered a harsh rebuke of the DSM, announcing that because the DSM diagnostic system lacks validity, the “NIMH will be re-orienting its research away from DSM categories.”

So, the great controversy today has now become just how psychiatry can be most fairly characterized given its record of being proven wrong about virtually all of its assertions, most notably its classifications of behaviors, theories of “mental illness” and treatment effectiveness/adverse effects.

Among critics, one of the gentlest characterizations of psychiatry is a “false narrative,” the phrase used by investigative reporter Robert Whitaker (who won the 2010 Investigative Reporters and Editors Book Award for Anatomy of an Epidemic) to describe the story told by the psychiatrists’ guild American Psychiatric Association.

In “Psychiatry as Bullshit,” McLaren begins by considering several different categories of “nonscience with scientific pretensions,” such as “pseudoscience” and “scientific fraud.”

“Pseudoscience” is commonly defined as a collection of beliefs and practices promulgated as scientific but in reality mistakenly regarded as being based on scientific method. The NIMH director ultimately rejected the DSM because of its lack of validity, which is crucial to the scientific method. In the DSM, psychiatric illnesses are created by an APA committee, 69 percent of whom have financial ties to Big Pharma. The criteria for DSM illness are not objective biological ones but non-scientific subjective ones (which is why homosexuality was a DSM mental illness until the early 1970s). Besides lack of scientific validity, the DSMlacks scientific reliability, as clinicians routinely disagree on diagnoses because patients act differently in different circumstances and because of the subjective nature of the criteria.

“Fraud” is a misrepresentation, a deception intended for personal gain, and implies an intention to deceive others of the truth—or “lying.” Drug companies, including those that manufacture psychiatric drugs, have been convicted of fraud, as have high-profile psychiatrists (as well as other doctors). Human rights activist and attorney Jim Gottstein offers an argument as to why the APA is a “fraudulent enterprise”; however, the APA has not been legally convicted of fraud.

To best characterize psychiatry, McLaren considers the category of “bullshit,” invoking philosopher Harry Frankfurt’s 1986 journal article “On Bullshit” (which became a New York Times bestselling book in 2005).

Defining Bullshit

What is the essence of bullshit? For Frankfurt, “This lack of connection to a concern with truth—this indifference to how things really are—that I regard as of the essence of bullshit.”

Frankfurt devotes a good deal of On Bullshit to differentiating between a liar and a bullshitter. Both the liar and the bullshitter misrepresent themselves, representing themselves as attempting to be honest and truthful. But there is a difference between the liar and the bullshitter.

The liar knows the truth, and the liar’s goal is to conceal it.

The goal of bullshitters is not necessarily to lie about the truth but to persuade their audience of a specific impression so as to advance their agenda. So, bullshitters are committed to neither truths nor untruths, uncommitted to neither facts nor fiction. It’s actually not in bullshitters’ interest to know what is true and what is false, as that knowledge can hinder their capacity to bullshit.

Frankfurt tells us that liar the hides that he or she is “attempting to lead us away from a correct apprehension of reality.” In contrast, the bullshitter hides that “the truth-values of his statements are of no central interest to him.”

Are Psychiatrists Bullshitters?

Recall establishment psychiatrist Pies’ assertion: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” What Pies omits is the reality that the vast majority of psychiatrists have been promulgating this theory. Were they liars or simply not well-informed? And if not well-informed, were they purposely not well-informed?

If one wants to bullshit oneself and the general public that psychiatry is a genuinely scientific medical specialty, there’s a great incentive to be unconcerned with the truth or falseness of the chemical imbalance theory of depression. Bullshitters immediately recognize how powerful this chemical imbalance notion is in gaining prestige for their profession and themselves as well as making their job both more lucrative and easier, increasing patient volume by turning virtually all patient visits into quick prescribing ones.

Prior to the chemical imbalance bullshit campaign, most Americans were reluctant to take antidepressants—or to give them to their children. But the idea that depression is caused by a chemical imbalance that can be corrected with Prozac, Paxil, Zoloft and selective serotonin reuptake inhibitor antidepressants sounded like taking insulin for diabetes. Correcting a chemical imbalance seemed like a reasonable thing to do, and so the use of SSRI antidepressants skyrocketed.

In 2012, National Public Radio correspondent Alix Spiegel began her piece about the disproven chemical imbalance theory with the following personal story about being prescribed Prozac when she was a depressed teenager:

My parents took me to a psychiatrist at Johns Hopkins Hospital. She did an evaluation and then told me this story: “The problem with you,” she explained, “is that you have a chemical imbalance. It’s biological, just like diabetes, but it’s in your brain. This chemical in your brain called serotonin is too, too low. There’s not enough of it, and that’s what’s causing the chemical imbalance. We need to give you medication to correct that.” Then she handed my mother a prescription for Prozac.

When Spiegel discovered that the chemical imbalance theory was untrue, she sought to discover why this truth had been covered up, and so she interviewed researchers who knew the truth. Alan Frazer, professor of pharmacology and psychiatry and chairman of the pharmacology department at the University of Texas Health Sciences Center, told Spiegel that by framing depression as a deficiency—something that needed to be returned to normal—patients felt more comfortable taking antidepressants. Frazer stated, “If there was this biological reason for them being depressed, some deficiency that the drug was correcting, then taking a drug was OK.” For Frazer, the story that depressed people have a chemical imbalance enabled many people to come out of the closet about being depressed.

Frazer’s rationale reminds us of Edward Herman and Noam Chomsky’s book Manufacturing Consent, the title deriving from presidential adviser and journalist Walter Lippmann’s phrase “the manufacture of consent”—a necessity for Lippmann, who believed that the general public is incompetent in discerning what’s truly best for them, and so their opinion must be molded by a benevolent elite who does know what’s best for them.

There are some psychiatrists who view the chemical imbalance theory as a well-meaning lie by a benevolent elite to ensure resistant patients do what is best for them, but my experience is that there are actually extremely few such “well-meaning liars.” Most simply don’t know the truth because they have put little effort in discerning it.

I believe McLaren is correct in concluding that the vast majority of psychiatrists are bullshitters, uncommitted to either facts or fiction. Most psychiatrists would certainly have been happy if the chemical-imbalance theory was true but obviously have not needed it to be true in order to promulgate it. For truth seekers, the falseness of the chemical imbalance theory has been easily available, but most psychiatrists have not been truth seekers. It is not in the bullshitters’ interest to know what is true and what is false, as that knowledge of what is a fact and what is fiction hinders the capacity to use any and all powerful persuasion. Simply put, a commitment to the truth hinders the capacity to bullshit.

What’s 11,000 Times Dirtier Than a Toilet Seat?

Hint: when you stop at a gas station, the grossest thing may not be the bathroom.

Photo Credit: Phovoir / Shutterstock

America is a gas-guzzling, car-obsessed, open-road nation. Few things appeal to Americans more than a (traffic-free, ideally) leisurely drive to a fun, kick-back-your-heels destination, all the while enjoying the passing scenery. Of course, in order to achieve this bucolic vision of paradise, we need to fuel up the car, and in order to do that, we have to stop at the gas station. A study by Kimberly-Clark in 2015 investigating bacterial hot spots in the workplace fingered gas pumps as one of the unhealthiest things you can handle, and a new survey recently corroborates those findings.

Admittedly, it’s probably no great surprise that gas pumps are not exactly pristine. Never mind the chemical contamination that comes from gasoline itself, think about the sheer number of people endlessly grabbing the pump, often after returning from a pit stop at the not-so-hygienic gas station bathroom. You get the idea. Still, the new study gives one pause and suggests a bottle of sanitizer might not be a bad glove compartment staple.

It’s not just the number of germs present on gas pump handles, but the quality of those germs. The earlier Kimberly-Clark study, led by a University of Arizona microbiologist named Charles Gerba (whom colleagues know as “Dr. Germ”), found that 71 percent of the pumps were highly contaminated with germs associated with disease. The new survey, conducted by Busbud, studied samples from three different gas stations, as well as three different charging stations, to see what we may be exposing ourselves to. The sample size is small, but the results mirror the larger earlier study and are eye-opening.

Based on laboratory results from swabs from the sample gas pumps, handles on gas pumps had an average of 2,011,970 colony-forming units (CFUs), or viable bacteria cells, per square inch. Worse, the buttons on the pumps (where you select the grade of gas you want), had 2,617,067 CFUs per square inch. To put that in perspective, money, which is considered quite dirty since it changes hands often, has only 5.2 CFUs per square inch. A toilet seat has 172 CFUs per square inch. That makes a gas pump handle about 11,000 times more contaminated than a toilet seat, and a gas pump button 15,000 times more contaminated.

OK. So there are over two million CFUs dancing around on the gas pump. What kind of germs are they? Luckily, about half of them are usually harmless. These are the CFUs known as gram-positive rods. (I say usually because gram-positive rods can sometimes cause some types of infections, but are not considered unusually worrisome.) But those other million or so CFUs are mostly of the gram-positive cocci variety, and these are nasty critters that can cause skin infections, pneumonia and toxic shock syndrome.

Does the type of gas you select safeguard you in any way? It would seem so, to some small degree. The sampling showed that the buttons for regular gas contained 3,255,100 CFUs per square inch, about a third of which were the gram-positive cocci (bad germs), and another third of which were bacilli, another type of bad-guy bacteria linked to food poisoning and infections in newborn babies. The other third were mostly the safer gram-positive rods, with a smattering, about 5 percent, of gram-negative rods. These latter germs are especially worrisome as they are linked to antibiotic resistance as well as meningitis and pneumonia. The premium gas button had about 2,022,034 CFUs per square inch, divided about half gram-positive rods and half yeast (and we all know about yeast infections).

Since a typical visit to the gas station involves pressing the gas grade button as well as lifting the pump handle, that means, for regular gas, exposure to about 5,267,070 CFUs per square inch, and for premium gas about 4,034,004 CFUs per square inch.

Tesla and Volt owners, rejoice! If you own an electric car, and use a charging station, you can breathe a lot easier. The typical car charger has only 7.890 CFUs per square inch.

If you want to minimize your exposure to these germs, use a paper towel to hold the handle and push the button, or keep that hand sanitizer around and wash your hands after filling up.

Read the full survey.

Larry Schwartz is a Brooklyn-based freelance writer with a focus on health, science and American history. 

U.S. Military Warns of Climate-Driven ‘Instability on an International Scale’

Posted on Sep 22, 2016

By Alex Kirby / Climate News Network

Naval Air Station Key West in Florida feels the forces of Hurricane Dennis in 2005. (Jim Brooks / US Navy via Wikimedia Commons)

LONDON—A group of senior defence experts in the US has warned that climate change is a threat to the country’s security, with the stark message that “the impacts of climate change present significant and direct risks to US military readiness, operations and strategy”.

They are members of the Climate Security Consensus Project, a bipartisan group of 25 senior military and national security experts—many of whom have served in previous Republican or Democratic administrations.

Meeting at a forum in Washington DC organised by the Centre for Climate and Security (CCS), the group said the effects of climate change “present a strategically-significant risk to US national security and international security”.

A statement from the members, who include retired senior officers from the US Army, Air Force, Navy and Marine Corps, expresses concern about risks to regions of the world of strategic significance to Washington—“risks that can contribute to political and financial instability on an international scale, as well as maritime insecurity”.

Likelihood of conflict

They say stresses resulting from climate change can increase the likelihood of conflict within and between countries, state failure, mass migration, and the creation of additional ungoverned spaces.

These could develop “across a range of strategically-significant regions, including but not limited to the Middle East and North Africa, Central Asia, the Indo-Asia-Pacific and the Arctic regions”.

They also fear that the impacts of climate change “will place significant strains on international financial stability through contributing to supply line disruptions for major global industries … disrupting the viability of the insurance industry, and generally increasing the political and financial risks of doing business in an increasingly unstable global environment”.

There’s absolutely nothing political about climate change. It’s a security risk, it makes other security risks worse, and we need to do something big about it”

Supporting their statement are two documents released at the forum, which the organisers said together urged “a robust new course on climate change”.

Francesco Femia and Caitlin Werrell, co-presidents of the CCS, said: “These reports make it crystal clear. To national security and defence leaders, there’s absolutely nothing political about climate change. It’s a security risk, it makes other security risks worse, and we need to do something big about it.”

One of the reports—on sea level rise and the US military—says a growing number of studies exploring the actual and potential physical impacts of sea level rise on US military installations “show that the risks are increasing at a faster rate than expected”.

The stability of the 1,774 US military sites spread worldwide along 95,471 miles of coastline “is set to change dramatically due to sea level rise and storm surge. …

“We cannot wait for perfect information before assessing the risks and impacts. … Essentially, the very geostrategic landscape in which the US military operates is going to be different from what it is today.”

The second report, described as a briefing book for a new administration, recommends ways to address the security risks of a changing climate. The first of these urges the new president to appoint a cabinet-level official to lead on domestic climate change and security issues.

Concerns about security

This is not the first time that the CCS has voiced its concerns about the security risks posed to the US by climate change.

What is notable this time is the group’s emphasis, during a bitterly divisive presidential election campaign, on the bipartisan nature of its work. Its language is uncompromising, and its insistence that there is “absolutely nothing political about climate change” will antagonise many Americans and reassure many more.

The presidential election in less than two months from now will see two viscerally-opposed contenders for the White House pushing diametrically different views on climate change, as well as many other issues.

Democrat candidate Hillary Clinton has said the science is “crystal clear”, and that climate change is an “urgent threat”.

But Republican candidate Donald Trump wrote this month: “There is still much that needs to be investigated in the field of ‘climate change’.” He has described it as a hoax invented by the Chinese, and earlier this year called it “bullshit”.

Alex Kirby is a former BBC journalist and environment correspondent. He now works with universities, charities and international agencies to improve their media skills, and with journalists in the developing world keen to specialise in environmental reporting.

I Came to San Francisco to Change My Life: I Found a Tribe of Depressed Workaholics Living on Top of One Another

8619892327_24549fb87a_z
Hacker House Blues: my life with 12 programmers, 2 rooms and one 21st-century dream.
By David Garczynski / Salon September 18, 2016

I might have been trespassing up there, but I would often go to the 19th-floor business lounge to work and study. Located on the top floor of the a luxury high-rise in the SOMA district of San Francisco, the lounge was only accessible to residents of the building. Yet for a while I found myself there almost every day.

Seventeen floors below, I lived in an illegal Airbnb with 12 roommates split between two rooms. There were six people packed into my bedroom alone — seven, if you included the guy who lived in the closet. Three bunk beds adorned the walls, and I was fortunate enough to score a bottom bunk. Unfortunately, though, it was not the one by the window, which, with the exception of one dim lamp, was the only source of light in the room. Even at midday, the room never lit up much more than a shadowed cave. At most hours of the day, you could find someone sleeping in there. Getting in and out of bed was a precarious dance in the darkness to avoid stepping into the suitcases on the floor, out of which most of us lived.

In the shared kitchen, the sink more often than not held a giant pile of dishes, and the fridge, packed with everyone’s groceries and leftovers, emanated a slightly moldy aroma. Mixed in there were the half-eaten meals and unfinished condiment jars of tenants who had long since moved out — all left to rot, but often too far buried in the mass of food to be located.

Let’s just say the room was not as advertised.

The Airbnb posting did boast of access to a 24-hour gym, roof deck and bocce courts. The building has an indoor basketball court, an outdoor hot tub and even a rock climbing wall. The 19th-floor business lounge alone comes with a pool table, a porch, several flat-screen TVs and an enviable view of much of San Francisco. For $1,200 a month, it all seemed worth it. The post did say it was a four-person apartment, not 13, and included a picture of a sunny room with a pair of bunk beds, but I figured for a short sub-lease while I attended coding school, it wouldn’t be so bad. The reviews, after all, were pretty positive, too: mostly 5-stars. However, none of them mentioned the fact that I wouldn’t even be given a front door key.

I’d have to sneak into the building every night. The only way I entered the building was by waiting until someone exited or entered, and then I’d slip through the door before it closed. From there I’d walk straight past the front desk guard and head to the bank of elevators. Despite my nerves, that part was surprisingly easy. The building caters to the young tech elite, so a backwards hat and a collegiate T-shirt practically made me invisible. When I got to my floor, I’d make sure none of the neighbors were watching, and if no one was around, I’d stand on my tiptoes and grab the communal key hidden atop the exit sign. Once the door was unlocked, I’d return the key to its perch for the next tenant to use.

I had moved to San Francisco to break into the tech world after being accepted into one of those ubiquitous 12-week coding boot camps. I had dreams of becoming a programmer, hoping one day I could land a remote contracting gig — a job where I could work from wherever and make a good living. My life would be part ski bum and part professional.

In my mid-20s uncertainty, the coding route seemed to have the most promise — high paychecks in companies that prized work-life balance, or so it seemed from afar. I knew the road wouldn’t be easy, but any time I’d mention my ambitions to family and friends, they responded with resounding positivity, affirming my belief that it was a well-worn path to an obtainable goal.

All of the people in that Airbnb were programmers. Some were trying to break into the industry through boot camps, but most were already full-time professional coders. They headed out early in the morning to their jobs at start-ups in the neighborhood. A lot of them hailed from some of the top schools in the country: Stanford, MIT, Dartmouth. If I was going to get through my program, I needed to rely on them, academically and emotionally. Once the program started up, I would find myself coding 15 hours a day during the week, with that number mercifully dropping to 10-12 hours on the weekends. Late at night, when my stressed-out thoughts would form an ever-intensifying feedback loop of questioning despair — What am I doing? Is this really worth it? — I would need to be able to look to the people around me as living reminders of the possibility of my goals.

Every night, the people whose jobs I coveted would come home from 10- to 12-hour shifts in front of a computer and proceed to the couch, where they’d open up their laptops and spend the remaining hours of the night in silence, sifting through more and more lines of code. Beyond preternatural math abilities and a penchant for problem solving, it seemed most didn’t have much in the way of life skills. They weren’t who I thought they would be — a community of intelligent and inspiring men and women bouncing ideas back and forth. Rather they were boys and girls, coddled by day in the security of companies that fed them, entertained them and nursed them. At home, they could barely take care of themselves.

Take for example the programmer who lived in my closet: Every night he’d come home around 9 p.m. He’d sit on the couch, pour himself a bowl of cereal and eat in silence. Then he would grab his laptop and head directly into the closet — a so-called “private room” listed on Airbnb for $1,400 a month. It was the only time I’d ever see him. The only way I could tell he was home was by the glow of his laptop seeping out from under the closet door. Hours later, deep into the night, the light would go out, and I would know he had to gone to sleep. By the time I arrived, he had been living there for 16 months, in a windowless closet with a thin mattress placed right on the floor. During the day he codes for Pinterest. Yeah . . . that Pinterest.

Maybe there were people working in this city who were living out the tech dreams of everyone else, but I’ve realized the number of people who dream about it far outnumber of people who obtain it. Everyone I spoke to in this town seemed doe-eyed about the future, even while they were living in illegal Airbnbs and working at failing startups across the city.

The odds weren’t in my favor. Most likely I’d find myself in the 92 percent of start-ups that go under in three years, trapped like some of my friends — much smarter and better programmers than I’ll ever be — bouncing from failing company to failing company.
Or maybe not. Maybe I would make it, only to become like my friends who earn six-figure paychecks and still lament that they’ll never be able to buy a home here. What illusions could I continue to maintain then?

There was a good chance I’d find myself in a situation like another roommate’s. During salary negotiations for a job at a start-up, he was encouraged to accept the pay tier with a lower salary but higher equity stake. Now he works 12-hour days just to try to keep the company (and his potential payout) afloat on a paycheck not much higher than some entry-level, non-programming jobs.

The most likely scenario, however, was that I’d become like the mid-30s man who slept in the bunk above me. The reality of his situation slowly slipped him into a depressive state, until he was sleeping most hours of the day. The rest of his waking hours were spent walking around slumped and gloomy.

Programming for me was never supposed to be more than a means to an end, but that end started to feel farther and farther away. The longer I lived in that Airbnb, the longer I realized my dreams would never be met. In all likelihood I would be swept up in an economy here that traded on hopes and dreams of the people clamoring to break in. The illegal Airbnbs that dot the city can afford to charge their amounts because there is no shortage of people wanting to break in. There is another smart kid around the corner who believes that despite the working and living conditions this is just the first step to striking it big. Never tell them the odds.

I had hinged my happiness on an illusion and naively fought to get into a community that wouldn’t help me advance in the direction of my dreams. Maybe in the end I would get everything I needed or at least a nice paycheck, but I’d lose all of myself in the process. I’d be churned and beaten by the underbelly of the tech world here long before I could ever make it out.

If you are interested, it’s not that hard to sneak up to the 19th-floor lounge. I still do sometimes, despite having long since moved out and given up programming. From up there the view of San Francisco takes on the artificial quality of a miniature model. To the north, you’ll see a sea of tech start-ups, their signs and symbols a wild mash of colors. From this distance, it can all look so peaceful. Just know that somewhere in that view is another “hacker house” with bright kids living in almost migrant-worker conditions. Somewhere out there is a coding boot camp with slightly inflated numbers, selling a dream. Their fluorescent halls and cramped bedrooms are filled with the perennially hopeful looking to take the place of those who have already realized this dream isn’t all it’s cracked up to be.

It is a beautiful view, though. Just one I no longer want for myself.

David Garczynski has lived in the Bay Area for one year now. In that time, he’s lived in an illegal Airbnb, on his cousin’s couch, in two short-term subleases, and has been evicted once. He just signed an official (and legal) lease last week.

http://www.alternet.org/labor/hacker-house-blues-my-life-12-programmers-2-rooms-and-one-21st-century-dream?akid=14654.265072.JhW8o4&rd=1&src=newsletter1063941&t=12

No One Is Asking Clinton or Trump About the No. 1 Threat to Security

Published on
by

The Washington Post

Matt Lauer and Hillary Clinton at NBC News’s Commander-in-Chief Forum on Sept. 7 in New York. (Photo: Justin Sullivan/Getty Images)

Last week we saw another installment of the media malpractice that has plagued the 2016 campaign. NBC’s Matt Lauer was widely criticized for his performance moderating the network’s Commander-in-Chief Forum, especially his failure to correct Donald Trump’s repetition of the lie that he opposed the invasion of Iraq. But another mistake has been getting far less attention. The nationally televised event yielded little serious debate about the many great security challenges facing the United States today, including perhaps the single most urgent threat on the planet: nuclear weapons.

Though Hillary Clinton was asked about the Iran nuclear deal, there was no discussion of nonproliferation or the perils of nuclear weapons in general. For that, to be fair, Lauer is only partially to blame. The unfortunate reality is that, at a time when experts have warned that the danger of a nuclear disaster is on the rise, neither of the major-party nominees has said much about it.

The nuclear threat was briefly in the headlines this summer when MSNBC’S Joe Scarborough rather melodramatically reported that Trump, in a private briefing, had repeatedly asked a national security expert why the United States could not use its nuclear weapons. The Trump campaign denied the report, but his comments on the record are similarly frightening. As Ploughshares Fund President Joe Cirincione has said of Trump, “He talks about nuclear weapons very loosely, casually — as if they’re just another tool in the toolbox.”

For instance, Trump has stated on multiple occasions that “you want to be unpredictable” with nuclear weapons. If the Islamic State strikes in the United States, he has suggested we should “fight back with a nuke.” He declined to rule out deploying nuclear weapons in Europe, saying, “Europe is a big place. I’m not going to take cards off the table.” And he explicitly said he would not object to Japan acquiring a nuclear weapon because “it’s not like, gee whiz, nobody has them.”

Clinton has seized on Trump’s reckless comments as evidence that he isn’t fit to command our nuclear arsenal. “A man you can bait with a tweet,” she has taken to saying, “is not a man we can trust with nuclear weapons.”

For a candidate so fond of touting her plans, though, Clinton has offered very few details about how she would approach the nuclear threat if elected. As of late last month, the “Issues” section of Clinton’s website featured 65 briefs totaling 112,735 words. (Trump’s, by contrast, tallied around 9,000 words.) But as Columbia University journalism and sociology professor Todd Gitlin recently documented, there were only three mentions of nuclear weapons among Clinton’s many position statements: two related to the Iran deal and one referencing the New START treaty negotiated with Russia during her tenure at the State Department.

Trump’s nuclear rhetoric is clearly alarming, but so is the nuclear status quo. There aremore than 15,000 nuclear weapons in the world today, with the United States and Russia keeping nearly 2,000 on hair-trigger alert. Though the treaty with Russia included significant weapons reductions, the Obama administration has also committed to “modernizing” our nuclear arsenal at a cost of $1 trillion over three decades. The National Nuclear Security Administration announced last month that it had completed development and testing of the United States’ first “smart” nuclear bomb, slated for full-scale production in 2020.

And despite rumors that President Obama would pursue “major nuclear policy changes” as part of his legacy over the final months of his term, he has reportedly decided against declaring “no first use” of nuclear weapons, long an unwritten rule, as official U.S. policy. Certifying that the United States will only use nuclear weapons as a last resort would be especially significant given the possibility that Trump could end up with unchecked power to launch a nuclear strike.

Now, eight years after Obama campaigned on his vision of “a world without nuclear weapons,” the nuclear threat is escalating. “The danger of a nuclear catastrophe is greater than it was during the Cold War and most people are blissfully unaware of this danger,”warns William J. Perry, defense secretary under Bill Clinton. Likewise, Eric Schlosser — whose 2013 book, “Command and Control,” has been turned into an important newdocumentary — says that “pure luck” is the main reason there has not been a nuclear disaster already.

In an election dominated by spectacle and confrontation, many policy issues have fallen by the wayside. But as the nuclear peril intensifies, we desperately need to have a real debate about issues such as the first use of nuclear weapons, taking our nuclear arsenal off hair-trigger alert, and at last ratifying the Comprehensive Nuclear Test Ban Treaty that President Clinton signed 20 years ago this month. Reports that North Korea conducted a nuclear test in recent days underscore the need for a new approach to this challenge.

And while there is no doubt that Trump is unfit, Clinton should put forward a serious nuclear weapons policy that doesn’t fit in a tweet. To start, she can reaffirm her support for Obama’s vision during her time as secretary of state, when she argued, “We can’t afford to continue relying on recycled Cold War thinking.” Clinton should make it clear that nonproliferation and elimination of nuclear weapons are not a utopian dream, but a security imperative, and that she meant it when she said, “We are sincere in our pursuit of a secure peaceful world without nuclear weapons.”

White House to maintain nuclear “first strike” policy

nuclearexplosion

7 September 2016

On Tuesday, the New York Times published as its front-page lead article a piece, written by longtime military/intelligence insider David Sanger, reporting internal White House discussions that the Obama administration is planning on maintaining the United States’ “first strike” nuclear weapons policy.

In recent months, the Washington Post and Times had published reports that President Obama had considered formally adopting a policy of not using nuclear weapons unless the US was attacked by such weapons first.

On July 10, The Washington Post reported, “The Obama administration is determined to use its final six months in office to take a series of executive actions to advance the nuclear agenda the president has advocated since his college days,” including the possible adoption of a “no first use” policy.

But Tuesday’s report in the Times declared that Obama “appears likely to abandon the proposal after top national security advisers argued” that it would “embolden Russia and China.”

The move takes place amidst a series of US provocations against both countries, including the deployment of thousands of troops on Russia’s border in Eastern Europe and ongoing “freedom of navigation” operations in the South China Sea. In their statements to the Times, White House and military officials were sending a clear signal that it will abide no scaling back of the US threat to kill millions of people to facilitate its geopolitical aims.

The White House decided ultimately to agree to the demands of Commander of Strategic Command Admiral Haney, Secretary of Defense Ashton Carter, Secretary of State John Kerry and others who declared, according to theTimes, that “new moves by Russia and China, from the Baltic to the South China Sea, made it the wrong time to issue the declaration.”

Both before and during his presidency, Obama had postured as a proponent of nuclear non-proliferation. In his April 2009 speech in Prague, Obama declared that “as the only nuclear power to have used a nuclear weapon,” the US is committed “to seek the peace and security of a world without nuclear weapons,” and that “to put an end to Cold War thinking, we will reduce the role of nuclear weapons.”

Earlier this year, Obama visited Hiroshima, Japan, becoming the first sitting US president to do so since President Truman made the decision to incinerate the city with an atomic weapon at the end of the Second World War. Despite ruling out any apology for this war crime, Obama hypocritically called on countries that possess nuclear weapons to “have the courage to escape the logic of fear and pursue a world without them.”

Yet Obama’s real “nuclear legacy” is something else entirely. Over his eight years in office, the White House has initiated one of the most sweeping expansions of its nuclear capabilities in US history.

The Pentagon has embarked upon a $1 trillion nuclear modernization program, seeking to make US nuclear weapons smaller, faster, more maneuverable and easier to use on the battlefield. The effect of this program is, as General James E. Cartwright, a retired vice chairman of the Joint Chiefs of Staff, told the Timesearlier this year, “to make the weapon more thinkable.”

At a cost of some $97 billion, the Navy is on track to replace its Ohio-class submarines, each of which is by itself equivalent to the world’s fifth-ranking nuclear power, with a new generation of ballistic missile submarines.

The Air Force, meanwhile, has contracted Northrop Grumman to build up to 100 next-generation B-21 nuclear-capable bombers, at a cost of nearly $60 billion. It is also in the midst of developing, at the cost of $20 billion, the so-called Long-Range Stand-Off Missile, which is capable of maneuvering at high speeds to deliver a nuclear payload behind enemy air defenses.

Experts have warned that the development of such a “dual use” nuclear-capable cruise missile makes the potential for a catastrophic miscalculation substantially greater, as countries attacked by these weapons, in addition to having little time to respond, have no way of knowing whether their payload is “conventional” or nuclear.

On Tuesday, Bloomberg reported that the Air Force also plans to spend another $85 billion to develop a set of new intercontinental ballistic missiles. The Pentagon is moving ahead with plans to buy some 642 of the new ICBMs “at an average cost of $66.4 million each to support a deployed force of 400 weapons.”

The dizzying pace of the US nuclear modernization program comes in the context of a deepening global geopolitical crisis, at the center of which is the ever expanding war drive of American imperialism.

Beginning with economic crises of the late 1960s and early 1970s, the American ruling class sought to offset the economic decline of US capitalism through the naked use of military force. With the dissolution of the Soviet Union, this process went into overdrive, kicking off a quarter century of intensifying war around the globe. Now, US-led regional wars and proxy conflicts, particularly in Syria, are metastasizing into ever-more direct conflicts with larger competitors, including Russia and China.

With the crisis-ridden US election dominated by allegations from the Clinton campaign of Russian cyberattacks and political subversion, together with ongoing and deepening tensions with China, the United States is sending a clear signal that it is thinking about the “unthinkable.”

Eighty years ago, Russian revolutionary Leon Trotsky warned, “In the period of crisis the hegemony of the United States will operate more completely, more openly, and more ruthlessly than in the period of boom.” Anyone who believes that the US would never again use nuclear weapons is underestimating not only the extent of the internal and external crisis confronting American imperialism, but the level of violence and criminality of which the American ruling class is capable.

Andre Damon

http://www.wsws.org/en/articles/2016/09/07/pers-s07.html

EpiPen price gouging

Epipen-Thailand

Capitalism and the US health care crisis

31 August 2016

Mylan Pharmaceutical’s enormous price hikes for EpiPen, an emergency drug for life-threatening allergic reactions, highlight both the outrageous practices of the US pharmaceutical industry and the deplorable state of health care in America.

A two-pack of EpiPen Auto-Injectors, which cost about $100 in 2004, adjusted for inflation, now costs over $600, putting the life-saving device out of reach for many adults and children. The device quickly delivers a controlled dosage of epinephrine to treat anaphylaxis, a potentially deadly allergic reaction to medication, food or insect bites.

Mylan’s price gouging has become a focal point of anger over the complete subordination of health care to huge corporations that are driven by an insatiable quest for profit. On a daily basis, working people see reports of multimillion-dollar bonanzas for executives at giant pharmaceutical and insurance companies, while tens of millions of people struggle to pay for essential prescription drugs and medical treatments because of ever-higher deductibles, co-pays and premiums.

Mylan’s price gouging is a particularly disgusting example of profiteering in the health care industry. A 2011 survey found that 8 percent of US children had a food allergy and nearly 40 percent of these individuals had a history of severe reactions. With the six-fold increase in price, families are gambling on not purchasing EpiPens or paying for the auto-injectors by going deeper into debt and forgoing other necessities.

Mylan is the second-largest generic and specialty drug company in the world, with about 35,000 employees, more than 1,400 products, and customers in more than 150 countries. Mylan obtained the EpiPen franchise through its 2007 purchase of the generic division of Merck, another pharmaceutical giant.

To generate sales, Mylan has spent tens of millions on EpiPen TV ads. This includes $1.7 million on ads broadcast during the Rio Olympics that show a teenager mistakenly ingesting peanut butter at a party and losing consciousness while her friends frantically call 911.

Forty-seven US states now require public schools to stock the devices. Its use has grown by 67 percent since 2008, and over 3.6 million prescriptions were written for EpiPens last year. Sales of the device have generated annual revenues of $1 billion, accounting for 40 percent of Mylan’s profits.

Mylan CEO Heather Bresch’s total compensation went from $2.4 million in 2007 to nearly $19 million in 2015. When questioned in an interview about the EpiPen price hikes, she said, “Look, we’re going to continue to run a business.”

But Bresch and Mylan, contrary to the media presentation, are not aberrations. Drug companies across the board are raising prices for both generic and brand name drugs. Here are some of the biggest recent price hikes:

• Between 2002 and 2013, the cost of insulin for treatment of diabetes rose nearly 200 percent, from $4.34 per milliliter to $12.92.

• Gilead prices a single course of treatment with Sovaldi, a hepatitis C drug, at $84,000, or $1,000 per pill.

• Turing Pharmaceuticals last year acquired US marketing rights for Daraprim, used to treat the parasitic disease toxoplasmosis, and raised the price from $13.50 to $750 a tablet.

A 2015 report found that prescription drugs cost up to 10 times more in the US than they do in other countries. The EpiPen is a case in point. Meda sells a two-pack of EpiPens in France for about $85, while the price for the antidote syringes in Canada is about $100.

An article in Tuesday’s New York Times pointed indirectly to the involvement of a whole network of corporate players in the profiteering that rests upon the inflation of prescription drug prices. It quotes the head of a consulting firm for the drug distribution industry as saying that “if Mylan had simply lowered the price, it would have risked angering all the parties in the distribution network, including pharmacy benefit managers, wholesalers and pharmacies, which take a piece of the total amount spent on the drug.”

Commenting on Mylan’s decision, in the face of a sharp fall in its stock price last week, to offer a generic version of EpiPen at a price of $300, half that of the brand-name version, the drug industry expert said that introducing a generic was “a way to do it without making enemies with a bunch of Fortune 25 companies who control your fate.”

In other words, health care provision in capitalist America is a racket in which the spoils are divided among a number of corporate players, at the expense of the health and lives of the general population.

Another industry analyst noted on Monday that even at the “bargain” price of $300, Mylan’s overall revenue per prescription would be about $280.

The Affordable Care Act, President Obama’s signature domestic program, is not aimed at shaking up this state of affairs, but at entrenching and deepening it. The legislation’s central provision, the “individual mandate,” compels individuals and families without insurance to purchase policies from private insurers under threat of a stiff tax penalty.

In the fourth year of Obamacare, it is a scandal in itself that some 27 million people in the US remain uninsured, as many people are too poor to buy coverage, even with the plan’s modest government subsidies. Most of the least expensive ACA plans come with deductibles in excess of $5,000 and other outrageous out-of-pocket costs that render the plans virtually useless in covering medical costs, forcing people to self-ration their medical care.

Obamacare, a plan devised by and for the insurance industry, places no serious limits or requirements on the corporations. They can do as they please, jacking up premiums, co-pays and deductibles, or pulling out of the program altogether if the profits are not sufficiently high. That is precisely what the biggest insurers are now doing, with the result that next year nearly one-third of counties in the US will have only one insurer under Obamacare.

From the insurance leviathans, to the pharmaceutical firms, to the giant hospital chains, to the drug store chains—the entire health care system in America is dominated by huge corporations in operation for one reason: to make a profit. The needs of people for medical treatments, tests and prescription drugs are entirely secondary.

Quality health care for everyone is a basic social right. But it is incompatible with a system based on the capitalist market.

Socialized medicine as part of a socialist economy is the only basis upon which a rational, humane and egalitarian health care system can be developed.

Kate Randall

WSWS