A Conflict Without End
Osama bin Laden had been dead only a few days when House Republicans began their efforts to expand, rather than contract, the war on terror. Not content with the president’s wide-ranging powers to pursue the archcriminals of Sept. 11, 2001, Republicans want to authorize the military to pursue virtually anyone suspected of terrorism, anywhere on earth, from now to the end of time.
This wildly expansive authorization would, in essence, make the war on terror a permanent and limitless aspect of life on earth, along with its huge potential for abuse.
The Authorization for Use of Military Force, approved by Congress a week after Sept. 11, 2001, gives the president the power to go after anyone who committed or aided in the 9/11 attacks, or who harbored such people, to prevent acts of terrorism. It was this document that authorized the war in Afghanistan and the raid on Bin Laden’s compound.
A new bill, approved last week by the House Armed Services Committee and heading for the floor this month, would go much further. It would allow military attacks against not just Al Qaeda and the Taliban but also any “associated forces that are engaged in hostilities against the United States.” That deliberately vague phrase could include anyone who doesn’t like America, even if they are not connected in any way with the 2001 attacks. It could even apply to domestic threats.
It allows the president to detain “belligerents” until the “termination of hostilities,” presumably at a camp like the one in Guantánamo Bay, Cuba. Since it does not give a plausible scenario of how those hostilities could be considered over, it raises the possibility of endless detention for anyone who gets on the wrong side of a future administration.
The bill, part of the National Defense Authorization Act, was introduced by the committee chairman, Howard McKeon of California, who said it simply aligns old legal authorities with current threats. We’ve heard that before, about wiretapping and torture, and it was always untrue.
These powers are not needed, for current threats, or any other threat. President Obama has not asked for them (though, unfortunately, the administration has used a similar definition of the enemy in legal papers). Under the existing powers, or perhaps ignoring them, President George W. Bush abused his authority for many years with excessive detentions and illegal wiretapping. Those kinds of abuses could range even more widely with this open-ended authorization.
As more than 30 House Democrats protested to Mr. McKeon, a declaration of “global war against nameless individuals, organizations, and nations” could “grant the president near unfettered authority to initiate military action around the world without further Congressional approval.” If a future administration wanted to attack Iran unilaterally, it could do so without having to consult with Congress.
This measure is unnecessary. The Bush administration demonstrated how dangerous it could be. The Democrats were right to demand the House conduct hearings on the measure, which was approved with little scrutiny. If it passes, the Senate should amend it out of existence, and President Obama should make clear he will veto it.
The Value of Comparison
Before you take a drug or undergo a medical procedure, wouldn’t you want to be sure it is the most effective and, if possible, the least costly available?
That is the idea behind so-called comparative effective research that is part of the health care reform law. Unfortunately, in the effort to win Republican support (support that never materialized), the bill’s sponsors agreed to bar Medicare from using comparative studies to determine which treatments to pay for. Critics charged it would mean more bureaucratic interference and a step toward socialized medicine.
The shortsightedness of that thinking was made clear last month when results were released of a government-sponsored study comparing two drug treatments for macular degeneration, which is the leading cause of vision loss and blindness in older Americans.
Both drugs are made by Genentech. Even so, there is a vast difference in their cost and, until now, uncertainty about their relative effectiveness.
Avastin was developed first to treat advanced cancer by blocking the formation of blood vessels that feed tumors. Genentech went on to develop Lucentis to block the blood vessel growth that is responsible for age-related macular degeneration.
Clinical trials sponsored by Genentech showed that Lucentis is highly effective in preserving and improving vision. The cost per monthly dose, however, was set by the company at $2,000. Enterprising eye doctors quickly realized they could get similar results by using Avastin in small doses. Avastin can cost thousands of dollars a month for the quantities used to treat cancer, but the doses suitable for injection into the eye cost about $50 a month.
Genentech did its best to head off the threat to its profitability by offering rebates to doctors who prescribed Lucentis in large quantities and by engaging in various tactics to thwart the use of low-dose Avastin. It had only limited success. In 2008, Medicare paid for 480,000 injections of Avastin to treat macular degeneration — at a cost of $20 million. And it paid for 337,000 injections of Lucentis, at a cost of $537 million.
Until now, however, there was no scientific proof about whether Avastin was as effective as Lucentis. The National Eye Institute sponsored a two-year clinical trial whose first-year results were published in late April. It suggests that the cheaper Avastin is just as effective as Lucentis at preventing vision loss. More people taking Avastin were hospitalized, an adverse effect that needs further exploration, but there were no significant differences in the rate of deaths, heart attacks and strokes.
If these findings and the drug’s safety are confirmed in the second year, Medicare could save hundreds of millions of dollars annually if doctors used Avastin. But, as the system now works, Medicare cannot push doctors to switch. That means that taxpayers will likely continue to pay a lot more for a treatment that is no more effective. That makes no sense for anybody, except the drug maker.
Another Misguided Idea From the Gun Lobby
The Environmental Protection Agency declined to block the use of lead in hunting and fishing last year. It was the wrong call. To ensure that the agency doesn’t come to its senses, the National Rifle Association — assisted, as usual, by Congress — is pushing legislation that would bar the E.P.A. from restricting the sale of lead shot and bullets or lead sinkers.
The Senate bill’s name — the Hunting, Fishing, and Recreational Shooting Protection Act — is a sign of how backward the Senate gets it. What needs protecting is wildlife that ingests the lead, including migratory waterfowl and birds of prey, notably California condors. Humans need protection, too. According to the Centers for Disease Control and Prevention, people show higher levels of lead in their blood after eating game killed with lead shot or bullets.
There are perfectly acceptable, nontoxic substitutes. Fishermen and hunters have been voluntarily adopting bismuth shot, copper bullets, and nonlead sinkers. Several states have set up exchange programs to encourage hunters to turn in lead-based shells for nonlead shells. In the past few years, 25 states have proposed bills to eliminate lead shot. They have regularly gone down to defeat thanks to deceptive campaigns that portray the effort as anti-gun, anti-hunting or anti-fishing.
Banning lead poses no threat to hunters or fishermen. It is a way of making sure they kill only the prey they seek without inadvertently killing other creatures as well. Congress should ignore the N.R.A.’s importunings and reject this latest misguided legislation. And the E.P.A. should issue the ban.
The Gateses as ‘Living Sitters’
The new portrait of Bill and Melinda Gates commissioned by the National Portrait Gallery in Washington depicts the leaders of the giant foundation bearing their name, and its work, with a respectful familiarity. Sitting on the arm of a chair with his arms crossed, Bill Gates appears supremely self-assured. Sitting slightly in front, Melinda looks confident. Over her shoulder is a video monitor showing two African girls and displaying “ALL LIVES HAVE EQUAL VALUE.” That is the credo of their foundation that addresses huge problems in American education, global health and other areas.
Until 2001, the gallery’s policy was to acquire a portrait of someone not a president only after the person had been dead for 10 years. Then-Director Marc Pachter decided portraits of prominent “living sitters” would interest the public. The gallery has since acquired many, but the new portrait of the Gateses, to be unveiled on Tuesday, is one of the first to be commissioned and completed.
The painting is the first the gallery has commissioned from Jon Friedman, who has won acclaim for his superb portraits hanging elsewhere of accomplished scientists like the Nobel laureates David Baltimore and Harold Varmus, of whom preliminary sketches hang at the gallery.
His work is so sharply realistic that it’s remarkable how little time he is usually allowed to spend with his subjects. In the past, artists counted on months of posing. Almost no one is that available today.
With the Gateses, he was granted just an hour. They chatted about dilemmas of education reform and the malarial parasite. While they spoke, Mr. Friedman took digital photos. Using tools of the Microsoft era (a computer, visual-processing software), he later cut and pasted photos of his subjects in different poses, creating a digital collage. After filling in the background with the two girls, he made a final digital composition to use as his model. Then he began to paint, capturing the Gateses as if he had worked with them for months. The result is quietly inspiring and surprisingly affecting.
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