Democracy For the Heart of America

Here's breaking news: Your trusts and estates lawyer has been violating U.S. law by helping his clients hide money offshore in illegal trusts. Previously, he had brushes with the law due to allegations he deceived his clients. He quietly settled these charges.

Would you still trust him to handle your estate?

Of course not.

So who's managing your money?

UBS describes itself as "one of the world's leading financial firms." It employs more than 70,000 people. In the U.S., it has more than 8,000 financial advisors "ready to serve you."

UBS has very lofty principles. Here they are:

"UBS is firmly committed to corporate responsibility and actively strives to understand, assess, weigh and address the concerns and expectations of the firm's stakeholders. This process supports UBS in its efforts to safeguard and advance the firm's reputation for responsible corporate conduct. In very direct ways, responsible corporate conduct helps create sustainable value for the company."

Trying to keep the tarnish off these values has been a full time occupation for teams of UBS lawyers recently. Here's what I mean:

In February, 2009, UBS paid a whopping $780 million to avoid a criminal indictment for defrauding the U.S. government by helping Americans secrete their assets in Switzerland.

In a settlement announced this week, UBS agreed to disclose the names of 4,450 Americans who used its services (for a fee, of course) to cheat the U.S. government.

This is not the first time UBS has engaged in conduct that crosses the line.

On August 8, 2008, UBS agreed to buy back $8.3 billion of auction-rate securities it sold retail customers. It was accused of misleading investors concerning the liquidity of these securities. Of course, it admitted nothing in the settlement agreement.

In April, 2003, UBS (and nine other top investment firms) agreed to settle claims that its analysts defrauded retail investors. UBS contributed $80 million to the global settlement fund, without admitting any wrongdoing.

As the analyst settlement demonstrates, UBS is probably no worse than many of its competitors.

It's bad enough that brokers separate clients from their money every day by touting their services as "financial pros" who add value, when the reality is quite to the contrary.

It's worse that their conduct is such a departure from the values they espouse.

You could make the case that refusing to do business with them is a moral imperative.

That is the case I am making.

The views set forth in this blog are the opinions of the author alone and may not represent the views of any firm or entity with whom he is affiliated. The data, information, and content on this blog are for information, education, and non-commercial purposes only. Returns from index funds do not represent the performance of any investment advisory firm. The information on this blog does not involve the rendering of personalized investment advice and is limited to the dissemination of opinions on investing. No reader should construe these opinions as an offer of advisory services. Readers who require investment advice should retain the services of a competent investment professional. The information on this blog is not an offer to buy or sell, or a solicitation of any offer to buy or sell any securities or class of securities mentioned herein.

Dan Solin is the author of The Smartest Retirement Book You'll Ever Read.
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Tonight's Rescue is brought to you by shayera, Elise, jlms qkw, YatPundit, mem from somerville, aloha and mahalo, and pico.

Diary Rescue is all about promoting good writers, so remember to subscribe to diarists whose work you enjoy reading.

• gjohnsit offers up some wonky goodness (and charts!) while asking What will the economic recovery build upon? (YatPundit)
• Inoljt analyzes the past and looks to the future in An Analysis of Ohio - Part II. (jlms qkw)
• cabaretic examines the blogs and the traditional media, the amateurs and the professionals, and finds The Scattered Truth: Or, a Heap of Broken Images. (mem from somerville)
• andrewmcleod suggests that the carrot-and-stick approach to getting things done is contrary to nature in No more giant carrots! (YatPundit)
• RLMiller tries to answer the question, Why Does Henry Waxman Regret His Own Landmark Bill? (Elise)
• Hood203 tells us of life as a scientist in a fundamentalist-dominated area in In the beginning God created... Evolution! (YatPundit)
• links takes a trip back in history to show how conservatives of previous generations handled economic crises in FDR, Bismarck and Activists. (YatPundit)
• Charlotte Lucas begins a heart rending account of her experience of the Nazi invasion of Danzig at the outset of World War II in Three Score and Ten Years Ago, Part I. (aloha and mahalo)
• Daveparts strolls through history, and finds that the path leads to any one of us, as we walk Into the Hut of Baba Yaga. (mem from somerville)

On Healthcare:

• ProgressiveTokyo brings us the story of another baby Born Under Single Payer- A Snarky Photo Diary Updated. (shayera)
• Health care is front and center right now. These three diaries remind us why we're fighting and how the battles are going. First time diarist squidflakes shares the story of a co-worker in The Ballad of Lucia; joriela pens a first diary to describe Finding Strength at Another Townhall; and MadScientist reports on a Culture Clash at Blue Dog Town Hall Meeting. (jlms qkw)

jotter has High Impact Diaries: August 24, 2009.

brillig brings us Top Comments - Emergency Room Edition.

Please suggest your own favorites from the last 24 hours, and use as an open thread.

There's a big overlap between the medically uninsured and the educationally underserved. Millions of kids caught in the Venn diagram most often live in or near poverty. Most are children of color. Some are children of undocumented parents.

When compared to other OECD countries, it's embarrassing how poorly we treat children of low income families. We're grown tolerant of failing schools and insurance as a benefit of upper middle class employment. Some people see these kids as a priority, other's don't seem to care. It comes down to what you believe about other people's children and how you think about economics.

The first question is, "do you accept any responsibility for other people's children?" If surveyed, I suspect a socially conscious majority of Americans--some liberal, some conservative--would say we have some responsibility to our brother and sister's children. They'd argue about whether it was a public or private responsibility, but they'd acknowledge that we need to do something for those in need. I find it incongruent with stated articles of faith that more religious leaders aren't leading the charge to insure the medically indigent (and that most religious conservatives seem to be opposed). And, other than a few urban church leaders, we don't hear much from churches about the education of urban kids as a moral issue.

On the subject of economics, I'm pro-growth: low taxes to and an opportunity platform that includes safety, transportation infrastructure, a strong public education system, and basic health care. By 'opportunity platform' I'm suggesting the basics for encouraging prosperity; people that live here legally should have a fair shot at joining the economic mainstream (and folks here illegally, like those waiting to get in, should have a pathway to citizenship). The first part of this equation--low taxes--aligns with self-interest and has broad support. The opportunity platform requires investment and that demands a sense of civic obligation and/or the ability to think about return on investment over decades rather than months--a tougher sell.

America is rapidly become less competitive in part because of a weak opportunity platform (and because the opportunity platform in other countries is rapidly improving). What's frustrating is that American spends a lot on education and health care--the most in the world--but neither works very well for low-income kids. We spend enough that we should have great health care and education for all, but we don't. Dramatically improving both delivery systems without spending a lot more money is where this gets complicated.

We seem incapable of discussing sacrifice. Of course there needs to be health care rationing--even after we wring out some of the waste, we've got more pills and machines than we can afford. If you want to pay for them, fine, but expecting American businesses to pay for everything for everyone has already made us uncompetitive (e.g., GM). And now that I'm AARP eligible I can say this: we need to reallocate investment from the last 18 months of life to the first 18 years of life. We spend more on death than we do on adolescence. We are collectively irrational and individually selfish.

President Obama, while leaving the details to Congress, wants a health care plan that expands access and reduces cost. Congress has proven that it's not very good at solving complicated problems like this. Interest group pressure has been intense, intentional misinformation has been inexcusable, and partisan politics all to typical.

Even if you don't accept a moral obligation to serve the less fortunate, you can make a strong pro-growth business case for providing infrastructure including quality education and at least basic health care. We can do it for less money and cover more people. The alternative is a permanent recession with a growing underclass. We just need to make some tough choices in favor of other people's children.

More on Barack Obama

It is the best of times; it is the worst of times. The climate isn't changing; we must move to a sustainable way of life.

Earlier in August, a meeting called "Debunking Climate Change Myths" was held in Springfield, Missouri, bringing together about 150 figures and sympathizers of the climate skeptic community. The meeting was organized by Ron Boyer, a member of the Missouri Air Conservation Commission who also founded a group called Scientists for Truth. I didn't attend their meeting, so I don't know firsthand what this event was aiming to accomplish, but here is a breathless report on how the meeting transpired.

Apparently, Mr. Boyer convened the meeting because he wanted to increase the public platform for climate skeptics to tell their story, which essentially boils down to this:

"We can't be sure that human-induced climate change is really happening, so therefore we shouldn't bend over backwards to do anything different until we're absolutely sure that human-induced climate change is really happening. And, in fact, we're absolutely sure that human-induced climate change is NOT really happening."

Put another way, the story being told in these self-referential (and self-reverential) circles is effectively:

"We like the way things are, thank you very much, and we don't want to change the way we produce or use energy. We're very pleased to be spewing lots of carbon dioxide in the atmosphere, and we're seduced by the allure of consuming lots of resources in doing so, and we simply can't be bothered to entertain any other different way of life, liberty or pursuit of happiness."

It seems as if the skeptics' story is gaining currency among a fearful, confused and angry public: a Gallup poll from earlier in 2009 reports an increase in the number of respondents doubtful about climate change, so the tactics of the climate skeptic storytellers seem to be effective in the current environment. As a result, I would guess that you'll be hearing their story told more frequently and loudly as the debates about the Waxman-Markey climate legislation to be considered in the Senate intensify: expect the disciples of the Springfield skeptic crowd to participate in Tea Party protests against any action, coming to a local auditorium near you.

While the climate skeptics congregated in Springfield, several hundred miles northeast in Cleveland, I joined about 700 other people in attending a city-wide sustainability summit entitled Sustainable Cleveland 2019. Convened by Cleveland Mayor Frank Jackson, the summit was designed to have a broad cross-section of interests begin charting a course for the region's future, premised on a concerted move to a green economy as an engine for overall revitalization.

After a rousing introductory keynote speech by Van Jones, the Special Adviser for Green Jobs, Enterprise and Innovation at the White House Council on Environmental Quality in the Obama Administration, the attendees spent three days assessing the region's strengths and opportunities to surface priorities for action in the coming decade, to provide something worth celebrating in 2019 - commemorating 50 years since the infamous Cuyahoga River fire, which awakened the U.S. environmental movement.

As profiled extensively in reporting by John Funk of The Plain-Dealer, Sustainable Cleveland 2019 was an exuberant gathering. In contrast to the "just say no" story being told among the climate skeptics in Springfield, the story being written in Cleveland is one of optimism and constructive engagement. The story goes something like this:

"We the people of Cleveland want to reinvent our city and region. Because of forces far larger than us, we know we must fundamentally change the way we live and work. We understand the situation we face, and we will not resist or complain. In fact, making the necessary changes provides us the opportunity to create something much better than we have now - and even better than we ever had."

A number of voices in the blogosphere pooh-poohed the Sustainable Cleveland 2019. To be sure, the summit was far from perfect: it was too long, and at times entailed too much hyperbole and rah-rah for my tastes, sometimes lapsing into unrealistic naivete. However, these faults are worth tolerating, if it means greater traction among a broader constituency so as to improve our chances for achieving wide-scale beneficial change. If I were to criticize anyone, it would be the cynical bloggers for sitting on the sidelines and throwing rocks at passers-by with their unhelpful comments.

Cleveland, Springfield: there's no doubt in my mind which city was hosting the more interesting and significant gathering - the one offering any path forward worth pursuing.

In his provocative remarks to the Cleveland audience, Peter Senge, Senior Lecturer at MIT's Sloan School of Management, observed that most segments of the world population were increasingly coming to the recognition that "the future has no future".

For those minds that convened in Springfield, this fear of the future has the skeptics running like lemmings back to the unrecapturable past. Here in Cleveland, a big chunk of our population sees that the present (much less the past) is truly unsustainable and is taking responsibility to invent a new and improved world for themselves: a future that indeed has a future.

More on Climate Change

Former president George W. Bush criticized President Barack Obama today for taking such a brief August vacation, arguing that the brevity of his summer break "sends the wrong message to terrorists."

"The one way to let the evildoers know that they don't have you all stressed out is by taking all of August off," Mr. Bush told reporters at his ranch in Crawford, Texas. "I always made sure I did that."

The former president called Mr. Obama's golf game in Martha's Vineyard today "a positive step," but added, "It may be a case of too little, too late."

Mr. Bush said "there's still time" for Mr. Obama to correct his mistake, and recommended that the president "take all of September off."

"I suggest he find a ranch that needs some brush cleared off of it and spend all of September doing that," Mr. Bush said.

In other news, a new study shows that serious injuries can occur from texting during sex. More here.

More on Barack Obama

On August 14th, comedian and storyteller Mike Birbiglia embarked on his third nationwide stand-up tour, "Comedy Central Live Starring Mike Birbiglia: I'm in the Future Also." Birbiglia isn't quite old enough not to be in the future, but, despite his young age, he's been on the comedy scene for nearly a decade. At 24, he became one of the youngest comics to perform on The Late Show with David Letterman. Since then, he's released three albums (Dog Years, Two Drink Mike, and My Secret Public Journal Live - the latter an album of comedic anecdotes pulled from his popular road blog/e-newsletter of the same name) and starred in a one-man, off Broadway show produced by Nathan Lane, called Sleepwalk with Me. The show, which closed last month and was nominated for multiple awards, tells the story of his struggle to come to terms with an unusual sleepwalking disorder - one that now forces the comedian to sleep in mittens and a sleeping bag. Today, the comic is finishing a move into a new apartment, working on book and film adaptations of Sleepwalk, and logging some fuel-efficient time on the road. I managed to catch him in some rare down time, in which we discussed a little stand-up vs. theater, Smirnoff Ice, awkwardness, and string theory.

Me: Mike, you just finished performing Sleepwalk With Me, in which you pulled off almost 200 performances in an 8 month time frame, are you okay?

Mike: Just give me 200! But, it was actually 198... At a certain point, in the final weeks of the Sleepwalk, Eli -- my producer - said, we should add two more shows, so that we could reach the 200 performance mark. My response was, no, no, no, we should just lie. I mean, is there an official counter?

Me: Maybe Nathan Lane, but I'm not sure. If you'd reached 200, you might have been given a parade...

Mike: We didn't get any calls from the Ripley's or Guinness people, unfortunately...

Me: So, now that it's over, what's it like looking back?

Mike: Well it's funny, I was so disoriented by the experience, in the last weeks of the show, I was like, wow, we did 6 months, and then a couple of weeks after it ended, I realized, wait, we did 8 months. I didn't even know how many months we had done...

Me: So does that mean it flew by or was just a grueling process?

Mike: Both. It was a completely transformative experience. It was like a high-octane graduate program in acting, writing, and publicity. It was my first professional theater experience in New York, where everyone is waiting to hate you -- as soon as you arrive. And they didn't, which was great. So that was nerve racking. The acting aspect was educational, because I had to find something new about the show every night, but without the ability to improvise, really. If you saw the show more than once, the performances were all different, but the words actually stayed the same. My director, Seth Barrish, and I had developed the precision of the words so that the show built towards this crescendo of the sleepwalking story.

Me: How was the experience of writing and performing this different from your experience in stand-up?

Mike: Well, I workshopped a lot of the material in the stand-up arena, at concert halls and colleges, over the course of the last five years, but there were certain things that I couldn't workshop, like the parts of the play where I'm definitively in the wrong. For example, there are parts where I talk about cheating on my girlfriend, and if you did those kind of bits in a comedy club ... well there's a certain tenor of a comedy club and it can go one of two ways: either the audience goes, we hate you, we don't like you at all, because up until now we liked you, but now you've done something that we hate, or it can go the other way, where they think you're one of these shock comedians that does all kinds of crazy shit and then brags about it. That stuff I really had to workshop in the theater environment. The theater audiences are open to the protagonist being flawed and making mistakes and seeing the show through. Stand-up comedy audiences are like, he did, what? There's definitely this baggage that went into comedy club performances where the people came to see me and knew me in a certain way, as opposed to the New York theater audience who just didn't know me, and so the majority of the audience that came out was a combination of theatergoers and This American Life listeners.

Me: You've said before that Sleepwalk is essentially about denial, can I ask, are you in denial?

Mike: The show revolves around this bout that I have with sleepwalking - that's spanned 10 years. For most of those 10 years, I knew there was a problem. For example, I'd wake up from having a dream that I was in the Olympics up on the podium, third place, for an event like dust bustering, and I'd wake up and be falling off the top of my 5 foot book case in my living room. It got dangerous. And I'd think, maybe I should see a doctor, and then I'd think, well, maybe I should eat dinner...So this went on for years, and then I had this incident that I talk about in the show that nearly killed me (Mike, while sleepwalking/dreaming, dove out of a second story window at La Quinta Inn to save his platoon from an incoming missile), so finally I saw a doctor. It parallels some other things in my life, like this relationship I was in for a long time -- a girl I was in love with from college -- I knew I didn't want to get married, and I knew she wanted to get married, but I didn't say no. And then we got engaged, I thought maybe I should break up with her, and then I was like, well, maybe I should eat dinner...so there's definitely this pattern in my life of being in denial of things that are right in front of me.

(Mike is shuffling around.) Sorry, it's one of these rare things, I'm going to the premiere of Paper Heart tonight. (A new film starring Charlyne Yi and Michael Cera.)

Me: So you're not making many appearances at premieres these days?

Mike: No, definitely not. I think I went to one last year. There was a red carpet, which they wanted me to go on, but the thing about me and red carpets is that, even when I went to the Drama Desk Awards and was nominated, even when I was there and there was a red carpet, I had to tap someone on the shoulder, in this herd of photographers, I had to be like, (whispers) I'm one of the people in the thing...I have to herd paparazzi, they don't chase me, I chase them. I have to redirect their cameras toward me.

Me: Have you considered lighting off fireworks to get attention?

Mike: I think I need to develop an entourage.

Me: You don't seem to be much of a publicity junky...

Mike: During the process of Sleepwalk, there was a real disconnect between me and the publicist for the show. He didn't get that what I do is inherently soft-spoken. I try not to get in people's faces -- that's kind of my thing -- I do this because it's what I like in comedy. I like Steven Wright and Mitch Hedberg, comedians who don't force comedy down your throat. Some people have been known to force comedy down the throats of audiences. Not me. My publicist is like 'you gotta be more aggressive, you gotta get in there.' It's not what I do. He also kept correcting me, because I didn't dress right. He was like, 'you need to dress up.' No, that's my whole thing is that I don't like to dress up, it doesn't make me comfortable. And so he changed it to, 'try to look nice.' He gave up on the idea of look nice, and then it was try to look nice. So there was always one shirt that I would wear that he was okay with, and he'd go, 'wear that one shirt.' That was my instruction. I did a series of interviews where I was wearing this one shirt.

Me: Have you since retired the shirt?

Mike: I haven't seen it, so that usually means its retired; that's usually how it works.

Me: I can imagine your publicist saying, 'uh, look, Mike, I don't know how to say this, but we had to put that shirt down...'

Mike: Yeah, I'm pretty sure that they covertly took that shirt out of my collection.

Me: You seem to be aware of staying true to yourself in your comedy, but comedians inherently develop a persona, a stage personality, and so it seems that it might be challenging to resolve the two, do you ever worry about becoming a caricature of Mike Birbiglia?

Mike: I have that in mind right now a lot. I'm writing a book right now for Simon and Schuster called "Sleepwalk With Me and Other Stories," which was exciting at first, until I realized that I have to write the other stories. I am writing all these personal stories, and I've been realizing that, when you're forced to write 80,000 words about yourself, you're forced to delve into different dimensions of your self. It's been very educational, going back and studying other parts of my life. To give you an example, I sometimes portray myself as a slacker, which is very true, but when I go back and look at my high school teacher comments on report cards, you see that there are recurring patterns. My teachers tended to say, 'Mike was really good out of the gate, at the beginning of the semester, but then kind of fell off. He got distracted and went in other directions.' It's a little more complicated then just 'Mike is constantly distracted.' In this example, it begins with Mike is focused and interested and then is like now Mike is distracted, it's a little more dimensional then just Mike is always distracted.

Me: Were you diagnosed with ADD as a kid?

Mike: I was not diagnosed, but I bet I would have been if I'd seen someone, because, you know, I'm not good at reading books. I do this bit on stage where I'm reading Peter Rabbit in school with other kids, and I start reading the book, but then begin thinking about this and this and this, and while I was thinking about all that...the other kids finished the book...

Me: I can relate, I frequently start reading something, don't intentionally lose interest, but naturally begin thinking about mufflers or why Kraft singles are individually wrapped and then realize I've read the same paragraph eight times.

Mike: I know, it's disheartening.

Me: You started your nationwide tour August 14 in Newport, Rhode Island at the Newport Yachting Tent...um, were you playing a boat show?

Mike: No, but I did set sail from the South Street Seaport in my yacht and took it to Newport. But that's the only part of the tour I did on a yacht.

Me: What was it like preparing for the tour?

Mike: Well, I was doing long shows, 80 or 90 minutes to prepare. It was tiring and why I always do one show at a time. But my agent has pointed out that I should be doing two shows, because, you know, they pay twice as much. And pay him twice as much. But what I'd prefer to do is, as they say in ice hockey, I'd prefer to 'leave it all out on the ice.' Just go out there and give it everything. And then go to sleep.

Me: Speaking of ice, I see that your tour is being sponsored by Smirnoff Ice...

Mike: Oh my God, yeah it is. That's my analogy now. It's complete.

Me: I'm thinking you could say on stage, "I'm leaving it all out on the ice," and then hold up a Smirnoff and wink...

Mike: "I'm leaving it all out on the Smirnoff Ice!"

Me: So what's next for Mike Birbiglia, besides the small tasks of touring and writing a book?

Mike: I'm working on the book and concurrently on a screenplay -- an adaptation of Sleepwalk, which I'm really excited about. Hopefully we'll begin shooting this year. It's not officially announced yet, but I think I can say I'm working on a screenplay of it. I can't say what company...

Me: Do you have someone in mind to play Mike Birbiglia?

Mike: Hmmm, maybe Justin Long... No, I'll be playing myself.

Me: So, you're working on a book that revolves around sleepwalking, a screenplay about sleepwalking, you just finished a play ... I'm seeing a pattern, are you worried about keeping it fresh?

Mike: I was talking to my wife the other day about this. I said, honey, we're going to spend another 2 ½ years on this, and then we'll move on. (Laughs.) My wife is a big part of the process, I talk through everything with her. And she seems okay with it, so...

Me: I imagine you telling her that you will be working on the sleepwalk theme for another two years, she agrees, and then the two of you high five with mittens on...

Mike: That's right. We actually just moved into a new place in New York, so that's another one of the things I've been doing, a lot of moving. So we'll cover sleepwalking for another couple of years, and I think the next show will come along, The Accidental Marriage, and then I will hopefully develop that as a film as well, I mean that's what I want to do, I want to make movies. I did a pilot for CBS last year, and it didn't get picked up, but I think it's probably for the best, because I came away thinking that what I really want to do is make movies. It was fun, but it wasn't precisely what I want to do.

Me: When did you know you wanted to be a comedian?

Mike: I saw Stephen Wright live at the Cape Cod Melody Tent in Hyannis, MA, which is the second stop on my tour, and I saw him and knew right then that that's what I wanted to do. I knew at age 16 that I wanted to be in comedy, but didn't gather the nerve to do it until I was 19. I loved it immediately. I won the funniest person on campus at Georgetown. Nick Kroll was in it, too, he's a very funny guy and a friend. I won the contest and that started me doing stand-up full time. But I was studying under this professor at Georgetown, who taught in the screenwriting program I was in, and it was there that I really developed this obsession with stand-up and film. I fell in love with all the Woody Allen films. I was like, I'd like to do that, that's where it's at. Making dramatic films that use comedy as a lubricant to tell the dramatic story -- that's what I admire about Woody Allen, James Brooks, Mike White -- people who tell great stories and use comedy not as an end in itself, but just as a tool for telling the story. Sleepwalk was my first stab at that, and hopefully I'll be able to take more stabs.

Me: Do you think it's possible to make it in comedy today without being part of the Judd Apatow machine?

Mike: God, I hope so.

Me: I've heard comedy writers say that when comedy becomes your profession, it can change the dynamic -- sometimes for the worse -- do you ever wrestle with not feeling funny?

Mike: When I go home, yeah. When I go to visit friends from childhood, my hometown, definitely, because I wasn't perceived as a comedian in any way growing up. I remember getting an email from someone one of the first times I was on TV, this kid goes, 'you are a comedian? You are one of the least funny people I grew up with...' That really builds the confidence. I think it's hard for people who know you so well to see you in that context. I don't know, it's almost like in the universe of my childhood, my idiosyncrasies fit into the dynamic of the people around me, there was nothing unusual. People who I grew up with were like, 'okay, I guess that's what Mike is like.' But then you go into the world, and you're a fish out of water. It's not Mike-from-Shrewsbury anymore, it's Mike-in-the-world. And then all of a sudden, the things that were small idiosyncrasies become big idiosyncrasies, and that's where a lot of my comedy comes from...

Me: Do you ever feel pressure to be "the funny guy" off stage?

Mike: I let that go years ago. Whenever people say, 'wait, how come you're not funny?' Or something like that, I'm always like, 'if I said to you casually the stuff that I say on stage, it would get really uncomfortable, and then you or I would end up leaving the conversation.' What's that worth? Why don't we just have a regular conversation? (Laughs)

Me: You touch on awkwardness frequently in your comedy, and it seems you find yourself in awkward scenarios frequently, any recently?

Mike: Well, My Secret Public Journal was devoted to awkward moments, and now that I am aware of it and observe it regularly, there's definitely the question of 'will that awkwardness go away? Will it be cured?' I recently did a show where I was talking about how I'd just been to Penn State University, and how I'd observed that the school has a serious drinking problem. When I showed up at [Penn State], the headline of their newspaper read "Drunk Driver Hits Drunk Walker." You have to start looking at yourself in the mirror at that point... There was a meet and greet after the show, and this woman came up to me and said, 'did you do that story because my son is here?' And I was like, 'uh, no? I don't think so...' Well, her son was the drunk walker. And I was like, ohhhh no...(laughs). It was so awkward. I really do not attempt to bring this stuff upon myself, I think it just follows me.

Me: That is awkward. I might have exploded. Mike, a lot of comics have begun using New Media for promotion and so on, do you think this is having a positive effect ... or is opening up comedy to people who otherwise wouldn't be seen?

Mike: Yeah, I think that's hard to avoid. More people are using Twitter than are watching TV. (Laughs.) So it's like, well, I sure as hell better be on Twitter. Social networking is kind of like a rock and roll and comedy dating service, where you plug in what kind of comedy you like, and simultaneously, comedians are like this is what kind of comedy I do, and then you pair up. It's a good way to find people with common interests.

Me: Any idea what might be next?

Mike: Well, we're open to holograms.

(Mike's doorbell rings.)

Mike: I don't know who this is at my door, hold on. Hello? I don't know what the hell...I think it's a delivery or something, I have this thing where I can see people through the peep hole.

To me: The guy said 'it's a delivery, it's okay,' and then just walked away.

Me: Wait, Mike, I don't know if I'd trust...

And that was the last we heard of Mike Birbiglia ...

Until he comes to a city near you. Buy your tickets now. And check out birbigs.com as well as Mike's appearance on Comedy Central's Friday Night Stand-up on August 28.

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The query gripping the nation: "How do we reform health care?"

But I don't hear anyone asking a far more essential question: "What is health?"

Given that we all want health and spend trillions to "care" for it, it's sobering how little thought we give to its true meaning. When I ask, the response I receive is typically "the absence of disease." Health is much more interesting and consequential than this. To define it in this negative sense is no more accurate than to define wealth as the absence of poverty.

I define health as a positive state of wholeness and balance in which an organism functions efficiently and interacts smoothly with its environment. Good health comes from an innate resilience that allows you to move through life without suffering harm from toxins, germs, allergens and changing environmental and dietary conditions.

By no stretch of the imagination does mainstream American "health care" move us closer to this vision of robust, resilient health. It is a fiscally unsustainable, technology-centric, symptom-focused disease-management system. Consider that two-thirds of all Americans die from cardiovascular disease, cancer, and diabetes, which are all strongly associated with lifestyle choices. Maintaining and paying for our current system will serve only to continue - if not exacerbate - this trend, and bankrupt the nation in the process.

A truly reformed health care system will care for our health rather than care for our ills. This does not mean it will abandon those who are sick or injured. Instead, measures that maximize our innate self-healing capacity - our health - will be used first whenever possible to both facilitate recovery and keep us whole and balanced.

How do we get there? Here is a summary of the health-promoting, disease-preventing agenda that I set forth in my new book, Why Our Health Matters: A Vision of Medicine That Can Transform Our Future available September 8, 2009.

• Our medical schools must teach health promotion along with disease management and crisis intervention. If the National Board of Medical Examiners included questions on these subjects in required student exams, schools would quickly add them to their curricula.
• Insurance companies, whether private or government owned, must be compelled to pay for health-promoting measures. In turn, this will encourage physicians to offer such treatments in earnest.
• The federal government must create new departments within the National Institutes of Health and the Department of Health and Human Services to emphasize health promotion and disease prevention. An Office of Health Education should be set up within the Department of Education to establish a K-12 curriculum of health, healing and disease prevention.
• Citizens must pressure the American Hospital Association, the American Public Health Association, the Centers for Disease Control and other relevant governmental agencies to make greening our hospitals and medical centers a top priority so that they themselves don't create even more illness. Examples of such changes: stopping environmental pollution caused by hospitals (e.g. mercury discharge) and banning the sale of junk food on their premises.
• We need to accept the seemingly obvious fact that a toxic environment can make people sick and that no amount of medical intervention can protect us. The health care community must become a powerful political lobby for environmental policy and legislation.
• We need to support grassroots movements to ban sales of soft drinks and junk foods in public schools, make schools serious about physical education and health education, and fight attempts by agribusiness to weaken federal organic standards.
• We must insist (with the power of our pocketbooks, voices and written words) that television networks, movie studios, radio, the internet and print use their tremendous influence in a positive way. The media showers us with destructive, illness-promoting messages (such as kids devouring junk food and adults popping pills for trivial, transient discomforts) and fear-based news reporting on health. We must use creative messages in the media to counteract this influence.
• American businesses are struggling to pay outrageous, exploitive insurance bills for their employees, hampering our ability to compete globally. In 2005, General Motors paid an estimated $1,525 in health-care costs for each car it made; Japan's Honda paid $97i. We must convince corporate America that preventable employee absenteeism and diminished productivity can be counteracted in a cost-effective way by offering workers health-promoting programs such as discounted gym memberships, smoking cessation programs, and more nutritious cafeteria food. Ultimately, the sophisticated American marketing talent that pushed us toward unhealthy behaviors might be marshaled to move us all in directions that are more consistent with good health.

Benjamin Franklin's adage "An ounce of prevention is worth a pound of cure" has never been more relevant. In Franklin's time, contagious disease was the scourge of humankind, but focused effort has rendered it a historic footnote. With sufficient will, we can do the same with chronic disease that now costs us so much to manage.


References:

iRelman, Arnold S., M.D. A Second Opinion: Rescuing America's Health Care. Public Affairs, 2007, p. 78

Andrew Weil, M.D., is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com. Become a fan on Facebook.

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A discussion about the cult-hit The Wire turned deadly when 27-year-old Steven Shaw was stabbed by friends who could not comprehend his lack of passion for the HBO drama.

Tensions initially arose when Shaw did not contribute to a "best instances of foreshadowing in the first season" debate. Explaining his silence, Shaw admitted that he thought there were "too many characters and plot-lines" for him to enjoy the viewing experience.

"Sure, those first few episodes can be slow," said one of the murdering friends, insisting the very same episodes took on new meaning after re-watching them three or four times. "But then he said the stopped watching after season 2 because he 'had no interest in a crime drama.' Clearly he had to die. "

Witnesses say that Shaw quickly backpedaled when he saw his friends each grab knives, acknowledging that he didn't dislike the show, but "couldn't see what all the hubbub was about."

"I just don't understand how someone could not like that show," said another friend/killer. "It's either you love it, or you just haven't gotten around to seeing it yet. No in-betweens. I'd kill him again if given the chance."

The funeral was Entourage-themed in honor of Shaw's favorite show, with the pallbearers begrudgingly dressed as the four principal characters.

-Dan Abramson, thehollywoodham.com

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Today, especially on the polling front, is considerably more quiet than the smorgasboard that was available on Monday. There is news, however, mostly on the candidate front.

WI-Gov: Partisan Poll Claims Walker Lead For Now-Open Govs Race
The only poll released today comes out of the gubernatorial race in Wisconsin, which became an open-seat race last week when two-term Democrat Jim Doyle elected to retire rather than seek a third term. It is a partisan poll, conducted by the Republican firm the Tarrance Group, so bring the salt. The pollster claims that Milwaukee County Executive Scott Walker leads all three potential Democrats, although he is in a virtual tossup with Milwaukee Mayor Tom Barrett (44-43). The leads over Lt. Governor Barbara Lawton (48-40) and Congressman Ron Kind (49-39) are a bit more secure. The same survey has Walker easily besting former Congressman Mark Neumann in a GOP primary (57-21), while it also has Barrett with a double-digit lead over Lawton and Kind in a Democratic Primary. Barrett leads the Dem primary with 39%, to 25% for Lawton and 19% for Kind. The poll, conducted last week, did not measure Neumann against the three Democrats.

NJ-Gov: AUSA At Center of Christie Controversy Tenders Her Resignation
Saying that she did not want to be a distraction to the U.S. Attorney's Office, Assistant U.S. Attorney Michele Brown offered her resignation today. Brown, you will recall, was the recipient of a $46,000 loan from former US Attorney (and current GOP nominee for Governor) Chris Christie, which raised questions about conflict-of-interest, as well as caused headaches for Christie, who refused to report the loan either in his public financial disclosure forms or his tax returns.

OR-Sen: Wyden Flirting With A Primary Challenge?
An interesting rumor (that appears to have already been shot down): recently word began to bubble up that Senator Ron Wyden might face a primary challenge from former Independent (and, before that, former Republican) John Frohnmeyer. Frohnmeyer nearly ran for the U.S. Senate in 2008 as an Independent, going after incumbent Gordon Smith from the left. Frohnmeyer talked to Jeff Mapes of the Oregonian, however, and confirmed that Wyden has angered him a bit on the health care issue, but also declared that he was not planning on channeling that anger into a primary challenge.

NY-Gov: Giuliani Sending Mixed Signals About Governor's Race
The odds on whether or not Rudy Giuliani will seek the Republican nomination for Governor depend upon whether you were reading  The New York Times today, or Politico. The NYT makes it appear as if Giuliani is laying the groundwork for a bid, while Politico chats with members of his inner circle, who are skeptical about the prospects of Rudy making the race. One of the doubters points out a lack of fundraising on his part (although one has to imagine he could raise whatever resources he needs).

UT-Sen: The Club For Growth Finds Their Latest Target
...And he is longtime Utah Republican Senator Bob Bennett. Bennett, facing a primary challenge from state Attorney General Mark Shurtleff (and possibly, also, from freshman Congressman Jason Chaffetz), has become the latest Republican to stray far enough from GOP orthodoxy to earn the emnity of the folks at CfG (of course, in Bennett's defense, straying three-and-a-quarter inches from GOP orthodoxy is enough to get the CfG's undies in a twist).

TX-Gov: GOP Primary Getting Ugly, Early
This is not necessarily breaking news, but it makes the cut for the wrap-up based on sheer entertainment value alone. Apparently, as U.S. Senator Kay Bailey Hutchison began her gubernatorial campaign with a kickoff tour last week, she got an unusual welcome from incumbent Republican Rick Perry. Perry, evidently, had some supporters crash her tour stop in Austin, bringing along two live pigs in a truck, and wearing pig snouts themselves. They handed out KBH "Bailout Bucks" and flaunted a sign which read "Pork: Washington's Other Financial Mess." Democrats, if they can coalesce around a serious candidate, could benefit from what promises to be an absolutely vicious primary between these two, who seem to have a genuine antipathy for one another.

CA-10: Special Election Now One Week Away
Californians in the 10th Congressional District head to the polls in exactly one week. A quartet of Democrats have emerged as the "lead pack" to earn the Democratic nomination in this (mostly) blue district. Lt. Governor John Garamendi has had a lead in the polls, but he is being chased by state Senator Mark DeSaulnier, state Assemblywoman Joan Buchanan, and political rookie and Iraq War vet Anthony Woods. David Dayen over at Calitics gives a solid rundown with seven days to go in the campaign.

KY-State Senate: Dems Pick Up Another Senate Seat in Special Election
If you rely solely on the traditional media for your political coverage, you might think that, at this point, the Democrats will never win another election. Ever. In the real world, however, the Democrats actually picked up a State Senate seat tonight in, of all places, rural Northern Kentucky. Democrat Robin Webb scored the narrow (282 vote) win over Republican Jack Ditty in the 18th Senate district. This was a closely-watched contest in a competitive Senate district. Is this indicative of a Democratic wave? Of course not. Special elections with low turnouts (this one had a 23% turnout) are rarely indicators of anything rather than the ability of the candidates to turn out their home base (although the press, and one DK diarist, tried to make them into a great deal more than that when the GOP scored some special election wins earlier in the year). In this case, Webb's entire margin of victory was owed to her 3-to-2 victory in her home county (Carter County), a county that went 58-42 for the Republican incumbent when this seat was last contested in 2006.

The Battle For the House: New Names Joining the 2010 Field
Crisitunity over at Swing State has a number of new challengers for 2010 in the battle for control of the U.S. House of Representatives. In OH-16, Democratic freshman John Boccieri gets a potentially legitimate (and, almost certainly, self-funded) challenge from nursing home owner Jim Renacci, who also was a co-owner of the local Arena Football franchise. Meanwhile, in CA-18, the GOP takes aim at the historically Democratic district of Dennis Cardoza. Republican Mike Berryhill is looking to take this seat, which has been in Democratic hands for decades. There are also a pair of potentially legitimate primary challengers, as DeKalb County Commissioner Lee May is pondering a challenge to Hank Johnson in GA-04, while Lee Terry is looking at a potential self-funder in businessman Matt Sakalosky, who already signalled his intention to make the race.

Source: [b]Newsweek[/b]

Source: [b]AP[/b]

I'm sitting in my Tokyo hotel room, studying the conflict over US health care reform from a comfortable distance. Here in Japan, they don't understand our problem. Here in Japan, there is no health care crisis - even with a rapidly aging population. No one goes bankrupt over medical bills. No one is denied medical services. If someone wants a special medical treatment, they can buy it here or in Switzerland or where ever. Yet they have a private system with no public option. What they do have is a strictly regulated medical insurance industry. While some shortages of specialized care exist and some rural hospitals are understaffed, they have a more robust primary care system than we have in the States, which means people see the doctor more often. More visits mean early detection and lower long-term treatment costs. The poor - and there are lots of unemployed people here - receive health care via government insurance subsidies - something like Medicaid. So while health care professionals earn a fraction of their counterparts in the US, they are a respected group and earn a good middle class living.

Here in this egalitarian middle class society, they have one of the healthiest populations among industrialized nations despite the fact that they smoke like chimneys. According to a recent post in The New York Times, "Japan has about the lowest per capita health care costs among the advanced nations of the world, and its population is the healthiest. That is largely due to lifestyle factors, such as low rates of obesity and violence, but the widespread availability of high-quality health care is also important." In Japan, adequate health care is a right that comes with being a member of this hard working society. Their government does not allow health care to become a major profit center for big businesses at the expense of public welfare.

With this in mind, I mentioned my particular situation to a Japanese colleague. I explained that I had a very mild heart attack about nine years ago. It was a wake-up call. I had gained a bit of weight, and my cholesterol was up slightly. Since then, I've been taking my meds and watching my diet. Today, the doctors can find no sign of artery disease, but no insurance company will give me coverage. Their adjusters simply right me off because of my 'pre-existing condition'. My friend wonders if that is legal. Sadly, it is completely legal, and then I quoted from an article by T.R. Reid for the Washington Post, "American health insurance companies routinely reject applicants with a "preexisting condition" - precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital."

So, what is the solution to our national health care crisis? In my opinion, it begins with insurance and pharmaceutical industry regulation - like they do in Japan and in other countries. Of course, these industries are large and powerful. They exert a lot of influence in Washington DC and through their mouthpieces at News Corp and the WSJ. Nevertheless, we need to ask ourselves, "is this a nation 'of the people and for the people' or is this a nation that serves the interests of business at the expense of the people's business?" I don't believe the Founding Fathers ever imagined that business would grow so powerful that its voice would drown out that of the people. Maybe it's time to pass that constitutional amendment to kick business and other special interests out of government?

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Source: [b]ABC News[/b]

We ignore Africa at our peril.

In vital resources -- oil, copper, diamonds, gold, timber and more -- the continent is rich beyond imagination.

Indeed, Africa is more breadbasket than basket case. The United States is projected to import some 25 percent of its oil from Western Africa in the coming years.

While the U.S. media pays Africa little attention, the Chinese leads by far in the mad dash for a share of the continent's natural treasures. Using some of the money it makes in trade with the U.S., China is investing heavily across Africa, building highways, hotels, bridges and dams, seeking to lock up long term access to resources and the good will of African leaders.

The United States is way behind.

The African continent will only become more important in the future. The whole world has a stake in what happens there.

For decades, Africa was little more than a pawn in the Cold War, before that the playing field of competing imperialist nations. Now it is a key geographic territory in the fight against terror after al-Qaida blew up embassies in Somalia and Kenya. The continent's mineral resources reinforce its strategic importance.

Africa matters.

Therefore it is in the U.S.' and the world's best interest that Africa's fledgling democracies succeed so that true democracy might spread across the vast continent.

That is why I recently spent five days in Cote d'Ivoire, meeting with its current President and opposition leaders and addressing youth groups and religious figures, as the West African nation prepares for a crucial Presidential election on Nov. 29 -- a day that will go a long way in determining the future of democracy in the region.

For most of its 49-year history as an independent nation, Cote d'Ivoire has been a shinning light of a dimly viewed West Africa. Politically stable, culturally tolerant and economically vigorous, Cote d'Ivoire was and is a regional powerhouse.

As one U.S. Embassy official described the nation of 18 million people to me, Cote d'Ivoire was to its neighbors what the United States is to Mexico and Central America. "This is where people went to find work,'' the official said. "If this economy gets shut down you will see a dramatic impact on the entire region.''

Cote d'Ivoire produces 40 percent of the world's coco and is a major exporter of bananas, coffee, cotton, palm oil, pineapples, rubber, timber and tuna. In recent years, according to U.S. Embassy figures, petroleum exports have risen significantly, and petroleum is now the country's largest foreign exchange earner.

As I toured its sprawling port -- the second largest in Africa -- I saw five cargo ships loaded with fruit and vegetables headed to Europe.

Abidjan, its biggest city once known as "Little Paris,'' was a popular destination for tourists from the United States and Europe for years.

But then there was a coup in 1999, followed by UN sanctions, another coup attempt in 2001 and a brutal civil war in 2002 that split the country between North and South, pushing Cote d'Ivoire to the brink of disaster.

Today, the shooting has stopped. But the nation remains on the brink.

A transparent and fair election is the key to restoring Cote d'Ivoire to its place among the family of nations. A world class democracy means world class investment.

That was my message as I met separately with President Laurent Gbagbo and leaders of the two opposition parties who are vying for the Presidential Palace. I had a long and fruitful discussion by phone with Henri Konan Bedie, a former president running for his old job, and I sat down with representatives of Alassane Ouattara, who was out of the country, seeking medical treatment in Paris.

As I made clear whenever and to whomever I spoke, I was there not to support a candidate but to support the process of democracy.

In addressing a pan-African youth conference and a meeting of Muslim and Christian religious leader I asked the people and the candidates to agree to three basic principles.

Number one: Campaign diligently and fairly.

Number two: Use the language of reconciliation and not destruction.

Number three: Publicly pledge to support the winner.

The will to build a great country must be stronger than personal rapaciousness. The winner must win with grace; the losers must lose with dignity. All must support and serve Cote d'Ivoire.

I also sat down with the Prime Minister, Guillaume Soro. Three years ago he was the leader of the rebellion in the North. Now he is overseeing the election, working night and day to heal his nation. He invited me back to act as a monitor of the election, which I intend to do.

I reminded him and everyone else I met that we in the United States had once been divided between North and South, locked in our own bloody civil war.

After that war we suffered through generations of American apartheid. It took a century before the right to vote of every American citizen was protected by law.

Through the depth of that pain, Americans are learning to live together across lines of class, gender and race.

America rose from the ashes of pain and division. Cote d'Ivoire can rise as well.

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Maybe he just forgot:

At a town hall today, Sen. John McCain (R-AZ) attacked the controversial deal supposedly struck between the White House and the pharmaceutical industry on health care reform. According to McCain, the deal was an example of the "special interests" getting "a seat at the table." "The lobbyist for the drug companies, a guy named Tauzin who makes over a million dollars a year went to the White House and he was quoted, he was quoted across this country when he says, and I quote: ‘We assured, we need somebody to come in first, if you come in first, you will have a rock solid deal.’"

The deal with PhRMA, which has been heavily criticized by the left, does raise questions, but it is odd to hear McCain criticize someone for soliciting the support of Billy Tauzin. In 2007, Tauzin contributed to McCain’s presidential campaign. When The Hill reported on the contribution in April 2008, Tauzin’s spokesman said, "Sen. McCain put out a call for help and Billy...answered it."

Typical McCain -- do as I say, not as I do.

Source: [b]guardian.co.uk[/b]

Michael Bennet has never had to run for election before, which has a lot of folks worried as he mounts up for a 2010 "re-election" bid for his U.S. Senate seat. With that in mind, Bennet has to be pretty happy that his strongest opponent (according to recent polling) has decided to stand down:

Former Congressman Bob Beauprez will not run for the U.S. Senate, he said in an email to supporters [Monday]afternoon.

"Having been presented with the potential to serve in the United States Senate, Claudia and I considered it very carefully. However after significant reflection, I will not be a candidate for the Senate in 2010," he wrote.

The folks at Colorado Pols think that Beauprez came to the realization that he was still damaged goods, having been thumped by Bill Ritter in the gubernatorial election three years ago. They also point out that Democrats are fairly optimistic about their chances against the next likely GOP candidate, former Lt. Governor Jane Norton:

Jane Norton's Senate bid is basically a lock at this point. Everybody's talking about it. Democrats we've talked to this evening seem awfully confident, like they know something we don't know. That's likely to be the case for a majority of Colorado voters, a good percentage of whom probably think her first name is Gale. Though to be fair, voters could think her first name was "Ken," and it's still a positive for her. Name ID is name ID, especially in a GOP primary--and general election--where nobody knows anybody.

This decision by Beauprez, incidentally, is not without precedent. Last week, the GOP got a double dose of bad news when both Charlotte Mayor Pat McCrory and former Congressman Robin Hayes declined a challenge to freshman Democrat Larry Kissell in NC-08. A few weeks earlier, Nevada Congressman Dean Heller resisted entreaties to make a Senate bid against Harry Reid. In early July, it was former Senator John Sununu  declining a bid for an open seat in New Hampshire.

This stands in stark contrast to the pervasive media narrative of the summer, which is that this election cycle will be positively atrocious for Democrats. Republicans, we keep hearing, are once again ascendant, ample polling evidence to the contrary.

But if that were true, wouldn't every ambitious Republican want in on the gravy train? Yet, with every passing week, we see another high-profile GOP recruit backing away from a 2010 bid. Indeed, the recruiting cycle thus far has been pretty even, with both sides landing some of their prized targets, and some slipping off of the hook.

That is not the way recruiting typically goes in a wave electoral cycle. The party on the weaker end of the cycle tends to have trouble recruiting candidates, and tends to lose a lot of their incumbents to retirement. Thus far in the House, according to Swing State Project, there are 21 open seats confirmed for the House: 12 Republicans and 9 Democrats (all of them, interestingly, are running for other offices). In the U.S. Senate, there are nine open seats: 7 Republicans and 2 Democrats.

Despite these very mixed messages, the conventional wisdom of the press corps is hardening. Not surprisingly, Fox News is already there: their headline story yesterday afternoon was "Democrats Brace for Tough Congressional Races in 2010".

Beauprez's decision, however, is yet another concrete example that the dynamics of the 2010 election are incredibly unclear, no matter how badly the traditional media would like to declare an overarching theme for this election fifteen months in advance.

Source: [b]NY Times[/b]

Source: [b]Globe and Mail [/b]

Medical and legal experts are now questioning whether military doctors violated professional ethics while monitoring harsh interrogation techniques described in the C.I.A. inspector general's report released yesterday by the Obama administration.

The report, written in 2004 by Inspector General John L. Helgerson, outlines brutal interrogation techniques, such as choking, shackling and waterboarding, used against terror suspects in secret overseas prisons. It includes an appendix on medical and psychological support, noting that medics were responsible for monitoring the health of the detainees subject to enhanced interrogation techniques.

The Hippocratic Oath states that doctors should consider first the health of the patient and never do physical harm.

Given that at least a dozen prisoners -- and likely more -- have died by homicide in military prisons this decade, many have wondered how often doctors monitored torturous interrogations without intervening, as was mandated by designers of the interrogation program.

"What we've learned is that high-value prisoners were subjected to a program designed to break them down psychologically and that medical professionals assessed and monitored them while they were being abused," said Steven H. Miles, whose book, Oath Betrayed: America's Torture Doctors, describes widespread medical abuses and cover-ups in U.S. military prisons.

A report written by the International Committee of the Red Cross in 2006 revealed that doctors in some instances physically participated in interrogations at C.I.A. black sites. That report, obtained and released by journalist Mark Danner earlier this year, describes an episode during which a doctor used a pulse oxymeter (a medical device that is placed on a patient's finger) to monitor the blood-oxygen level of a detainee being waterboarded for an hour.

"This is a technology that was developed for therapeutic purposes, and instead it's being employed basically to monitor torture to make sure we don't kill the person," said Greg Bloche, a doctor and law professor at Georgetown University. "That's a pretty egregious misuse of medical technology."

During a waterboard session, a prisoner is strapped to a bench while water is poured onto a cloth draped over his face, in order to simulate drowning, giving a prisoner a sense of imminent death.

According to the Red Cross report, doctors measured the swelling around the shackled ankles of detainees in order to detect signs of low-blood circulation. "The doctors weren't minimizing pain, they were helping calibrate pain," said Scott Allen, a Rhode Island doctor and adviser to Physicians for Human Rights.

The interrogation methods have been widely condemned as torture and abandoned by the Obama administration. The American Medical Association and the American Psychiatric Association have also denounced them. United States Attorney General Eric H. Holder Jr. has recruited John H. Durham, a veteran federal prosecutor, to investigate the abuse of prisoners.

Doctors stationed at the secret prisons intervened when interrogation methods grew too rough on more than one occasion, according to the Red Cross report. But many familiar with the report suggest that doctors failed to intervene on other occasions.

"You have examples where someone's getting their arm dislocated, and an unidentified medical professional pops the arm back in and says, 'continue,' " said Nathaniel Raymond, a spokesman for the advocacy group Physicians for Human Rights.

Some argue that military doctors are complicit in torture and should face trials or sanctions. As precedent, they point to the Nuremberg hearings following World War II. After top Nazi military commanders were tried, the next in line to face charges were doctors stationed at the death camps.

Health officials affiliated with the military from 2002 to 2004 -- when the harshest interrogations were taking place -- have disappeared from the debate. "This is not something that's daily supper-table conversation among me or my peers," said Michael Cowen, the surgeon general of the Navy during that time period.

William Winkenwerder, the assistant secretary of defense for health affairs during the Bush administration, who served as the principal medical adviser to Secretary of Defense Donald Rumsfeld, said in an e-mail, "Matters relating to the subject of interrogations are the subject of ongoing litigation. It would not be appropriate for me to comment outside the context of litigation."

Some former military doctors defended the interrogation methods, claiming that physicians stationed at military prisons are, in effect, combatants, and the Hippocratic Oath needn't apply.

"War is not a sanitary operation," said Stephen Cunnion, a retired captain in the U.S. Navy Medical Corps and now a senior fellow at the Potomac Institute for Policy Studies. He said the interrogation methods kept Americans safe. "Once the enemy finds your weaknesses, they use them. They'll just laugh this off and won't tell us anything."

Kelly Faucette, a retired colonel and Army doctor, who saved the life of a terrorist while he was in Iraq, disagreed, saying the methods violate a doctor's mission.

"They're completely against any ethical principles that go with medicine," he said. "We have a right to help people and to treat their illnesses ... (not to) evaluate whether a person was medically able to tolerate being abused or tortured."

The numbers of interrogated detainees and participating doctors are not known. Miles said the number of detainees exposed to harsh interrogations reached the hundreds, and likely the thousands.

In the C.I.A. report, designers of the program stated that the interrogation methods do not cause severe mental pain or suffering. Critics, however, point to the Red Cross report, which describes a claim by prisoner Abu Zabaydah that he lost control of his urine while being waterboarded in 2002 and continued to lose control of his urine during stressful situations. Zabaydah was waterboarded at least 83 times in August that year.

It's possible that medical complicity went beyond torture. Many experts, including Miles and Bloche, said that some military doctors altered death certificates of detainees to cover up homicides. Others claim that doctors violated confidentiality codes by handing over to interrogators the medical records of detainees, which were then used to create individually tailored interrogation regimes.

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