New malpractice idea in health care debate

RICARDO ALONSO-ZALDIVAR Associated Press


President Barack Obama's willingness to consider alternatives to medical malpractice lawsuits is providing a boost for taking such cases out of the courtroom and letting experts, not juries, decide their merits.

The idea of appointing neutral experts to sift malpractice facts from allegations appeals to conservatives in both political parties. They want to address medical liability as part of health care legislation that's now largely silent on the issue. Trial lawyers remain steadfastly opposed to curbs.

Nonetheless, the American Hospital Association has been shopping a new plan to lawmakers, hoping it will be considered during Senate floor debate on health care in the coming weeks.

Separately, at a Health and Human Services hearing next week, proponents of the idea will urge the administration to provide funds for a pilot program. Obama has set aside $25 million to test a range of alternatives to malpractice litigation, and the hearing is the first step in deciding how to distribute it.

"There is a progressive opportunity here to leapfrog what has been a stereotypically polarized debate in Washington," said Will Marshall, president of the Progressive Policy Institute, a centrist Democratic think tank. "This serves both progressive and conservative goals. You wouldn't have to have a terrible injury and attract an enterprising malpractice lawyer to have access to court. And it would reduce malpractice premiums."

Doctors have maintained for years that fear of being sued leads them to order unneeded tests that raise costs for everyone. In Obama, they've found a Democratic president who accepts that premise.

Validation has also come from the Congressional Budget Office. In a turnaround, it recently concluded that malpractice curbs would lower the federal deficit by $54 billion over 10 years, mainly because Medicare and Medicaid wouldn't have to pay as much for defensive medicine.

What Obama doesn't accept is the idea of slapping hard limits on jury awards in malpractice cases, the remedy long advocated by doctors' groups. So the search is on for alternatives.

That's what Richard Umbdenstock, president of the hospital association, says his industry has come up with. "We are trying to offer this as a constructive approach, to see if we can generate some interest," he said.

Under the plan, patients who've suffered an injury at the hands of a medical professional or institution could take their case to a local panel of experts appointed by state authorities.

The patient wouldn't have to prove negligence, only that the doctor could have avoided the problem by following established guidelines for clinical practice.

If the experts find that a patient was harmed and the injury could have been avoided, the panel would offer compensation. Payments would not be open-ended, but based on a publicly available compensation schedule.

A patient who disagrees with the local panel's ruling could appeal to a higher-level panel, and ultimately, to a court.

The hospitals' proposal is similar to an idea for "health courts" from Common Good, a nonprofit group that advocates for changes in the legal system. All patients would benefit from such a system because it would create an incentive for doctors to follow clinical best practice guidelines, said lawyer Philip Howard, the group's founder.

It would also protect doctors who adhere to the standards, getting at the root of the problem of defensive medicine.

"Defensive medicine is the result of distrust by doctors in situations where they are blamed when a sick person get sicker, but they didn't do anything wrong," said Howard.

But trial lawyers say that such an approach could infringe on constitutional rights.

"We think that health courts take away the right to a jury trial," said Susan Steinman, policy director for the American Association for Justice, which represents lawyers.

It's unlikely that Congress would pass a law ordering states to adopt health courts. For one thing, trial lawyers are among the biggest contributors to Democratic candidates. But Harvard law and public health professor Michelle Mello says the federal government could encourage states to adopt such changes themselves, by offering financial grants. Sen. Mike Enzi, R-Wyo., an influential voice on health care, has advocated such an approach.

The Obama administration is keeping all its options open. A stronger medical malpractice initiative could help the health care bill get votes from moderates and conservatives. It could also alienate some liberals. The political balance is unclear.

HHS spokesman Nick Papas said any proposal that advances the president's goals of protecting patients, reducing frivolous lawsuits, fairly and quickly compensating patients who are injured, and fostering more open communication between doctors and patients will be considered for funds under the administration's $25 million pilot program.

"Medical malpractice reform is a hand extended to the Republicans," said Marshall, the Democratic centrist. "But there's no telling if they might swat it away."

MediaMatters Reviews the Week

Limbaugh's NFL dream slips through his "formerly nicotine-stained fingers"

Six years after Rush Limbaugh was forced to resign in disgrace from his gig on ESPN's Sunday NFL Countdown for, as CNN reported at the time, "his statement that Philadelphia Eagles quarterback Donovan McNabb was overrated because the media wanted to see a black quarterback succeed," the nation's top conservative radio host was dropped from a group seeking to purchase the NFL's St. Louis Rams.

A statement released by Dave Checketts -- a member of the group seeking to buy the Rams and the chairman of the NHL's St. Louis Blues -- said Limbaugh was dropped because his "involvement ... has become a complication ... endangering our bid."

"Complication" sure is a nice way of putting what transpired this week.

In the week since El Rushbo confirmed his intention to help buy the Rams: the executive director of the NFL players union came out against Limbaugh's bid, saying football "overcomes division and rejects discrimination"; Indianapolis Colts owner Jim Irsay said he "couldn't even think of" supporting Limbaugh's Rams bid due to his divisive rhetoric; NFL players reportedly said they "wouldn't play for" a Limbaugh-owned team due to his "flat-out racist" comments; NFL commissioner Roger Goodell said Limbaugh's "divisive comments are not what the N.F.L. is all about"; and a host of sports media figures blasted the very notion of the right-wing talker being an NFL owner based on his controversial statements.

As you might imagine, Limbaugh didn't take the controversy surrounding the bid or his ultimate exclusion from the group seeking to buy the Rams lying down.

Attempting to defend himself from mounting criticism, Limbaugh said -- with a straight face, no less -- "I'm colorblind. ... I treat everybody equally." Of course, such a statement ignores his "colorblind" history of racially charged comments. Who could forget these gems?

"We are being told that we have to hope [President Obama] succeeds, that we have to bend over, grab the ankles ... because his father was black." [1/21/09]
"I do believe" Obama is an "angry black guy." [7/27/09]
"Obama's entire economic program is reparations." [7/22/09]
Obama is "Halfrican-American." [7/24/07]
Or my personal favorite: the time Limbaugh invented a "racial component" to Iraq war vet Paul Hackett's decision to withdraw from a Democratic primary campaign for U.S. Senate in Ohio. Yep, after Hackett's departure from the race against then-Rep. Sherrod Brown, Rush said, "And don't forget, Sherrod Brown is black. There's a racial component here, too." In fact, Brown is white.

One needn't dig too far back -- Rush was happy to offer more racially charged statements this week. For starters, he whined that the NFL was an "outpost of racism and liberalism," apparently missing last month's report by the Center for Responsive Politics that showed that since 1989, NFL teams, owners, players and personnel gave overwhelmingly to the GOP.

In what can only be described as an odd attempt to beat back criticism for his past remarks, Limbaugh turned to basketball, complaining that rappers "own parts of NBA teams" and "[t]hey're celebrated -- 'Cool, daddy, cool!' " He even said that acclaimed sportscaster "Bob Costas is a ... very unhappy little diva." Is it any wonder that the world of professional athletics resoundingly rejected El Rushbo, dashing his dream of team ownership?

Limbaugh's defensive line was quick to come to his aid. Right-wing pundit Ann Coulter said NFL players would pick Rush over "Nazi collaborator" George Soros because "a lot of them" are "real Christians" -- as opposed to fake ones? MSNBC's resident cranky uncle and in-house bigot Pat Buchanan played defense, as well, which unsurprisingly resulted in more bigotry.

The Wall Street Journal came to Rush's defense with an op-ed making a ... I'll just say it -- stupid false comparison between Limbaugh and Keith Olbermann's work on NBC's Football Night in America. The Journal claimed not to have "heard anyone on the right say Mr. Olbermann's nightly ad-hominem rants should disqualify him from hanging around the NFL." Perhaps the Journal could use a hearing test, because various right-wing media figures and bloggers have done just that.

So, no, El Rushbo won't be purchasing a pro football team any time soon. He could always try his "formerly nicotine-stained" hand (or "fingers," as he would say) at owning a fantasy football team.

Then again, he's got the 2010 Miss America pageant to look forward to, where he'll be serving as a judge.

Other major stories this week
Fox News vs. The White House

Be sure to check out the latest from Media Matters' Eric Boehlert, who offers up a compelling "memo to the media," which reads, in part:

Fox News has changed the rules. Now the press needs to change the way it covers Fox News.

Rupert Murdoch's cable cabal is now, first and foremost, a political entity. Fox News has transformed itself into the Opposition Party of the Obama White House, which, of course, is unprecedented for a media company in modern-day America. That partisan embrace means the news media have to expand beyond typing up Fox News-ratings-are-up and the White-House-is-angry stories, and it needs to start treating the cable channel for what it is: a partisan animal.

The press needs to drop its longstanding gentleman's agreement not to write about other news outlets as news players -- not to get bogged down in criticizing the competition -- because those newsroom rules no longer apply. Fox News has exited the journalism community this year. It's a purely political player, and journalists ought to start covering it that way.

I understand Fox News still wants to enjoy the benefits of being seen as a news operation. It still wants the trappings and the professional protections that go with it. But it no longer functions as a news outlet, so why does the rest of the press naively treat it that way?

Fox News is now at the forefront of a political movement.

[...]

Completely detached from traditional newsroom standards, Fox News has become a political institution, and the press needs to start treating it that way. The press needs to treat Fox News the same way it treats the Republican National Committee, even though, frankly, the RNC probably can't match the in-your-face partisanship that Fox News flaunts 24/7. Think about it: Murdoch's "news" channel now out-flanks the Republican Party when it comes to ceaseless partisan attacks on the White House.

Truth is, in recent years the RNC used to use Fox news to help amplify the partisan raids that national Republicans launched against Democrats. It was within the RNC that the partisan strategy was mapped out and initiated. (i.e. it was the RNC that first pushed the Al-Gore-invented-the-Internet smear). But it was on talk radio and Fox News where the partisan bombs got dropped. Today, that relationship has, for the most part, been inversed. Now it's within Fox News that the partisan witch hunts are plotted and launched, and it's the RNC that plays catch-up to Glenn Beck and company.

And I'm sorry, but the Fox News defense that it's a just a few on-air pundits who (relentlessly) attack the White House and that the news team still plays it straight is, at this point, a joke. What kind of "news" team, in the span of five days, airs 22 clips of health reform forums featuring only people who oppose reform? What kind of "news" team tries to pass off a GOP press release as its own research -- typo and all? What kind of "news" team promotes a partisan political rally? (Or did I miss the 100-plus free ads that CNN aired in 2003 promoting an anti-war rally?)

[...]

It's clear that in 2009, Fox News is no longer in the business of journalism. Fox News isn't trying to inform people, it's trying to misinform them. That's not journalism. It's propaganda. But as long as the press continues to hold up the façade of journalism, Fox News will try to hide behind it.

Boehlert's takedown of Fox News can be read in its entirety here.

We're through Dobbs' foggy looking glass (or camera lens)

CNN's Lou Dobbs is none too pleased with his critics. At issue is a new television commercial from Media Matters and America's Voice that was to air during CNN's broadcast of its upcoming Latino in America special. In what appeared to be talking points prepared in the style of Mad Libs, Dobbs denounced the ad, claiming it was created by "George Soros attack groups" as "propaganda."

CNN, for its part, refused to run the ad -- skipping out on yet another opportunity to provide some accountability and distance itself from its ongoing Dobbs problem. In August, Media Matters bought a week of ad time on CNN, MSNBC, and Fox News in Washington, D.C., New York, and Atlanta to air an ad calling on CNN to address Dobbs' repeated promotion of birther conspiracy theories. As The Huffington Post reported at the time, "[F]ive of the six cable providers contracted for the project have informed the group that they are declining to put the spot on CNN."

Dobbs was in rare form this week in going after his critics. He decried the "mad propaganda emanating ... from the extreme left, the Media Matters folks, all of them funded by George Soros" and complained to Rep. Luis Gutierrez (D-IL) that "left-wing ethnocentric interest groups" are "calling for my firing from CNN." You know what happens when you point a finger, right, Lou? That's right: Three are pointing back at you.

Firing or reining in Dobbs may be a moot point anyway. According to recent reports, Dobbs met with Fox News president Roger Ailes over dinner last month. Could Dobbs be taking his immigrant-smearing hysteria and loony quest for Obama's already-available birth certificate to Fox Business Network?

We do agree with this one, perhaps Freudian, comment Dobbs made this week: "It's getting so you can't trust cable networks anymore."

EXCLUSIVE: CNN's Castellanos on the take from insurance industry

This week, Media Matters exclusively obtained evidence that CNN contributor Alex Castellanos' political consulting firm, National Media, is the ad buyer for the new ad blitz by the insurance industry group America's Health Insurance Plan (AHIP) that attacks Democratic health care reform plans.

According to the detailed ad buy information obtained by Media Matters, Castellanos is responsible for placing, beginning October 11, more than $1 million of AHIP advertising in five states. A review of National Media's client list indicates that Castellanos' work for AHIP isn't his only conflict with regard to health care reform. National Media has done work for the Federation of American Hospitals, the pharmaceutical industry group PhRMA, and the HCA Sunrise Hospital. Castellanos last appeared on CNN September 30; during a debate with Rep. Alan Grayson (D-FL) on The Situation Room, Castellanos defended Republican health care proposals.

After noting CNN's responsibility to properly identify Castellanos' industry ties and ensure that his obvious conflict of interest does not tarnish the network's future coverage of the health care debate, Washington Post Co.'s Greg Sargent reported that CNN admitted that Castellanos worked for the health insurance industry and promised full disclosure in the future.

United States losing about 900,000 people

Iraqi death toll at more than 85,000
Rebecca Santana, Associated Press

Iraq's government said at least 85,000 people were killed from 2004 to 2008, officially answering one of the biggest questions of the conflict - how many perished in the sectarian violence that nearly led to a civil war.

What remains unanswered is how many died in the 2003 U.S. invasion and in the months of chaos that followed it.

A report by the Human Rights Ministry said 85,694 people were killed from the beginning of 2004 to Oct. 31, 2008, and 147,195 were wounded. The figures included Iraqi civilians, military and police but did not cover U.S. military deaths, insurgents or foreigners, including contractors. And it did not include the first months of the war after the 2003 U.S.-led invasion.

The Associated Press reported similar figures in April based on government statistics obtained by the AP showing that the government had recorded 87,215 Iraqi deaths from 2005 to February 2009. The toll included violence ranging from catastrophic bombings to execution-style slayings.

Until the AP report, the government's toll of Iraqi deaths had been one of the war's most closely guarded secrets. Both supporters and opponents of the conflict have accused the other of manipulating the toll to sway public opinion.

The 85,694 represents about 0.3 percent of Iraq's estimated 29 million population. In a sign of how significant the numbers are, that would be akin to the United States losing about 900,000 people over a similar period.

The ministry's report came out late Tuesday as part of a larger study on human rights in the country. It described the years that followed the invasion, which toppled Saddam Hussein's regime, as extremely violent.

Nominees for the Hall of Jerks

POLITICO By: Roger Simon

Jerks. You know who you are. But why do there seem to be more of them around this year? Or did we always have the Joe Wilsons, and Alan Graysons, and John Ensigns and Kanye Wests and just not notice them as much?

We notice them now. They intrude upon our lives and must be labeled for what they are.
So others can have their Halls of Fame, we have the Hall of Jerks.

We are ignoring people who are jerks for a living - - the Glenn Becks, the Rush Limbaughs - - because their jerkiness is a provocation and a pose, a way of increasing ratings.

Instead, we are enshrining people who don’t actually believe they are jerks. But they are.

There are many kinds of jerks - - boors, creeps, doofusses - - and many definitions. As a starting point, one from the Urban Dictionary seems both poignant and apt.

A jerk, one contributor wrote, is a “person you really love that just doesn’t see how much you care for them, and yet, every so often actually treats you good, only to then act completely different from who they were when you first met them.”

Enter our first nominee.

1. JOHN EDWARDS. Mere infidelity does not get you in the Hall of Jerks. (We would be overrun.) No, you have to add something a little more slithery. Not even mere hypocrisy gets you in our hall, though Edwards does pin the hypocrisy needle to the wall.

Here is John Edwards on his high horse on Feb. 12, 1999, speaking about Bill Clinton and his affair with Monica Lewinsky.

“I think this president has shown a remarkable disrespect for his office, for the moral dimensions of leadership, for his friends, for his wife, for his precious daughter,” Edwards said. “It is breathtaking to me the level to which that disrespect has risen.”

But it was John Edwards who took our breath away, when he was dealing with his girlfriend Rielle Hunter. According to a story in The New York Times on Sept. 19, “Mr. Edwards once calmed an anxious Ms. Hunter by promising her that after his wife died, he would marry her in a rooftop ceremony in New York with an appearance by the Dave Matthews Band.”

As we said, it’s not the affair. It’s not even the hypocrisy. We just think that anybody who makes promises to his lover about what he is going to do “after his wife dies” is a special kind of jerk.

2. TOM DELAY. Didn’t this guy resign his House seat in disgrace after corruption allegations? And prior to that, wasn’t he unanimously admonished by the House Ethics Committee for creating “the appearance that donors were being provided with special access”? And isn’t he the guy who continues to ally himself with the disgraceful “birther” movement by replying “I have no idea” when asked if he thought Barack Obama was a citizen?

So why did we have to endure DeLay shaking his booty on “Dancing with the Stars”? We do not wish to see him in sequins and high heels on TV or off. And isn’t “Dancing with the Stars” on during family hour? Don’t we have an FCC to save us from such things?

This week, announcing he had stress fractures in both feet, DeLay decided to dance on - - just before he decided to drop out.

“I’m insane or stupid - - what?” he said. “I can’t figure out which.”

The envelope, please. Yep, it’s like we figured: a toss-up.


3. SHEILA JOHNSON. Think only men can be jerks? Ha! We wish. How else can you explain the behavior of Sheila Johnson, who made fun of Virginia gubernatorial candidate Creigh Deeds for stuttering?

Johnson, the billionaire co-founder of BET, who backs Deeds’ Republican opponent, Bob McDonnell, was addressing a group of supporters when she said: “We need someone who can really communicate. And Bob McDonnell can communicate. The other people that I talk to, and especially his op-op-op-op-op-op-opponent di-di-did this all through my interview with him. He could not articulate what needed to be done.”

Does Sheila Johnson wag her fingers in the faces of blind people? Does she pretend to have difficulty walking when she sees people with muscular dystrophy? Does she mock people in wheelchairs? We refuse to believe she was raised this way. We believe she developed this unpleasant character flaw on her own.

And when she apologized - - two weeks late and only after being caught - - she issued a classic non-apology apology. “I shouldn’t have done it in the manner in which I did, and for that I apologize for any offense he, or others, may have taken,” she said.

Hey, you don’t apologize for others taking offense. You apologize for being offensive.

4. DAVID LETTERMAN. We like David Letterman. We think he is very funny and smart and politically informed. He is also tall and rich and good looking and married to a lovely woman whom he dated for more than 20 years and who is the mother of his 5-year-old son.

So he has to hit on his employees to get dates?

We know he has been very funny about this on TV and has won over a lot of people who now view him as a victim. But we can’t help thinking: Did those women employees he hit on really feel they could say no to the boss? And isn’t that kind of a jerky thing to do?

So: The Top Ten Reasons David Letterman Should Stop Hitting on the Women Who Work for Him.

10. He is too old.

9. They are too young.

8. The difference between what he did and sexual harassment is … what exactly?

7. He is a role model for millions of Americans who have insomnia.

6. Even Bill Clinton would have told him not to. (Well, maybe not.)

5. He is in danger of becoming a stupid human trick.

4. Drew Barrymore will never flash him again.

3. He is going to end up with more troubles than a monkey on a rock.

2. Sarah Palin will never put him on the ticket now.

1. He will make the Hall of Jerks.

So that’s our freshman class. But we have a feeling we missed a few. Or more than a few. Nominations are now open.

Putting America’s Diet on a Diet

NYTimes By ALEX WITCHEL
On his first day in Huntington, W. Va., Jamie Oliver spent the afternoon at Hillbilly Hot Dogs, pitching in to cook its signature 15-pound burger. That’s 10 pounds of meat, 5 pounds of custom-made bun, American cheese, tomatoes, onions, pickles, ketchup, mustard and mayo. Then he learned how to perfect the Home Wrecker, the eatery’s famous 15-inch, one-pound hot dog (boil first, then grill in butter). For the Home Wrecker Challenge, the dog gets 11 toppings, including chili sauce, jalapeños, liquid nacho cheese and coleslaw. Finish it in 12 minutes or less and you get a T-shirt.

So much for local color. Earlier that day, Oliver met with a pediatrician, James Bailes, and a pastor, Steve Willis. Bailes told him about an 8-year-old patient who was 80 pounds overweight and had developed Type 2 diabetes. If the child’s diet didn’t change, the doctor said, he wouldn’t live to see 30. Willis told Oliver that he visits patients in local hospitals several days a week and sees the effects of long-term obesity firsthand. Since he can’t write a prescription for their resulting illnesses, he said, all he can do is pray with them.

Last year, an Associated Press article designated the Huntington-Ashland metropolitan area as the unhealthiest in America, based on its analysis of data collected in 2006 by the Centers for Disease Control and Prevention. Nearly half the adults in these five counties (two in West Virginia, two in Kentucky and one in Ohio) were obese, and the area led the nation in the incidence of heart disease and diabetes. The poverty rate was 19 percent, much higher than the national average. It also had the highest percentage of people 65 and older who had lost their teeth — nearly 50 percent.

All of which makes Huntington the perfect setting for the next Jamie Oliver Challenge. While he understands the allure of Home Wreckers and Big Macs alike, this British celebrity chef has made it his mission in recent years to break people’s dependence on fast food, believing that if they can learn to cook just a handful of dishes, they’ll get hooked on eating healthfully. The joy of a home-cooked meal, rudimentary as it sounds, has been at the core of his career from the start, and as he has matured, it has turned into a platform.

Oliver became famous at 23 for his television series “The Naked Chef,” which was broadcast from 1999 to 2001, first in Britain, then here, on the Food Network. The title referred not to his lack of clothing but to his belief in stripping pretense and mystery from the kitchen — the idea that anyone can cook and everyone should. He was loose and playful, measuring olive oil not in spoonfuls but in “glugs,” making a mess and having a ball. In the years since, that laddish charmer has morphed, somewhat unexpectedly, into a crusading community organizer. “Jamie’s School Dinners,” his award-winning four-part series, exposed the shameful state of school lunches in Britain and made for riveting television — he and the school cooks working feverishly to prepare dishes like tagine of lamb that the students either refused to try or dumped in the trash after one bite. When he eventually succeeded in getting them to abandon their processed poultry and fries and eat his food, the teachers reported a decrease in manic behavior and an increase in concentration. The school nurses noted a reduction in the number of asthma attacks. Those findings, along with “Feed Me Better,” his online campaign and petition drive, were the impetus for the British government to invest more than a billion dollars to overhaul school lunches.

In addition to TV specials like “Jamie’s Fowl Dinners” and “Jamie Saves Our Bacon” (exposing the state of the British poultry and pork industries, respectively), Oliver got personal with his series “Jamie’s Kitchen,” based on the Fifteen Foundation, which he created in 2002. Each year it sponsors 15 (give or take a few) young adults from disadvantaged backgrounds, including those with criminal records or a history of drug abuse, and trains them in the restaurant business. To kick-start the program and to finance Fifteen, the upscale London restaurant that would employ them, he put up his own house as collateral — without telling his wife. In addition to the London flagship, whose customers have included Brad Pitt and Bill Clinton, branches of the restaurant have opened in Cornwall, Amsterdam and Melbourne. So far, the program has graduated 159 students at a cost of $49,500 each. Oliver endowed the foundation with proceeds from his book “Cook With Jamie,” and it now operates as an independent entity.

If he were just a professional do-gooder, Oliver, who is 34, would be a bore. But food has given his life focus and meaning since childhood, and he has honored it ever since. Born and raised in Essex, northeast of London, Oliver, the son of a pub owner, grew up hyperactive and dyslexic. In school, he failed every subject except Art (he got an A) and Geology (a C). By the time he was 6, his tough-love father, Trevor, put him to work in the pub, cleaning up. His father’s work ethic was such that on summer vacations he would aim the garden hose through Jamie’s bedroom window, soaking his bed to get him out of it, at 6:30 a.m. “People die in bed,” he liked to say.

It seems to have worked. By the time he was 13, Jamie was turning out between 100 and 120 meals on a Sunday night alongside the pub’s chef. In a work-study program, he spent six weeks at a high-end restaurant, starting at the appetizers station. When the head chef quit, he took over.

Though his father was proud of him, Oliver says, he is mindful that the pub owner’s motto remains “You can’t make a silk purse from a sow’s ear.” Having started out as the ear, Oliver has worked hard to prove his father wrong. Cooking saved his life. He wants it save yours too. “Being in the kitchen is the most simple part of life,” he said. “People talk about it like it was some sort of science experiment.”

In last year’s U.K. series, “Jamie’s Ministry of Food,” Oliver expanded his reach past the school system into people’s homes. He chose Rotherham, an industrial town in northern England with a high rate of obesity and related illnesses, where 20 percent of the working-age population was on public assistance. He built a community center where residents could learn to cook inexpensively for their families while instilling the idea that healthful eating is not a luxury. “They thought that cooking a meal and feeding it to your family was for posh people,” he said. Some participants in the show had never even had a kitchen table. They ate takeout food on their floors.

That project has proved a success and the perfect model for Oliver’s mission in Huntington. The community center here will be called Jamie’s Kitchen and will teach both adults and children the basic skills for cooking healthful, economical meals at home. Oliver will also work with local schools on eliminating junk food in vending machines and in cafeterias, replacing reheated processed foods with meals cooked from scratch with fresh ingredients. But there is no guarantee of success. In spite of the resources the British government has allocated for school lunches, Oliver admits that only half the schools are functioning properly; the other half are still experiencing difficulty training cafeteria staff and enforcing new guidelines. And follow-up reports show that while students now understand the benefits of eating healthfully, many still opt out of their school-lunch plans, reverting to fast food instead.

What’s really happening is about more than old habits dying hard or the love of frying. The reason the world is still waiting for the Messiah is that most people don’t actually want one, no matter how many fresh fruits and vegetables he’s carrying. Oliver expects some of the same pushback in Huntington, whether it comes from recalcitrant teenagers, petty bureaucrats or parents who don’t like being told they’ve failed. It remains to be seen whether the contest between being threatened and resentful versus forthright and true can trump the American intoxication with show business: will this much-maligned area let a Member of the British Empire play Pygmalion and win? In this country, ordinary people seem willing to do or say almost anything to be immortalized in the latter-day vaudeville of reality shows. Oliver’s goals here, no matter how authentic, can be thwarted if the balance between camera hunger and social reform goes off-kilter. The series, “Jamie Oliver’s Food Revolution,” is a co-production of his company and Ryan Seacrest Productions. ABC will broadcast it in six parts in early 2010.

Like Rotherham’s, Huntington’s economy was buoyed for years by the coal mines nearby as well as by manufacturing jobs in the chemical industry, glassworks, steel foundries and locomotive-parts plants. In 1950 its population was near 90,000. Manual labor took care of excess calories, if not hardened arteries. When the coal industry was modernized and the changing economy resulted in the loss of manufacturing jobs, the population dropped to less than 50,000; hospitals became one of the city’s largest employers. Another is Marshall University, home of the “Thundering Herd” football team and the subject of the 2006 film “We Are Marshall.” Its students are aficionados of the delicacies at Hillbilly Hot Dogs (a sign out front reads, “If you hit it on the run, we’ll put it on a bun”), and Oliver doesn’t blame them.

“That was 15 pounds of madness,” he said of the trademark burger, jumping into the car outside the restaurant. “But it tasted good.” He had been shooting all afternoon and was 90 minutes behind schedule, an occurrence his publicist calls “Jamie Time.” He gets so involved in what he’s doing that he tends to lose track. He was due downtown in 30 minutes to hold a town-hall meeting to talk about the show. On the way there, he agreed to run through Kroger, a local supermarket, to see what Huntington residents were buying.

As we drove there, Oliver talked about his first day in town. He likes to say that the C.D.C. statistics on obesity in the Huntington-Ashland metropolitan area are only a few percentage points higher than the national average. In fact, the C.D.C.’s numbers vary from year to year: obesity rates in the last two years hovered near the national average, 34 percent, but the A.P. report that brought Oliver to West Virginia was based on 2006 figures that put the area’s obesity rate at 45 percent. From what I saw in one day, the locals were plenty touchy about their collective waistlines, so Oliver was wise to tread lightly. That is typical of his style. Effortlessly charismatic, he has an easy warmth — happy to shake hands or pat a back, though he takes the business of listening to people quite seriously. When he finds a kindred spirit, a sharp focus, an open mind, he leaps, immediately connecting. He is genuinely polite, which is in itself so rare that it is genuinely winning. Though he is still hyperactive — if he’s standing he’s pacing; if he’s sitting, a leg bounces — his mind seems insatiable.

Oliver is at the head of a multinational corporation that has produced 12 television series and assorted specials seen in 130 countries; he has written 10 cookbooks that have been translated into 29 languages and sold almost 24 million copies in 56 countries. In addition to the Fifteen Foundation and restaurants, he has opened six Jamie’s Italian restaurants in the U.K. in the past two years, high-volume yet high-quality odes to a cuisine he loves; he sells his own brands of cookware, cutlery, tableware and gift foods; he publishes his own magazine; and he continues in his ninth year as spokesman for Sainsbury’s, an upscale supermarket chain in England. Because his company is privately held, it does not release its annual earnings, but he is said to be personally worth at least $65 million.

All told, 2,150 people work for his businesses. He keeps every fact and figure in his head — no reading, no writing, no notes. The format he has worked out for so many of his series — Jamie identifies a problem, Jamie sets out to fix the problem, Jamie encounters evil forces along the way, Jamie triumphs — comes naturally to him because that’s exactly how he has lived his own life so far.

Once inside Kroger we started with produce. “I find it fascinating looking at people’s trolleys,” he said. “The ones here are twice the size they are at home.” He picked up a bag of salad greens. “A lot of these are washed in chlorine, so they lose their nutrition,” he said, tossing it back. “It takes no time to get lettuce and spin it about.” He picked up a bottle of salad dressing. “Four dollars? You can make your own for less than half that price.” He looked at its ingredients. “Water. I’ve never been taught to put water in any dressing.”

Well, how about those packages of cut-up fresh fruit? He shrugged. “I don’t understand why people can’t cut it up themselves. Don’t they own knives?”

Two little girls ran past us, playing tag while an older man trailed them, his cart bearing bananas and M&M’s. “Two things happen when shopping with kids,” Oliver said. “You either give in and buy everything they want, or if you’re a strong parent you make certain choices.”

We headed toward frozen foods. No one recognized him. Six weeks from now he’d be mobbed doing this. “Or punched,” he said. “I’m a respectful person, and I’m going to try to do things in the nice way. But it’s almost as if parents here have stopped saying no. It’s as if the kids rule the roost.” We came upon a table of Krispy Kreme doughnuts. “They’re a treat, there to be loved,” he said. “But start having them every day, job done. It’s harsh to say, but these parents, when they’ve been to the doctor and keep feeding their kids inappropriate food, that is child abuse. Same as a cigarette burn or a bruise.”

Town Hall awaited. Oliver is so practiced at doing these series that he spoke automatically in sound bites, sensing it was the moment to build suspense. “Ultimately, I’m a foreigner,” he said. “I’ve got no place being here, but I’ve got all the right reasons.” He headed for the door. “I just bloody hope I pull it out of the bag.”

THE DAY IN Huntington wasn’t my first meeting with Oliver. He came to New York in August on business and, in a borrowed apartment arranged by his publisher, cooked us some lunch before we sat down to talk. His new cookbook, “Jamie’s Food Revolution: Rediscover How to Cook Simple, Delicious, Affordable Meals,” is based on the “Ministry of Food” series and will be published by Hyperion on Oct. 13. He prepared a dish from it that he often makes for his daughters Poppy, who is 7, and Daisy, who is 6: Mini Shell Pasta With a Creamy Smoked Bacon and Pea Sauce.

A timeout here for self-anointed Health Nazis. Oliver cooks and eats all kinds of meat and feels free to use butter, cream and cheese, in sane amounts. He is not a diet cop; he’s about scratch cooking, which to him means avoiding processed and fast food, learning pride of ownership, encouraging sparks of creativity and finding a reason to gather family and friends in one place. If you can make pancakes or an omelet, a pot of chili or spaghetti sauce and know how to perk up some vegetables, you can spend less and eat a more healthful meal that’s delicious.

Oliver’s hyperactivity finds its perfect expression when he’s cooking. His movements were almost balletic, charged and graceful, even when he stuck his finger straight into the pot of water to feel if it was near boiling. It was. He cut the pancetta with lightning speed. “I swear I could do that at 10 years old,” he said. “Tuck your fingers in, you never get cut.”

He dressed the salad, which he filled with fresh herbs, tossing it with his hands. Then he threw frozen peas into the pan with the pancetta. Two women who work for him moved in and out of the kitchen, talking on cellphones. “The key to life is to surround yourself with lots of women,” Oliver said. “Men would just lie to me. Girls say, ‘Give me half an hour and I’ll find out.’ They’re intelligent, more loyal and they make things happen. Everything I do is about team, really. So 90 percent of my team are women.” The dish was done within minutes. (It was also done within minutes when I made it at home, at a more leisurely pace, the following day.)

We sat at the dining-room table. “The key to life is to know what you’re good at and stay away from what you’re bad at,” he said. Well, the pasta was certainly delicious. As for the bad part, we talked about school. He said he recently ran into his “special needs” teacher, Mrs. Murphy, and actually blushed as he told me, “I gave her a big hug and kiss, and she said she was really proud of me.” Oliver has often recounted the story of being one of five children out of 150 pulled from regular classes each week to learn how to read and write, as the other kids taunted them, singing the phrase “special needs” to the tune of “Let It Be.”

He left school at 16 and graduated from Westminster Catering College. After a brief stint cooking in France, he returned to London to work at Antonio Carluccio’s Neal Street Restaurant, where he met his mentor, Gennaro Contaldo, who taught him to make bread and pasta and to love all things Italian. (Contaldo now supervises bread- and pasta-making at the Jamie’s Italian restaurants.) Then Oliver moved on to the trendy River Café, where a camera crew came to shoot one day and found him to be a natural.

Since 2000, Oliver has been married to his longtime love, Juliette Norton. A former model, she is known to his viewers and fans as “the lovely Jools.” They live in the Primrose Hill section of London and spend weekends at his farm in Essex, near where he grew up. His father’s pub, the Cricketers, is still in business. Oliver says: “I have my two girls waitressing there. Poppy is gentle, sensitive. Daisy is sort of a bit mad, incredibly funny. She eats for England. She’s only 6, and she’ll eat squid, she’ll try anything.”

Poppy and Daisy have an infant sister, Petal. Really.

“That’s Jools,” he said, easily. “My opinions in the name department don’t get much of a looking. We live very segregated sort of lives, really. Jools isn’t into anything workwise that I do. It means that home is home, and when I’m there I don’t talk about work. Like a lot of working mums or dads, I see the girls a bit in the morning, and then I really don’t see them until the weekend, which is the way it’s always been, so I don’t feel bad. Mum does a great job of being a mum.” But Oliver doesn’t just come home from work; he comes home from being an international entertainment conglomerate. That seems hard to leave at the door.

“It’s the battle of life isn’t it, trying to get the right balance,” he said. “The problem with me is, no one truly understands how I tick as a person, even my wife.” That includes his parents, he added. “When I started the Fifteen Foundation and opened that restaurant, I spent all my savings. It was kind of reckless, and the key people around me, the business accountants and my parents, it took them five years to get it. That’s why I try and take them to every graduation to meet the kids. You know my old man’s saying was ‘You can’t make a silk purse out of a sow’s ear,’ but I’ve spent the last eight years disagreeing with that. I like giving people a bit of extra.”

But his father still doesn’t understand him? Oliver’s leg bounced ferociously. “He’s really proud, but he doesn’t know how I manage to multitask. I don’t know if it’s part of my dyslexia, but I can jump from one place into another, into another. So whether it’s the restaurant or the charity or the direct-sales business or the next book — there’s probably 30 things going on now — I think it scares my dad because he’s always been very good at one thing. But he’s starting to relax. I think he thinks I’m happy, and ultimately you’re only as happy as your most miserable child, aren’t you?”

What is his mother, Sally, like? “She’s hilarious. A hundred-miles-an-hour avalanche of energy. She’s superbright and fairly encyclopedic about stuff, but at the same time she’s a complete liability. She just worries and flusters and runs around the place, saying inappropriate things. She’s fairly similar to me, really. But growing up, she was a brilliant mum and a great friend. Dad was strict, hard core, waking me up with the hose.”

Oliver got his revenge ­— or at least tried to. Before he started cooking in the pub, he and his friends set off a stink bomb there during dinner time, sending 30 people out onto the street without paying their bills. “That was just stupid, really,” Oliver said, chagrined that I mentioned it and seemingly still ashamed. “That was an attack on a family business by a moron child.”

High jinks aside, he said that his parents consistently supported him and his younger sister, Anna-Marie. “I was brought up in a family where they would wish the best for you,” he said. “But doing these projects like ‘School Dinners’ and ‘Ministry of Food,’ it amazed me that around so many of these people there was no positivity. With one woman, if she started doing good stuff for herself, people that were her own flesh and blood got jealous. With Fifteen, one of the biggest problems we have is the students’ families, the lack of positive role models. That’s why I disagree with Dad.” He spoke proudly of his graduates, mentioning one who works in New York at the renowned gastropub the Spotted Pig and another who is about to become the head chef at Jamie’s Italian in Guildford. Five years ago, Oliver said, he was on the South Bank of the Thames in a courtroom getting that young man out of jail.

“Look, I think the brilliant and beautiful thing in life is that anyone can do anything,” he said. “When I used to go to special needs, we got laughed at, but we’re not supposed to all be academic. What is education? A bunch of stuff that people think we should know. Ultimately if you can put a wall up, if you can paint, if you can work with other people and, most important, if you find out what you are good at, that’s the key. Kids can do detailed, technical things, and they can do them well. Have you seen them on skateboards and surfing? It doesn’t have to be a BMX, it can be a pot and a pan and a knife, but we wrap them up in cotton wool and treat them like babies and they’re not.”

It certainly didn’t hurt him to have started early. “No,” he said, “but it’s ironic that the one thing I hated I sort of specialize in now,” referring to the cookbooks. He added, good-naturedly, “When I do writing, it’s more imagination than sentences as we know it.” But he is very visual — remember that A in art — and he works on every aspect of the books’ photography and design. “Almost 24 million copies, by someone who swore he’d never ever do any revolting reading and writing when he left school,” Oliver said with smile of pure delight. “It’s funny how things work out.”

AFTER OUR DASH through Kroger, Oliver arrived at City Hall and disappeared backstage. The auditorium was less than half full, and the front rows were filled with local reporters. Mothers brought young children with an eye toward the camera. One even armed her daughter with an oversize school menu as a visual aid. Another woman seemed to have mistaken scratch cooking for “American Idol” — she raced back and forth, trying to persuade someone, anyone, to ask Oliver to listen to her daughter sing.

Oliver picked up the mike. “Hi, guys,” he began. “Some say this is the most unhealthy town in America. We’re going to spend the next few days getting under the skin of the problem, and we’re asking families, individuals, schools and churches to spread the word. Here, the odds are against you, you live an unhealthy life and die young. That’s what the report said. So, this is not a sparkly, pretty show. It’s about finding local ambassadors for change.”

He asked people to raise their hands if friends or family were affected by obesity and bad health. Almost every hand went up. Oliver nodded. “What do you think the problems are?” Among the answers were: too much processed food in school cafeterias; a need for better prenatal nutrition; a call to stop putting Kool-Aid in toddlers’ sippy cups (earlier, Oliver heard about infants’ bottles filled with Coca-Cola); suggestions that restaurants offer smaller portions and that children’s menus offer alternatives to burgers and fries.

Oliver took it in. “This isn’t a freak show here,” he said. “You’re only a few percent away from the national average. Every child should be taught to cook in school, not just talk about nutrition all day. Good food can be made in 15 minutes. This could be the first generation where the kids teach the parents.” That earned a round of applause.

“I got a billion dollars out of the British government and put it into the school system,” he went on. “But it’s still in transition, it’s not all glossy yet. When parents get angry anything can happen. So I’ll need your help. Hopefully over the next few months, we’ll do some really good things together.”

After he left the lectern, the crew restaged the applause they would use for his entrance. It was thin before, but now it ended with a standing ovation. The townsfolk seemed as quick a study on theatrics as they were on health reform; many angled to be interviewed, to establish themselves as characters.

They were actually so intent on chasing the limelight that few seemed to notice an untended table outside the rear of the auditorium. There, in what seemed the ultimate mixed message, was the 15-pound burger Oliver helped make that afternoon. Sitting near a bowl of candy and a half-eaten plate of sandwiches, it filled an enormous platter. It had been cut into pieces, but hardly any had been taken.

As Oliver spoke to the camera downstairs and audience members jockeyed for position upstairs, the table stood ignored. Until two little boys stormed it, prompting their mother to pull herself free from the media hubbub. They stopped just short and stared at the bounty before them.

“Is it free?” one son asked. She looked around, nervously. “Yes,” she said. He reached past the burger and grabbed a box of Milk Duds. Then she got back in line, to be on TV.

Alex Witchel is a staff writer for the magazine.

How Nonsense Sharpens the Intellect

By BENEDICT CAREY

In addition to assorted bad breaks and pleasant surprises, opportunities and insults, life serves up the occasional pink unicorn. The three-dollar bill; the nun with a beard; the sentence, to borrow from the Lewis Carroll poem, that gyres and gimbles in the wabe.

An experience, in short, that violates all logic and expectation. The philosopher Soren Kierkegaard wrote that such anomalies produced a profound “sensation of the absurd,” and he wasn’t the only one who took them seriously. Freud, in an essay called “The Uncanny,” traced the sensation to a fear of death, of castration or of “something that ought to have remained hidden but has come to light.”

At best, the feeling is disorienting. At worst, it’s creepy.

Now a study suggests that, paradoxically, this same sensation may prime the brain to sense patterns it would otherwise miss — in mathematical equations, in language, in the world at large.

“We’re so motivated to get rid of that feeling that we look for meaning and coherence elsewhere,” said Travis Proulx, a postdoctoral researcher at the University of California, Santa Barbara, and lead author of the paper appearing in the journal Psychological Science. “We channel the feeling into some other project, and it appears to improve some kinds of learning.”

Researchers have long known that people cling to their personal biases more tightly when feeling threatened. After thinking about their own inevitable death, they become more patriotic, more religious and less tolerant of outsiders, studies find. When insulted, they profess more loyalty to friends — and when told they’ve done poorly on a trivia test, they even identify more strongly with their school’s winning teams.

In a series of new papers, Dr. Proulx and Steven J. Heine, a professor of psychology at the University of British Columbia, argue that these findings are variations on the same process: maintaining meaning, or coherence. The brain evolved to predict, and it does so by identifying patterns.

When those patterns break down — as when a hiker stumbles across an easy chair sitting deep in the woods, as if dropped from the sky — the brain gropes for something, anything that makes sense. It may retreat to a familiar ritual, like checking equipment. But it may also turn its attention outward, the researchers argue, and notice, say, a pattern in animal tracks that was previously hidden. The urge to find a coherent pattern makes it more likely that the brain will find one.

“There’s more research to be done on the theory,” said Michael Inzlicht, an assistant professor of psychology at the University of Toronto, because it may be that nervousness, not a search for meaning, leads to heightened vigilance. But he added that the new theory was “plausible, and it certainly affirms my own meaning system; I think they’re onto something.”

In the most recent paper, published last month, Dr. Proulx and Dr. Heine described having 20 college students read an absurd short story based on “The Country Doctor,” by Franz Kafka. The doctor of the title has to make a house call on a boy with a terrible toothache. He makes the journey and finds that the boy has no teeth at all. The horses who have pulled his carriage begin to act up; the boy’s family becomes annoyed; then the doctor discovers the boy has teeth after all. And so on. The story is urgent, vivid and nonsensical — Kafkaesque.

After the story, the students studied a series of 45 strings of 6 to 9 letters, like “X, M, X, R, T, V.” They later took a test on the letter strings, choosing those they thought they had seen before from a list of 60 such strings. In fact the letters were related, in a very subtle way, with some more likely to appear before or after others.

The test is a standard measure of what researchers call implicit learning: knowledge gained without awareness. The students had no idea what patterns their brain was sensing or how well they were performing.

But perform they did. They chose about 30 percent more of the letter strings, and were almost twice as accurate in their choices, than a comparison group of 20 students who had read a different short story, a coherent one.

“The fact that the group who read the absurd story identified more letter strings suggests that they were more motivated to look for patterns than the others,” Dr. Heine said. “And the fact that they were more accurate means, we think, that they’re forming new patterns they wouldn’t be able to form otherwise.”

Brain-imaging studies of people evaluating anomalies, or working out unsettling dilemmas, show that activity in an area called the anterior cingulate cortex spikes significantly. The more activation is recorded, the greater the motivation or ability to seek and correct errors in the real world, a recent study suggests. “The idea that we may be able to increase that motivation,” said Dr. Inzlicht, a co-author, “is very much worth investigating.”

Researchers familiar with the new work say it would be premature to incorporate film shorts by David Lynch, say, or compositions by John Cage into school curriculums. For one thing, no one knows whether exposure to the absurd can help people with explicit learning, like memorizing French. For another, studies have found that people in the grip of the uncanny tend to see patterns where none exist — becoming more prone to conspiracy theories, for example. The urge for order satisfies itself, it seems, regardless of the quality of the evidence.

Still, the new research supports what many experimental artists, habitual travelers and other novel seekers have always insisted: at least some of the time, disorientation begets creative thinking.

Go Without Insurance Let Congress

NYTimes NICHOLAS D. KRISTOF
Let me offer a modest proposal: If Congress fails to pass comprehensive health reform this year, its members should surrender health insurance in proportion with the American population that is uninsured.

It may be that the lulling effect of having very fine health insurance leaves members of Congress insensitive to the dysfunction of our existing insurance system. So what better way to attune our leaders to the needs of their constituents than to put them in the same position?

About 15 percent of Americans have no health insurance, according to the Census Bureau. Another 8 percent are underinsured, according to the Commonwealth Fund, a health policy research group. So I propose that if health reform fails this year, 15 percent of members of Congress, along with their families, randomly lose all health insurance and another 8 percent receive inadequate coverage.

Congressional critics of President Obama’s efforts to achieve health reform worry that universal coverage will be expensive, while their priority is to curb social spending. So here’s their chance to save government dollars in keeping with their own priorities.

Those same critics sometimes argue that universal coverage needn’t be a top priority because anybody can get coverage at the emergency room. Let them try that with their kids.

Some members also worry that a public option (an effective way to bring competition to the insurance market) would compete unfairly with private companies and amount to a step toward socialism. If they object so passionately to “socialized health,” why don’t they block their 911 service to socialized police and fire services, disconnect themselves from socialized sewers and avoid socialized interstate highways?

I wouldn’t wish the trauma of losing health insurance on anyone, but our politicians’ failure to assure health care for all citizens is such a longstanding and grievous breach of their responsibility that they deserve it. In January 1917, Progressive Magazine wrote: “At present the United States has the unenviable distinction of being the only great industrial nation without universal health insurance." More than 90 years later, we still have that distinction.

Theodore Roosevelt campaigned for national health insurance in 1912. Richard Nixon tried for universal coverage in 1974. Yet, even now, nearly half of Congress is vigorously opposed to such a plan.

Health care has often been debated as a technical or economic issue. That has been a mistake, I believe. At root, universal health care is not an economic or technical question but a moral one.

We accept that life is unfair, that some people will live in cramped apartments and others in sprawling mansions. But our existing insurance system is not simply inequitable but also lethal: a very recent, peer-reviewed article in the American Journal of Public Health finds that nearly 45,000 uninsured people die annually as a consequence of not having insurance. That’s one needless death every 12 minutes.

When nearly 3,000 people were killed on 9/11, we began wars and were willing to devote more than $1 trillion in additional expenses. Yet about the same number of Americans die from our failed insurance system every three weeks.

The obstacle isn’t so much money as priorities. America made it a priority to provide tax breaks, largely to the wealthy, in the Bush years, at a 10-year cost including interest of $2.4 trillion. Allocating less than half that much to assure equal access to health care isn’t deemed an equal priority.

The plan emerging in the Senate is no panacea. America needs to promote exercise and discourage sugary drinks to hold down the rise in obesity, diabetes and medical bills. We need more competition among insurance companies. And conservatives are right to call for tort reform to reduce the costs of malpractice insurance and defensive medicine.

But those steps are not a substitute for guaranteed health coverage for all Americans. And if health reform fails this year, then hopes for universal coverage will recede again. There was a lag of 19 years after the Nixon plan before another serious try, and a 16-year lag after the Clinton effort of 1993. Another 16-year delay would be accompanied by more than 700,000 unnecessary deaths. That’s more Americans than died in World War I, World War II, Korea, Vietnam and Iraq combined.

The collapse of health reform would be a political and policy failure, but it would also be a profound moral failure. Periodically, there are political questions that are fundamentally moral, including slavery in the 19th century and civil rights battles in the 1950s and ’60s. In the same way, allowing tens of thousands of Americans to die each year because they are uninsured is not simply unwise and unfortunate. It is also wrong — a moral blot on a great nation.

The Uneducated American

NYTimes PAUL KRUGMAN
If you had to explain America’s economic success with one word, that word would be “education.” In the 19th century, America led the way in universal basic education. Then, as other nations followed suit, the “high school revolution” of the early 20th century took us to a whole new level. And in the years after World War II, America established a commanding position in higher education.

But that was then. The rise of American education was, overwhelmingly, the rise of public education — and for the past 30 years our political scene has been dominated by the view that any and all government spending is a waste of taxpayer dollars. Education, as one of the largest components of public spending, has inevitably suffered.

Until now, the results of educational neglect have been gradual — a slow-motion erosion of America’s relative position. But things are about to get much worse, as the economic crisis — its effects exacerbated by the penny-wise, pound-foolish behavior that passes for “fiscal responsibility” in Washington — deals a severe blow to education across the board.

About that erosion: there has been a flurry of reporting recently about threats to the dominance of America’s elite universities. What hasn’t been reported to the same extent, at least as far as I’ve seen, is our relative decline in more mundane measures. America, which used to take the lead in educating its young, has been gradually falling behind other advanced countries.

Most people, I suspect, still have in their minds an image of America as the great land of college education, unique in the extent to which higher learning is offered to the population at large. That image used to correspond to reality. But these days young Americans are considerably less likely than young people in many other countries to graduate from college. In fact, we have a college graduation rate that’s slightly below the average across all advanced economies.

Even without the effects of the current crisis, there would be every reason to expect us to fall further in these rankings, if only because we make it so hard for those with limited financial means to stay in school. In America, with its weak social safety net and limited student aid, students are far more likely than their counterparts in, say, France to hold part-time jobs while still attending classes. Not surprisingly, given the financial pressures, young Americans are also less likely to stay in school and more likely to become full-time workers instead.

But the crisis has placed huge additional stress on our creaking educational system.

According to the Bureau of Labor Statistics, the United States economy lost 273,000 jobs last month. Of those lost jobs, 29,000 were in state and local education, bringing the total losses in that category over the past five months to 143,000. That may not sound like much, but education is one of those areas that should, and normally does, keep growing even during a recession. Markets may be troubled, but that’s no reason to stop teaching our children. Yet that’s exactly what we’re doing.

There’s no mystery about what’s going on: education is mainly the responsibility of state and local governments, which are in dire fiscal straits. Adequate federal aid could have made a big difference. But while some aid has been provided, it has made up only a fraction of the shortfall. In part, that’s because back in February centrist senators insisted on stripping much of that aid from the American Recovery and Reinvestment Act, a k a the stimulus bill.

As a result, education is on the chopping block. And laid-off teachers are only part of the story. Even more important is the way that we’re shutting off opportunities.

For example, the Chronicle of Higher Education recently reported on the plight of California’s community college students. For generations, talented students from less affluent families have used those colleges as a stepping stone to the state’s public universities. But in the face of the state’s budget crisis those universities have been forced to slam the door on this year’s potential transfer students. One result, almost surely, will be lifetime damage to many students’ prospects — and a large, gratuitous waste of human potential.

So what should be done?

First of all, Congress needs to undo the sins of February, and approve another big round of aid to state governments. We don’t have to call it a stimulus, but it would be a very effective way to create or save thousands of jobs. And it would, at the same time, be an investment in our future.

Beyond that, we need to wake up and realize that one of the keys to our nation’s historic success is now a wasting asset. Education made America great; neglect of education can reverse the process.

First Lady’s Roots

In First Lady’s Roots, a Complex Path From Slavery

NYTimes RACHEL L. SWARNS&JODI KANTOR

WASHINGTON — In 1850, the elderly master of a South Carolina estate took pen in hand and painstakingly divided up his possessions. Among the spinning wheels, scythes, tablecloths and cattle that he bequeathed to his far-flung heirs was a 6-year-old slave girl valued soon afterward at $475.

In his will, she is described simply as the “negro girl Melvinia.” After his death, she was torn away from the people and places she knew and shipped to Georgia. While she was still a teenager, a white man would father her first-born son under circumstances lost in the passage of time.

In the annals of American slavery, this painful story would be utterly unremarkable, save for one reason: This union, consummated some two years before the Civil War, represents the origins of a family line that would extend from rural Georgia, to Birmingham, Ala., to Chicago and, finally, to the White House.

Melvinia Shields, the enslaved and illiterate young girl, and the unknown white man who impregnated her are the great-great-great-grandparents of Michelle Obama, the first lady.

Viewed by many as a powerful symbol of black advancement, Mrs. Obama grew up with only a vague sense of her ancestry, aides and relatives said. During the presidential campaign, the family learned about one paternal great-great-grandfather, a former slave from South Carolina, but the rest of Mrs. Obama’s roots were a mystery.

Now the more complete map of Mrs. Obama’s ancestors — including the slave mother, white father and their biracial son, Dolphus T. Shields — for the first time fully connects the first African-American first lady to the history of slavery, tracing their five-generation journey from bondage to a front-row seat to the presidency.

The findings — uncovered by Megan Smolenyak, a genealogist, and The New York Times — substantiate what Mrs. Obama has called longstanding family rumors about a white forebear.

While President Obama’s biracial background has drawn considerable attention, his wife’s pedigree, which includes American Indian strands, highlights the complicated history of racial intermingling, sometimes born of violence or coercion, that lingers in the bloodlines of many African-Americans. Mrs. Obama and her family declined to comment for this article, aides said, in part because of the personal nature of the subject.

“She is representative of how we have evolved and who we are,” said Edward Ball, a historian who discovered that he had black relatives, the descendants of his white slave-owning ancestors, when he researched his memoir, “Slaves in the Family.”

“We are not separate tribes of Latinos and whites and blacks in America,” Mr. Ball said. “We’ve all mingled, and we have done so for generations.”

The outlines of Mrs. Obama’s family history unfolded from 19th century probate records, yellowing marriage licenses, fading photographs and the recollections of elderly women who remember the family. Ms. Smolenyak, who has traced the ancestry of many prominent figures, began studying the first lady’s roots in earnest after conducting some preliminary research into Mrs. Obama’s ancestry for an article published in The New York Times earlier this year.

Of the dozens of relatives she identified, Ms. Smolenyak said, it was the slave girl who seemed to call out most clearly.

“Out of all Michelle’s roots, it’s Melvinia who is screaming to be found,” she said.

When her owner, David Patterson, died in 1852, Melvinia soon found herself on a 200-acre farm with new masters, Mr. Patterson’s daughter and son-in law, Christianne and Henry Shields. It was a strange and unfamiliar world.

In South Carolina, she had lived on an estate with 21 slaves. In Georgia, she was one of only three slaves on property that is now part of a neat subdivision in Rex, near Atlanta.

Whether Melvinia labored in the house or in the fields, there was no shortage of work: wheat, corn, sweet potatoes and cotton to plant and harvest, and 3 horses, 5 cows, 17 pigs and 20 sheep to care for, according to an 1860 agricultural survey.

It is difficult to say who might have impregnated Melvinia, who gave birth to Dolphus around 1859, when she was perhaps as young as 15. At the time, Henry Shields was in his late 40s and had four sons ages 19 to 24, but other men may have spent time on the farm.

“No one should be surprised anymore to hear about the number of rapes and the amount of sexual exploitation that took place under slavery; it was an everyday experience, “ said Jason A. Gillmer, a law professor at Texas Wesleyan University, who has researched liaisons between slave owners and slaves. “But we do find that some of these relationships can be very complex.”

In 1870, three of Melvinia’s four children, including Dolphus, were listed on the census as mulatto. One was born four years after emancipation, suggesting that the liaison that produced those children endured after slavery. She gave her children the Shields name, which may have hinted at their paternity or simply been the custom of former slaves taking their master’s surnames.

Even after she was freed, Melvinia stayed put, working as a farm laborer on land adjacent to that of Charles Shields, one of Henry’s sons.

But sometime in her 30s or 40s, census records show, Melvinia broke away and managed to reunite with former slaves from her childhood on the Patterson estate: Mariah and Bolus Easley, who settled with Melvinia in Bartow County, near the Alabama border. Dolphus married one of the Easleys’ daughters, Alice, who is Mrs. Obama’s great-great-grandmother.

A community “that had been ripped apart was somehow pulling itself back together,” Ms. Smolenyak said of the group in Bartow County.

Still, Melvinia appears to have lived with the unresolved legacy of her childhood in slavery until the very end. Her 1938 death certificate, signed by a relative, says “don’t know” in the space for the names of her parents, suggesting that Melvinia, then in her 90s, may never have known herself.

Sometime before 1888, Dolphus and Alice Shields continued the migration, heading to Birmingham, a boomtown with a rumbling railroad, an iron and steel industry and factories that attracted former slaves and their children from across the South.

Dolphus Shields was in his 30s and very light skinned — some say he looked like a white man — a church-going carpenter who could read, write and advance in an industrializing town. By 1900, he owned his own home, census records show. By 1911, he had opened his own carpentry and tool sharpening business.

A co-founder of First Ebenezer Baptist Church and Trinity Baptist Church, which later became active in the civil rights movement, he supervised Sunday schools at both churches, which still exist today, and at Regular Missionary Baptist Church.

“He was the dean of the deacons in Birmingham,” said Helen Heath, 88, who attended church with him. “He was a serious man. He was about business.”

He carried his family into the working-class, moving into a segregated neighborhood of striving black homeowners and renters. In his home, there was no smoking, no cursing, no gum chewing, no lipstick or trousers for ladies and absolutely no blues on the radio, which was reserved for hymns, remembered Bobbie Holt, 73, who was raised by Mr. Shields and his fourth wife, Lucy. She said the family went to church “every night of the week, it seemed like.”

He carried peppermints for neighborhood children, Mrs. Holt said, and told funny stories about his escapades as a boy. But his family struggled.

His first wife, Alice Easley Shields, moved around after they split up, working as a seamstress and a maid, and two of their sons stumbled.

Robert Lee Shields, Mrs. Obama’s great-grandfather, married Annie Lawson in 1906 and worked as a laborer and a railroad porter but disappeared from the public record sometime around his 32nd birthday.

Willie Arthur Shields, an inventor who obtained patents for improving dry cleaning operations, ended up working as a maintenance man, Mrs. Holt said.

As for his ancestry, Dolphus Shields didn’t talk about it.

“We got to the place where we didn’t want anybody to know we knew slaves; people didn’t want to talk about that,” said Mrs. Heath, who said she assumed he had white relatives because his skin color and hair texture “told you he had to be near white.”

At a time when blacks despaired at the intransigence and violence of whites who barred them from voting, from most city jobs, from whites-only restaurants and from owning property in white neighborhoods, Dolphus Shields served as a rare link between the deeply divided communities.

His carpentry shop stood in the white section of town, and he mixed easily and often with whites. “They would come to his shop and sit and talk,” Mrs. Holt said.

Dolphus Shields firmly believed race relations would improve. “It’s going to come together one day,” he often said, Mrs. Holt recalled.

By the time he died in 1950 at age 91, change was on the way. On June 9, 1950, the day that his obituary appeared on the front page of The Birmingham World, the black newspaper also ran a banner headline that read, “U.S. Court Bans Segregation in Diners and Higher Education.” The Supreme Court had outlawed separate but equal accommodations on railway cars and in universities in Texas and Oklahoma.

Up North, his grandson, a painter named Purnell Shields, Mrs. Obama’s grandfather, was positioning his family to seize the widening opportunities in Chicago.

But as his descendants moved forward, they lost touch with the past. Today, Dolphus Shields lies in a neglected black cemetery, where patches of grass grow knee-high and many tombstones have toppled.

Mrs. Holt, a retired nursing assistant, said he came to her in a dream last month. She dug up his photograph, never guessing that she would soon learn that Dolphus Shields was a great-great-grandfather of the first lady.

“Oh, my God,” said Mrs. Holt, gasping at the news. “I always looked up to him, but I would never have imagined something like this. Praise God, we’ve come a long way.”

Why Women Have Sex By Alyssa Fetini

While figuring out what women want has stumped men for centuries, understanding how they think about sex may have just gotten easier. Cindy Meston and David Buss, psychologists at the University of Texas, interviewed over 1,000 women around the world for their book Why Women Have Sex and managed to come up with 237 reasons, ranging from the predictable — commitment — to the puzzling — curing a headache. Spoiler alert: love may be further down on the list than one might think. TIME spoke to Buss about the myriad mind games, turn-ons and turn-offs involved in female sexuality, and what a guy can do to stand a chance.

You co-authored a famous 2007 study "Why Humans Have Sex." Why focus on women this time around?
We discovered that women's sexual psychology turned out to be far more complex than we envisioned. [It] deserved an entire book-length treatment. (See photos: "The Best of the Bond Girls")

What differences between men and women did you notice?
There are important gender differences in sexuality, but these must be interpreted within the context of a high level of similarity. Both women and men have sex because they are physically attracted to the person, for pure pleasure, because they are in love, or simply because they are horny. But within the overall similarity, I'd say women's sexuality tends to be more linked with love and emotional bonding. Women, more than men, like sex when there's some kind of emotional connection. Men were more likely to have sex simply because the opportunity presented itself. Women tend to be pickier, especially for short-term sexual encounters. And men are more motivated to have sex to boost their status among their peers, although some women in our study also had sex for precisely this reason. (Read more about the chemistry of desire.)

What are the main reasons why women have sex?
The most frequent reasons include: sexual attraction to the person, the desire for physical pleasure, to express affection, to express their love for a person or because they were sexually aroused and wanted release.

Other important reasons are to boost their self-esteem or sexual esteem, to get revenge, to secure "mate insurance" in case a partner dumps them, to relieve pain, to achieve health benefits such as getting rid of a headache — yes, it works — to decrease stress, to lose weight and as a sleep aid. We devote one chapter to "sexual economics," which focuses on all the ways in which women have sex as an exchange for other benefits, such as getting her partner to take out the garbage, securing free dinners or getting expensive gifts. We also devote one chapter to what we call "the dark side" of women's sexuality — when women have sex because they were deceived, coerced or forced into it. (See photos: "Same-Sex Overtures Across Species")

Any particularly surprising findings?
I was surprised by the importance of revenge. A few had sex in order to give someone else a sexually transmitted disease. More commonly, women's revenge sex involved getting back at a cheating partner, or having sex with the partner of a friend who had poached her partner. Actually, the frequency of mate-poaching also surprised me — the frequency with which women try to lure men who are already "taken," either for a short-term sexual liaison or a longer-term relationship. Most women have experienced mate-poaching in one form or another, either as the mate poacher or as the victim.

How does evolution explain some of these complexities?
Sexual attraction often boils down to what Darwin called "female choice." Modern women are the descendants of a long and unbroken line of ancestral mothers who made wise sexual choices. As descendants of these successful women, modern women carry with them the sexual psychology — the ancestral wisdom — that led to the success of their female forebears. So women find cues to health, status and protection to be sexually attractive. These are all qualities that led to better survival and reproductive outcomes.(Read about teen girls and sex.)

On the competition side, evolution by selection is an inherently competitive process. It's a cliché that "the good men are all taken, permanent bachelors or gay." And there's some truth to this. The number of truly desirable and available men is limited. So women are in sexual competition with other women for access to the most desirable men. Modern women are the descendants of ancestral mothers who succeeded in besting other women in these sexual competitions.

What physical features do women tend to find most attractive in men?
Body is important to women. Women are sexually attracted to men with a V-shaped torso, or a high shoulder-to-hip ratio, and men who are taller than average. Interestingly, women do not like muscle-bound men, and men misperceive how muscular women want them to be. The face is also critical. A symmetrical face is a health cue, as are a good head of hair and masculine features such a strong jaw and a deep voice. Women generally don't find feminine-looking or feminine-sounding men to be sexually attractive.

What advice could you give to the men out there not blessed with Michael Phelps' torso and George Clooney's face? What can they do to stay in the game?


Have good hygiene. Sense of smell is critical. A man who smells bad, or who has bad breath — that can be a sexual kill switch for women. Interestingly, women have a keener sense of smell than men, so men are sometimes oblivious to how bad they smell to women. A man's scent conveys critical information to women about a man's health status.

The other thing to note about what women find sexually attractive centers on cues that convey personality, sense of humor, self-confidence and social status. These things can transform an average-looking man into a sexually attractive man in the minds of many women.