Kristof’s Christmas List

Gail Collins is off today.  Mr. Kristof, in “A Most Meaningful Gift Idea,” says some of the best kinds of gifts don’t need to be wrapped, just donated. He gives us a list of worthy, unknown charities.  Here he is:

Are the kids demanding the latest murder-and-mayhem video game? Do your loved ones have all the neckties/bottles of perfume/sweaters that can be used in a lifetime? Tired of celebrating spiritual holidays with crass commercialism?

If so, then perhaps it’s time to try a different kind of gift. After all, nothing says “happy holidays” like donating in Aunt Tilda’s name to build a composting toilet in Haiti or to deworm kids in Kenya. And a deworming pill will never be regifted!

This time of year I’m always barraged with inquiries about well-run charitable groups doing effective work. So let me tell you about some of the organizations that I’ve encountered that tackle global poverty in innovative ways.

In this column, I’m putting aside the larger, well-known aid organizations like CARE, Save the Children, Mercy Corps and Heifer International. They all do fabulous work, but today I want to bring to show-and-tell some organizations laboring in obscurity. These groups are also a reminder that the gap in savvy, creativity and effectiveness between the business world and the nonprofit sector is narrowing — in some cases vanishing.

So here’s my quirky holiday list of nifty, unknown charities:

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Acumen Fund, www.acumenfund.org, brings a venture capital sensibility to aid work. It invests money in for-profit businesses — like WaterHealth International, whose business model is to provide clean drinking water where none is available. Acumen also invests in LifeSpring Hospitals, which runs low-cost maternity centers where impoverished women can safely deliver babies.

Acumen argues that these businesses, because they earn profits and treat the poor as customers, are more sustainable than giveaways. This reflects a growing trend of using business mechanisms to fight poverty.

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Afghan Institute of Learning, www.creatinghope.org, is an aid group run by Afghan women. It is led by Sakena Yacoobi, a force of nature who was educated in the United States, and it now serves 350,000 Afghan women and children annually.

Yacoobi runs education programs, training centers and clinics, emphasizing local buy-in and self-reliance. Western aid programs in Afghanistan have not always been successful, and my hunch is that if more aid had been routed through Afghan-managed programs like this, more would have been accomplished.

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BRAC, www.brac.net, is a Bangladeshi antipoverty organization that has had huge success serving tens of millions of people there and is now branching out to Afghanistan and Africa. It emphasizes organizing village women and promoting education, health and microfinance.

One of BRAC’s strengths is its ability to turn impoverished women into agents of change for the entire community.

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Developments in Literacy, www.dil.org, builds terrific modern schools in Pakistan, particularly for girls. It frustrates me that rural Pakistan abounds with hard-line madrassas financed by fundamentalist Muslims who channel the students toward extremism. Extremists recognize the transformative power of education, and so should we. This is a security issue, for D.I.L. schools can help protect us from terrorism.

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Deworm the World, www.dewormtheworld.org, tackles a problem most Americans don’t even think about: intestinal worms. Most kids in poor countries have worms, and the result is anemia, malnutrition and sicknesses that cause absences from school. One of the most cost-effective ways of getting more children into school appears to be deworming them with one pill a year, for about 50 cents per person reached.

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SOIL, www.oursoil.org, is bringing dry, composting toilets to Haiti. Run by two remarkable American women, SOIL operates on a shoestring budget in impoverished communities.

One aim is to improve sanitation and public health. Another is to compost waste so that it can be safely used as fertilizer to boost agricultural production.

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Sustainable Health Ventures, www.sheinnovates.com, is a new effort to help women and girls in poor countries to manage menstruation, so that they miss less school and work. S.H.E. is trying to help African women start their own businesses based on making and distributing low-cost sanitary pads.

Although one Nepal study found contrary evidence, education experts increasingly believe that a cost-effective way to keep high school girls from dropping out in poor countries is to help provide them with sanitary products and perhaps ibuprofen for cramps.

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The Worldwide Fistula Fund, www.wfmic.org, and the Fistula Foundation, www.fistulafoundation.org, are dedicated to correcting a childbirth injury that is one of the worst things that can happen to a person: an obstetric fistula. This is an internal injury that leaves a girl or young woman incontinent, leaking wastes, scorned and ostracized.

A $450 surgical repair can usually solve the problem and give these young women their lives back. For fistula suffers, it’s truly the gift of a lifetime.

I would also add the much better-known Heifer International.

Collins, solo.

Mr. Herbert and Mr. Blow are both off today.  In “The New Perils of Pauline” Ms. Collins has a question — Has the health care bill been so abused by the various politicians who’ve held its fate in their hands that it’s time to put it out of its misery?  I wish I had an answer to that one.  I hate the mandate…  Here she is:

When we last left the health care reform bill, it was tied up on the railroad track, writhing helplessly with the train bearing down. The role of Snidely Whiplash was played by Senator Joseph Lieberman.

Time for a new episode. Having stripped away all the parts that offended his sensibilities, Lieberman has slunk off and the fate of the legislation is now in the hands of Senator Ben Nelson of Nebraska.

People, when did it become necessary for average, conscientious-but-not-fanatic citizens to know the names of so many senators? There was probably a time when you thought “Max Baucus” was a brand of sausage. And now we not only know that he is the chairman of the Senate Finance Committee and from Montana, we are also up to the minute on his divorce and his “mature and happy” relationship with his live-in girlfriend.

We know more about Max Baucus than we do about Brad Pitt! That seems wrong, so very wrong.

Nelson is the most conservative Democrat in the Senate and a guy who seems to really enjoy having the fate of the health care bill in his hands. We have mentioned before that George W. Bush used to call him “The Benator.” Have we mentioned that he used to be president of an insurance company?

He is being treated like a visiting superpower. When the prime minister of India came to the United States, he got that one crasher-wracked party and an hour of face time with Barack Obama. Ben Nelson has met Obama at least three times in the last nine days. The president, he said serenely, “made a strong case for passing health care reform, but it remains to be seen if it was compelling.”

Good work making your case, most powerful person on the planet. But we will see if it meets the standards of Senator Ben Nelson.

So the health care bill, which was already watered down for Max Baucus and then stripped down for Joe Lieberman, is now being sent to the sauna for Ben Nelson. The big question on the liberal side is whether what remains will still be worth supporting. On Friday, MoveOn started a petition urging progressive senators “to block the current Senate bill until it is improved.” The blogosphere resounds with calls to go back and start over.

Our question for today is: Does this make sense? Has the health care bill been so abused by the various pols who’ve held its fate in their hands that it’s time to put it out of its misery?

Let me tell you a story. …

Back in 1971, Congress passed a bill aimed at providing high-quality early childhood education and after-school programs for any American family that wanted them. It was bipartisan, which in those days meant more than a whole lot of Democrats and somebody from Maine. “Having been a working mother, I knew what day-care problems were like,” said Martha Phillips, who was at that time a staffer at the Republican Research Committee in the House.

Then Richard Nixon surprised almost everyone by vetoing it, with a scathing message written by Pat Buchanan, claiming the bill would “commit the vast moral authority of the National Government to the side of communal approaches to child rearing.”

The social right, which was just beginning to come into its own, was delighted! Opponents reinforced the message with a massive letter-writing campaign. They accused members of Congress of plotting to deprive parents of the right to take their offspring to church, give children the power to sue their parents for forcing them to do chores, and, in general, turn the country into a Maoist concentration camp.

“We really saw the beginning of the right-wing religious agenda,” said Walter Mondale, who was the chief Senate sponsor of the bill. “They used this bill to raise fears about undermining parents, Sovietizing American youth. People were afraid to touch it for a while.”

Meanwhile, there was hardly a peep from the other side. Children’s advocates had been enthusiastic at first, but as the legislation made its way through Congress, they squabbled over what kinds of community groups should be allowed to deliver the services. Advocates for poor children were worried that subsidies for middle-class families would reduce the amount available to help the neediest.

“It wasn’t perfect,” said Mondale. “We’ve never passed a perfect bill in American history. But it would have made a big difference.”

In the end, the people who hated the whole idea were much more energized than the people who loved the idea, but disagreed on the details.

“People always think there will be another day,” said Jack Duncan, who was counsel for the subcommittee that handled the bill in the House. “Well, there might be another day, but not in my lifetime.”

Remind you of anything?

Collins and Blow

Mr. Herbert is off today.  In “Going Naked in Kabul” Ms. Collins asks when did we decide that letting private contractors stand in for our military in sensitive and dangerous situations was a good plan?  Gail, sweetie, it’s what happens when you insist on having an all-volunteer armed forces.  Look it up.  Mr. Blow, in “Paranormal Flexibility,” says Americans continue to cobble together spiritual identities from a hodgepodge of beliefs — bending dogmas to suit them instead of bending themselves to fit a dogma.  Here’s Ms. Collins:

Do you remember the scandal about the U.S. Embassy guards in Kabul, Afghanistan, who got naked and held wild hazing rituals?

I am bringing this up because I want to talk about government contracting. When you venture into topics like that, it’s always a good idea to try to begin with an orgy.

The guards at the American Embassy in Afghanistan worked for a private contractor called ArmorGroup. A few months ago, a nonprofit watchdog organization reported that some of the guards were being pressured to have sex in a “Lord of the Flies environment.” Whistle-blowers turned over pictures of men in various states of undress, fondling and urinating on one another.

In general, guards from countries like Australia, New Zealand and the United States were the ones involved in the bad behavior. Fortunately, the bulk of the workers were Gurkhas from Nepal who took their jobs very seriously. Unfortunately, the Gurkhas could not understand English.

So the American Embassy in one of the most dangerous spots on the planet was being protected by a combination of people who couldn’t communicate with Americans and thuggish party animals.

The biggest surprise was that the United States did not have its own soldiers guarding its Embassy in a war zone. We have been getting surprised like that a lot lately. Many of the worst stories involve Blackwater Worldwide, a private security contractor that changed its name to Xe Services after a series of mishaps in Iraq, one of which involved spraying bullets around a square in Baghdad and killing 17 civilians.

On Friday, James Risen and Mark Mazzetti of The Times reported that Blackwater employees had taken part in clandestine C.I.A. “snatch and grab” raids in Iraq and Afghanistan, in which suspected insurgents were abducted and taken away for detention and questioning.

This was, of course, in the past. In fact, on Friday, it was revealed that the C.I.A. director, Leon Panetta, had canceled a contract under which Blackwater loaded missiles on Predator drones in Pakistan — another activity that sort of came as a surprise when The Times first reported it last summer.

But Lord knows what Xe Services is up to.

What do you think Dwight Eisenhower would say about all of this? In his last speech as president, Eisenhower famously warned the country about “the potential for the disastrous use of misplaced power” if the military industrial complex got too big. That was back when defense contractors just sold the Pentagon fighter jets and wildly expensive widgets. Imagine how Ike would have reacted if they were driving the C.I.A. to snatch-and-grab dates.

When did we decide this was a good plan?

Let’s pretend for a minute that it is not stupendously irresponsible to let private contractors stand in for our military in wildly sensitive and dangerous situations abroad. Even if it was a terrific idea, we would still have to ask whether huge government agencies, which frequently have a difficult time finding cost-effective ways to order a hammer, know how to purchase services that actually work.

These days, there’s virtually nothing the government doesn’t contract out. At the height of the war in Iraq, there were 190,000 contracted personnel taking part in the effort — 23 times the number of allied troops who were lending a hand. “What we created was not a coalition of the willing. We’re relying on coalitions of the billing,” said P.W. Singer, a contracting expert with the Brookings Institution.

This is the real surge, with a dwindling number of overseers riding herd. In 1997, Singer said, each defense auditor was responsible for overseeing about $642 million in contracts on average. “The last figures I saw, it was one auditor to $2.02 billion.”

There’s no reason to believe the government has the capacity to determine how well all these private contractors are doing their jobs. And it’s doubtful that if the government did know, it could do much about it.

All of this brings us back to the Embassy in Kabul. Long before the news about the guards gone wild hit the media, the State Department had been issuing a long stream of warnings to ArmorGroup about contract violations ranging from sleep-deprived workers to corrupt managers. It demanded that the contractor meet its obligation to provide English-speaking guards and rejected several requests for more time to fix the problem.

None of which meant that the guards learned to speak English. It’s just that they continued to not understand English without official permission.

Then word about the sex parties got out and everybody was embarrassed. The State Department announced that it was “seeing a very, very serious case made for termination” of the contract.

Which has not actually happened.

Officials decided to stick with the status quo because they couldn’t figure out how to get anyone else to staff the Embassy.

But good news! A spokeswoman said the State Department is working on “preparation for solicitation of a contract that we expect to be awarded by June 2010.”

As an aside, I’m willing to bet that if we drafted the kids of Congresscritters they’d be a lot less willing to send them gallivanting off on fool’s errands.  Here’s Mr. Blow:

The Pew Forum on Religion and Public Life released a report on Wednesday that is bound to stir conversation about the increasingly complicated cacophony of spirituality in America — a mash-up of traditional faiths, fantasy and mythology.

Entitled “Many Americans Mix Multiple Faiths,” the report points out that many Americans are now choosing to “blend Christianity with Eastern or New Age beliefs” and that “sizable minorities of all major U.S. religious groups” said that they have had supernatural experiences, like encountering ghosts.

For the first time in 47 years of polling, the number of Americans who said that they have had a religious or mystical experience, which the question defined as a “moment of sudden religious insight or awakening,” was greater than those who said that they had not.

(Question: Does the first time I saw Michael Jackson’s “Thriller” video count?)

Twenty percent of Protestants and 28 percent of Catholics said they believe in reincarnation, which flies in the face of Christianity’s rapture scenario. Furthermore, about the same percentages said they believe in astrology, yoga as a spiritual practice and the idea that there is “spiritual energy” pulsing from things like “mountains, trees or crystals.” Uh-oh. Someone’s God is going to be jealous.

Surprisingly, in some cases, those who identified themselves as Christian were more likely to believe these things than those who were unaffiliated. (It should be noted that unaffiliated is not the same as nonbeliever. Many are spiritual people who simply haven’t found the right church, synagogue, mosque, coven, Ouija board club, or whatever.)

Furthermore, 16 percent of Protestants and 17 percent of Catholics said that they believe that some people can use the “evil eye” to “cast curses or spells that cause bad things to happen.” I have to say that based on the looks my mother used to shoot me when I was misbehaving, that evil eye thing might have legs.

Since 1996, the percentage of Americans who said that they have been in the presence of a ghost has doubled from 9 percent to 18 percent, and the percentage who said that they were in touch with someone who was dead has increased by about a third, rising from 18 percent to 29 percent.

For those keeping political score, Democrats were almost twice as likely to believe in ghosts and to consult fortune-tellers than were Republicans, and the Democrats were 71 percent more likely to believe that they were in touch with the dead. Please hold the Barack-Obama-as-the-ghost-of-Jimmy-Carter jokes. Heard them all.

The report is further evidence that Americans continue to cobble together Mr. Potato Head-like spiritual identities from a hodgepodge of beliefs — bending dogmas to suit them instead of bending themselves to fit a dogma. And this appears to be leading to more spirituality, not less. Cue the harps, and the sitars, and the tablas, and the whale music.

(A small comment to Mr. Blow: — it’s not “Christianity’s” rapture scenario.  That’s the lunacy primarily of the Talibangelicals.)

Dowd, Friedman, Kristof and Rich

For reasons best known to herself MoDo has decided to play film buff/historian today.  In “Ballet’s Mean Streets” she fizzes that “The Red Shoes,” a classic 1948 film directed by Michael Powell and Emeric Pressburger, is a gorgeously haunting work of art.  One wonders if they dragged out one of her “anytime” columns they have in the can while they’re adjusting her medications…  The Moustache of Wisdom, in “Call White House, Ask for Barack,” says until the Palestinians and Israelis are serious about the peace process, the United States should get out of the picture.  Mr. Kristof addresses food safety in “Something Scary in the Pantry.”  He says bisphenol A, or BPA, is linked to things like cancer, obesity, attention deficit disorder and genital abnormalities, and it’s been found in our food.  Mr. Rich, in “The Night They Drove the Tea Partiers Down,” says Democrats need to realize they appear overly sympathetic to fat-cat bankers, particularly because Republicans may not self-destruct.  Here’s MoDo:

Some movies you have to watch whenever they’re on.

One of those, for me, is “The Red Shoes.” Like its doomed heroine, I’m pulled inexorably along by the bewitched crimson ballet slippers into a lush, swirling landscape that turns into an inescapable, bloody hell.

There are many great works of art about obsession, from Heathcliff’s wailing to Ahab’s whaling, but this is surely the most gorgeously haunting. The destructive obsession portrayed here is not with a lover or outside object of desire. It’s about the tyranny of creativity.

As the white-skinned, blue-blooded ballerina Vicky Page, Moira Shearer dons the red slippers and is forced to choose between love and art.

There was never a screen pairing more magical than Moira and Technicolor. The flame-haired Scottish dancer is so radiant in the Criterion DVD of the 1948 classic directed by Michael Powell and Emeric Pressburger that it’s impossible to believe she could glow more brightly. But in the lovingly polished version of the British movie that debuted at Cannes and is now showing at Film Forum in New York, Moira is even more incandescent.

The original backers of the movie had so little confidence that a stylized tragic ballet film could do well that they didn’t even give it an official London premiere.

Now Martin Scorsese calls “The Red Shoes” “one of the true miracles of film history.” He long ago began an obsessive campaign to restore Powell’s reputation. His Film Foundation and the UCLA Film and Television Archive have taken the lead in digitally alchemizing the movie from cracked, shrunk, moldy negatives.

Scorsese fell in love with the movies of Powell and Pressburger when he was an asthmatic kid living in a four-room tenement apartment in New York, watching “Million Dollar Movie” on TV and going to theaters with his dad.

“They have a flair and flamboyance you don’t usually find in films being made at that time,” he told me. “And a fearlessness about emotion. They create worlds that take no prisoners.”

In “Black Narcissus,” their 1947 movie about a lustful nun in the Himalayas, played by Deborah Kerr — they seemed drawn to redheads for Technicolor — the sister faints from sexual desire and the screen goes orange. “That’s such a wonderful way to express desire,” Scorsese marveled.

In a letter to Kerr in the early ’40s, Pressburger laid out their manifesto, including: “No artist believes in escapism. And we secretly believe that no audience does. We have proved, at any rate, that they will pay to see the truth, for no other reason than her nakedness.”

In the early ’70s, Scorsese tracked down the broke and discredited Powell in London and took him to a pub.

“Michael was very surprised to hear that his films had thrilled a younger audience and given fuel to the imagination of myself and Brian De Palma and Francis Coppola,” Scorsese once recalled. “He went home that night and recorded in his diary that he felt his blood course through his veins again after meeting us in the bar.”

In 1980, Coppola invited Powell to become a consultant at Zoetrope Studios. He moved to America and married Scorsese’s film editor, Thelma Schoonmaker.

It is interesting that Powell twice counseled Scorsese against the color red. He didn’t like the red boxing gloves in the early rushes of “Raging Bull” and urged Scorsese to switch to a black-and-white film. (He did.) Powell told him “Mean Streets” had too much red lighting and he should take some out. (He didn’t.)

“The Red Shoes” is based on a Hans Christian Andersen fairy tale of the same name about a little girl who becomes vain about her red shoes and gets confused about her priorities. As in the movie, the shoes force the girl to dance day and night, and then she dies. But the fable has an even grimmer coda: The girl asks an executioner to cut off her feet.

The shimmering Moira Shearer could never take off the red shoes, either.

“To be constantly associated with that one film is really quite dismaying,” she once said. “It’s as though I’d done nothing else in my life. I mean, it’s odd, when you’re 61, to be haunted by something you’ve done when you were 21!”

She resisted doing the movie, finding the script “silly and banal”; she feared it would deflect her from a classical ballet career. And when she died at 80 in 2006, her husband dismissively called her film work “a bit of a distraction.”

Shearer said she faced hostility when she returned to the ballet world from some who considered her overnight movie fame frivolous. She always worried that she was succeeding more for her looks than her dancing.

She was eclipsed by Margot Fonteyn, married, had four children and receded. She wrote a book about her experiences with George Balanchine. As Clive Barnes wrote in Dance Magazine, “She had a disappointing and disappointed dance career.”

In later years, Shearer was asked to give her occupation in “Who’s Who.”

“Writer,” she replied.

This belonged in the entertainment section, not the op-ed page.  Here’s The Moustache of Wisdom:

The Israeli-Palestinian peace process has become a bad play. It is obvious that all the parties are just acting out the same old scenes, with the same old tired clichés — and that no one believes any of it anymore. There is no romance, no sex, no excitement, no urgency — not even a sense of importance anymore. The only thing driving the peace process today is inertia and diplomatic habit. Yes, the Israeli-Palestinian peace process has left the realm of diplomacy. It is now more of a calisthenic, like weight-lifting or sit-ups, something diplomats do to stay in shape, but not because they believe anything is going to happen. And yet, as much as we, the audience, know this to be true, we can never quite abandon hope for peace in the Holy Land. It is our habit. Indeed, as I ranted about this to a Jordanian friend the other day, he said it all reminded him of an old story.

“These two guys are watching a cowboy and Indian movie. And in the opening scene, an Indian is hiding behind a rock about to ambush the handsome cowboy,” he explained. “ ‘I bet that Indian is going to kill that cowboy,’ one guy says to the other. ‘Never happen,’ his friend answers. ‘The cowboy is not going to be killed in the opening scene.’ ‘I’ll bet you $10 he gets killed,’ the guy says. ‘I’ll take that bet,’ says his friend.

“Sure enough, a few minutes later, the cowboy is killed and the friend pays the $10. After the movie is over the guy says to his friend, ‘Look, I have to give you back your $10. I’d actually seen this movie before. I knew what was going to happen.’ His friend answers: ‘No, you can keep the $10. I’d seen the movie, too. I just thought it would end differently this time.’ ”

This peace process movie is not going to end differently just because we keep playing the same reel. It is time for a radically new approach. And I mean radical. I mean something no U.S. administration has ever dared to do: Take down our “Peace-Processing-Is-Us” sign and just go home.

Right now we want it more than the parties. They all have other priorities today. And by constantly injecting ourselves we’ve become their Novocain. We relieve all the political pain from the Arab and Israeli decision-makers by creating the impression in the minds of their publics that something serious is happening. “Look, the U.S. secretary of state is here. Look, she’s standing by my side. Look, I’m doing something important! Take our picture. Put it on the news. We’re on the verge of something really big and I am indispensable to it.” This enables the respective leaders to continue with their real priorities — which are all about holding power or pursuing ideological obsessions — while pretending to advance peace, without paying any political price.

Let’s just get out of the picture. Let all these leaders stand in front of their own people and tell them the truth: “My fellow citizens: Nothing is happening; nothing is going to happen. It’s just you and me and the problem we own.”

Indeed, it’s time for us to dust off James Baker’s line: “When you’re serious, give us a call: 202-456-1414. Ask for Barack. Otherwise, stay out of our lives. We have our own country to fix.”

The fact is, the only time America has been able to advance peace — post-Yom Kippur War, Camp David, post-Lebanon war, Madrid and Oslo — has been when the parties felt enough pain for different reasons that they invited our diplomacy, and we had statesmen — Henry Kissinger, Jimmy Carter, George Shultz, James Baker and Bill Clinton — savvy enough to seize those moments.

Today, the Arabs, Israel and the Palestinians are clearly not feeling enough pain to do anything hard for peace with each other — a mood best summed up by a phrase making the rounds at the State Department: The Palestinian leadership “wants a deal with Israel without any negotiations” and Israel’s leadership “wants negotiations with the Palestinians without any deal.”

It is obvious that this Israeli government believes it can have peace with the Palestinians and keep the West Bank, this Palestinian Authority still can’t decide whether to reconcile with the Jewish state or criminalize it and this Hamas leadership would rather let Palestinians live forever in the hellish squalor that is Gaza than give up its crazy fantasy of an Islamic Republic in Palestine.

If we are still begging Israel to stop building settlements, which is so manifestly idiotic, and the Palestinians to come to negotiations, which is so manifestly in their interest, and the Saudis to just give Israel a wink, which is so manifestly pathetic, we are in the wrong place. It’s time to call a halt to this dysfunctional “peace process,” which is only damaging the Obama team’s credibility.

If the status quo is this tolerable for the parties, then I say, let them enjoy it. I just don’t want to subsidize it or anesthetize it anymore. We need to fix America. If and when they get serious, they’ll find us. And when they do, we should put a detailed U.S. plan for a two-state solution, with borders, on the table. Let’s fight about something big.

Here’s Mr. Kristof, who made my hair stand up on end:

Your body is probably home to a chemical called bisphenol A, or BPA. It’s a synthetic estrogen that United States factories now use in everything from plastics to epoxies — to the tune of six pounds per American per year. That’s a lot of estrogen.

More than 92 percent of Americans have BPA in their urine, and scientists have linked it — though not conclusively — to everything from breast cancer to obesity, from attention deficit disorder to genital abnormalities in boys and girls alike.

Now it turns out it’s in our food.

Consumer Reports magazine tested an array of brand-name canned foods for a report in its December issue and found BPA in almost all of them. The magazine says that relatively high levels turned up, for example, in Progresso vegetable soup, Campbell’s condensed chicken noodle soup, and Del Monte Blue Lake cut green beans.

The magazine also says it found BPA in the canned liquid version of Similac Advance infant formula (but not in the powdered version) and in canned Nestlé Juicy Juice (but not in the juice boxes). The BPA in the food probably came from an interior coating used in many cans.

Should we be alarmed?

The chemical industry doesn’t think so. Steven Hentges of the American Chemistry Council dismissed the testing, noting that Americans absorb quantities of BPA at levels that government regulators have found to be safe. Mr. Hentges also pointed to a new study indicating that BPA exposure did not cause abnormalities in the reproductive health of rats.

But more than 200 other studies have shown links between low doses of BPA and adverse health effects, according to the Breast Cancer Fund, which is trying to ban the chemical from food and beverage containers.

“The vast majority of independent scientists — those not working for industry — are concerned about early-life low-dose exposures to BPA,” said Janet Gray, a Vassar College professor who is science adviser to the Breast Cancer Fund.

Published journal articles have found that BPA given to pregnant rats or mice can cause malformed genitals in their offspring, as well as reduced sperm count among males. For example, a European journal found that male mice exposed to BPA were less likely to make females pregnant, and the Journal of Occupational Health found that male rats administered BPA had less sperm production and lower testicular weight.

This year, the journal Environmental Health Perspectives found that pregnant mice exposed to BPA had babies with abnormalities in the cervix, uterus and vagina. Reproductive Toxicology found that even low-level exposure to BPA led to the mouse equivalent of early puberty for females. And an array of animal studies link prenatal BPA exposure to breast cancer and prostate cancer.

While most of the studies are on animals, the Journal of the American Medical Association reported last year that humans with higher levels of BPA in their blood have “an increased prevalence of cardiovascular disease, diabetes and liver-enzyme abnormalities.” Another published study found that women with higher levels of BPA in their blood had more miscarriages.

Scholars have noted some increasing reports of boys born with malformed genitals, girls who begin puberty at age 6 or 8 or even earlier, breast cancer in women and men alike, and declining sperm counts among men. The Endocrine Society, an association of endocrinologists, warned this year that these kinds of abnormalities may be a consequence of the rise of endocrine-disrupting chemicals, and it specifically called on regulators to re-evaluate BPA.

Last year, Canada became the first country to conclude that BPA can be hazardous to humans, and Massachusetts issued a public health advisory in August warning against any exposure to BPA by pregnant or breast-feeding women or by children under the age of 2.

The Food and Drug Administration, which in the past has relied largely on industry studies — and has generally been asleep at the wheel — is studying the issue again. Bills are also pending in Congress to ban BPA from food and beverage containers.

“When you have 92 percent of the American population exposed to a chemical, this is not one where you want to be wrong,” said Dr. Ted Schettler of the Science and Environmental Health Network. “Are we going to quibble over individual rodent studies, or are we going to act?”

While the evidence isn’t conclusive, it justifies precautions. In my family, we’re cutting down on the use of those plastic containers that contain BPA to store or microwave food, and I’m drinking water out of a metal bottle now. In my reporting around the world, I’ve come to terms with the threats from warlords, bandits and tarantulas. But endocrine disrupting chemicals — they give me the willies.

And last but not least here’s Mr. Rich:

For all cable news’s efforts to inflate Election 2009 into a cliffhanger as riveting as Balloon Boy, ratings at MSNBC and CNN were flat Tuesday night. But not at Fox News, where the audience nearly doubled its usual prime-time average. That’s what happens when you have a thrilling story to tell, and what could be more thrilling than a revolution playing out in real time?

As Fox kept insisting, all eyes were glued on Doug Hoffman, the insurgent tea party candidate in New York’s 23rd Congressional District. A “tidal wave” was on its way, said Sean Hannity, and the right would soon “take back the Republican Party.” The race was not “even close,” Bill O’Reilly suggested to the pollster Scott Rasmussen, who didn’t disagree. When returns showed Hoffman trailing, the network’s resident genius, Karl Rove, knowingly reassured viewers that victory was in the bag, even if we’d have to stay up all night waiting for some slacker towns to tally their votes.

Alas, the Dewey-beats-Truman reveries died shortly after midnight, when even Fox had to concede that the Democrat, Bill Owens, had triumphed in what had been Republican country since before Edison introduced the light bulb. For the far right, the thriller in Watertown was over except for the ludicrous morning-after spin that Hoffman’s loss was really a victory. For the Democrats, the excitement was just beginning. New York’s 23rd could be celebrated as a rare bright spot on a night when the party’s gubernatorial candidates lost in Virginia and New Jersey.

The Democrats’ celebration was also premature: Hoffman’s defeat is potentially more harmful to them than to the Republicans. Tuesday’s results may be useless as a predictor of 2010, but they are not without value as cautionary tales. And the most worrisome for Democrats were not in Virginia and New Jersey, but, paradoxically, in the New York contests where they performed relatively well. That includes the idiosyncratic New York City mayor’s race that few viewed as a bellwether of anything. It should be the most troubling of them all for President Obama’s cohort — even though neither Obama nor the national political parties were significant players in it.

But first let’s make a farewell accounting of the farce upstate. The reason why the Democratic victory in New York’s 23rd is a mixed blessing is simple: it increases the odds that the Republicans will not do Democrats the great favor of committing suicide between now and the next Election Day.

This race was a damaging setback for the hard right. Hoffman had the energetic support of Sarah Palin, Glenn Beck, Rush Limbaugh and Fox as well as big bucks from their political auxiliaries. Furthermore, Hoffman was running not only in a district that Rove himself described as “very Republican” but one that fits the demographics of the incredibly shrinking G.O.P. The 23rd is far whiter than America as a whole — 93 percent versus 74 — with tiny sprinklings of blacks, Hispanics and Asians. It has few immigrants. It’s rural. Its income and education levels are below the norm. Only if the district were situated in Dixie — or Utah — could it be a more perfect fit for the narrow American demographic where the McCain-Palin ticket had its sole romps last year.

If the tea party right can’t win there, imagine how it might fare in the nation where most Americans live. Some G.O.P. leaders have started to notice. Mitt Romney didn’t endorse Hoffman despite right-wing badgering to do so. On Wednesday, Michael Steele dismissed the right’s mantra that somehow Hoffman’s loss could be called a victory and instead talked up the newly elected Republican governors who won by appealing to independents and moderates. Chris Christie and Bob McDonnell are plenty conservative, but both had rejected Palin’s offers to campaign for them. They also avoided the tea party zanies, the fear-mongering National Organization for Marriage and the anti-abortion-rights zealots Hoffman embraced. They positioned themselves as respectful Obama critics, not haters likening him to Hitler.

In the aftermath of this clear-cut demonstration of how Republicans can win, the revolutionaries are still pledging to purge the party’s moderates by rallying behind more Hoffmans in G.O.P. primaries from Florida to California. And they may get some scalps. But Tuesday’s loss revealed that they’re better at luring freak-show gawkers into Fox’s tent than voters into the G.O.P.’s. As if to prove the point, protesters hoisted a sign likening health care reform to Dachau at the raucous tea party rally convened by Michele Bachmann on Capitol Hill on Thursday.

Should the G.O.P. avoid self-destruction by containing this fringe, then the president and his party will have to confront their real problem: their identification with the titans who greased the skids for the economic meltdown from which Wall Street has recovered and the country has not. If there’s one general lesson to be gleaned from Christie’s victory over Jon Corzine in New Jersey, it’s surely that in today’s zeitgeist it’s less of a stigma to be fat than a former Goldman Sachs fat cat, even in a blue state.

Michael Bloomberg’s shocking underperformance in New York was an even more dramatic illustration of this animus. Tuesday’s exit polls found that he had a whopping 70 percent approval rating, as befits a mayor who, whatever his quirks and missteps, is widely regarded as a highly competent, nonideological executive who has run the city well. Yet only 72 percent of those who gave him a thumb’s up voted for him. Though the mayor wildly outspent and out-campaigned his bland opponent, Bill Thompson, he received only 50.6 percent of the vote.

This shortfall has been correctly attributed to Bloomberg’s self-serving, highhanded undoing of the term limits law he had once endorsed. The ferocity of the public reaction to this power grab surprised him, pollsters and the press alike. That it became a bigger deal than anyone anticipated — arguably bigger than it merited — is an indicator of how much antipathy there is toward the masters of the universe in the financial capital. Americans don’t hate rich people, but they do despise those who behave as if the rules don’t apply to them. “Michael Bloomberg is About to Buy Himself a Third Term” was the cover line on New York magazine in October. However unfairly, some voters conflated his air of entitlement with the swaggering Wall Street C.E.O.’s who cashed out before the crash and stuck the rest of us with the bill.

The Obama administration does not seem to understand that this rage, left unaddressed, could consume it. It has pushed aside the entreaties of many — including Paul Volcker, the chairman of the White House’s own Economic Recovery Advisory Board — to break up too-big-to-fail banks. Those behemoths, cushioned by the government’s bailouts, low-interest loans and guarantees, are back making bets that put the entire system at risk. Yet last Sunday, we once again heard the Treasury secretary, Timothy Geithner, on “Meet the Press” dodging questions about the banks in general and Goldman in particular with unpersuasive bromides. “We’re not going to let the system go back to the way it was,” he said.

Surely he jests. On Monday morning, a business-savvy Democratic senator, Maria Cantwell of Washington, publicly questioned Geithner’s fitness for his job, given his support of loopholes in proposed regulations of the derivatives that enabled last year’s collapse. On Tuesday, Congressional Democrats, with the White House’s consent, voted to gut the Sarbanes-Oxley Act, the post Enron-WorldCom law passed in 2002 to prevent corporate accounting tricks and fraud. Arthur Levitt, the former Securities and Exchange Commission chairman, told me on Friday it was “surreal” that Democrats were now achieving the long-held Republican goal of smashing “the golden chalice” of reform. If investors cannot have transparency, Levitt said, “the whole system is worthless.”

The system is going back to the way it was with a vengeance, against a backdrop of despair. As the unemployment rate crossed the 10 percent threshold at week’s end, we learned that bankers were helping themselves not just to bonuses as large as those at the bubble’s peak but to early allotments of H1N1 vaccine. No wonder 62 percent of those polled by Hart Associates in late September felt that “large banks” had been helped “a lot” or “a fair amount” by “government economic policies,” but only 13 percent felt the “average working person” had been. Unemployment ranked ahead of the deficit and health care as the No. 1 pocketbook issue in the survey, with 81 percent saying the Obama administration must take more action.

The tea party Republicans vanquished on Tuesday have no jobs plan. They just want to eliminate all Washington spending — a prescription that didn’t go down too well in New York’s 23rd, where the federal government has the largest payroll. The G.O.P. establishment’s one-size-fits-all panacea is tax cuts — thin gruel for those with little or no taxable income. The administration’s answer is the stimulus, whose iffy results so far, it argues, can’t be judged this early on.

Fair enough. But a year from now the public will register its verdict in any event. Meanwhile, both parties have their own delusions, not the least of which is the Republicans’ conviction that Tuesday was a referendum on what Obama has done so far. If anything, it was a judgment on just how much he has not.

 

Kristof, solo

Gail Collins is off today.  Mr. Kristof, in “More Schools, Not Troops,” says a compelling argument against more troops in Afghanistan rests on this trade-off: For the cost of an additional soldier stationed in Afghanistan for a year, nearly 20 schools could be built.  Here he is:

Dispatching more troops to Afghanistan would be a monumental bet and probably a bad one, most likely a waste of lives and resources that might simply empower the Taliban. In particular, one of the most compelling arguments against more troops rests on this stunning trade-off: For the cost of a single additional soldier stationed in Afghanistan for one year, we could build roughly 20 schools there.

It’s hard to do the calculation precisely, but for the cost of 40,000 troops over a few years — well, we could just about turn every Afghan into a Ph.D.

The hawks respond: It’s naïve to think that you can sprinkle a bit of education on a war-torn society. It’s impossible to build schools now because the Taliban will blow them up.

In fact, it’s still quite possible to operate schools in Afghanistan — particularly when there’s a strong “buy-in” from the local community.

Greg Mortenson, author of “Three Cups of Tea,” has now built 39 schools in Afghanistan and 92 in Pakistan — and not one has been burned down or closed. The aid organization CARE has 295 schools educating 50,000 girls in Afghanistan, and not a single one has been closed or burned by the Taliban. The Afghan Institute of Learning, another aid group, has 32 schools in Afghanistan and Pakistan, with none closed by the Taliban (although local communities have temporarily suspended three for security reasons).

In short, there is still vast scope for greater investment in education, health and agriculture in Afghanistan. These are extraordinarily cheap and have a better record at stabilizing societies than military solutions, which, in fact, have a pretty dismal record.

In Afghanistan, for example, we have already increased our troop presence by 40,000 troops since the beginning of last year, yet the result has not been the promised stability but only more casualties and a strengthened insurgency. If the last surge of 40,000 troops didn’t help, why will the next one be so different?

Matthew P. Hoh, an American military veteran who was the top civilian officer in Zabul Province, resigned over Afghan policy, as The Washington Post reported this week. Mr. Hoh argues that our military presence is feeding the insurgency, not quelling it.

Already our troops have created a backlash with Kabul University students this week burning President Obama in effigy until police dispersed them with gunshots. The heavier our military footprint, the more resentment — and perhaps the more legitimacy for the Taliban.

Schools are not a quick fix or silver bullet any more than troops are. But we have abundant evidence that they can, over time, transform countries, and in the area near Afghanistan there’s a nice natural experiment in the comparative power of educational versus military tools.

Since 9/11, the United States has spent $15 billion in Pakistan, mostly on military support, and today Pakistan is more unstable than ever. In contrast, Bangladesh, which until 1971 was a part of Pakistan, has focused on education in a way that Pakistan never did. Bangladesh now has more girls in high school than boys. (In contrast, only 3 percent of Pakistani women in the tribal areas are literate.)

Those educated Bangladeshi women joined the labor force, laying the foundation for a garment industry and working in civil society groups like BRAC and Grameen Bank. That led to a virtuous spiral of development, jobs, lower birth rates, education and stability. That’s one reason Al Qaeda is holed up in Pakistan, not in Bangladesh, and it’s a reminder that education can transform societies.

When I travel in Pakistan, I see evidence that one group — Islamic extremists — believes in the transformative power of education. They pay for madrassas that provide free schooling and often free meals for students. They then offer scholarships for the best pupils to study abroad in Wahhabi madrassas before returning to become leaders of their communities. What I don’t see on my trips is similar numbers of American-backed schools. It breaks my heart that we don’t invest in schools as much as medieval, misogynist extremists.

For roughly the same cost as stationing 40,000 troops in Afghanistan for one year, we could educate the great majority of the 75 million children worldwide who, according to Unicef, are not getting even a primary education. We won’t turn them into graduate students, but we can help them achieve literacy. Such a vast global education campaign would reduce poverty, cut birth rates, improve America’s image in the world, promote stability and chip away at extremism.

Education isn’t a panacea, and no policy in Afghanistan is a sure bet. But all in all, the evidence suggests that education can help foster a virtuous cycle that promotes stability and moderation. So instead of sending 40,000 troops more to Afghanistan, how about opening 40,000 schools?

If you haven’t read it yet, I’d strongly urge you to read Three Cups of Tea.  It’s a wonderful book.

Blow and Herbert

Gail Collins is off today.  Mr. Blow, in “The Magic of Michelle,” says this is America. We respect fearlessness, regardless of what we feel about the person who embodies it. With Michelle Obama, we have it both ways.  Mr. Herbert, in “We Know What He Means,” asks why has Mayor Michael Bloomberg allowed Rudy Giuliani to fan the flames of racial tension while campaigning on his behalf?  Here’s Mr. Blow:

Forgive me in advance for fawning, but Michelle Obama is the coolest first lady ever. She clinched it for me this week by jumping double Dutch on the South Lawn as part of a “healthy kids fair.”

The scene underscored my impression of the first lady as utterly unencumbered by convention. She seems to feel free — free enough to loosen up and laugh a little, free enough to let her inner child peek through the veil of parenthood, free enough to be herself.

I couldn’t imagine recent first ladies jumping a puddle on the sidewalk, let alone two ropes swinging at the same time in opposite directions. So, on behalf of New York City, the so-called double Dutch capital of the world (so much so that this year it became a varsity sport in the city’s schools), allow me to say: Well played.

I could pile on platitudes here about her professional accomplishments, or explore to what degree she is redefining the role of women, or predict how she will be viewed by historians in the pantheon of her predecessors. I could, but I won’t. That’s not my bailiwick.

But I will say that she seems particularly suited to these times. She provides a certain authenticity and clarity of self in a time of uncertainty, projecting a casual grace onto a world of amplified anxiety. She has become a powerful symbol of fearlessness, refinement, frugality and frivolity, managing to be both fun and serious simultaneously. She’s genuinely human.

Mrs. Obama is redefining my concept of a first lady, and I like it. Apparently, I’m not alone.

In April, at the peak of her popularity, a New York Times/CBS News poll measured her favorability at 67 percent. The same poll found that a stratospheric 84 percent approved of how she was handling her role as first lady. That means that even half of those who didn’t hold a favorable view of her as a person still liked what she was doing as first lady.

(It should be noted that polls by USA Today/Gallup and CNN/Opinion Research Corporation, both released this week, put the first lady’s favorability ratings in the 60s and above those of her husband.)

It’s hard to believe that this is the same woman who during the presidential campaign was repeatedly portrayed as the neo-radical albatross to a postracial candidate.

This is America. We respect fearlessness, regardless of what we feel about the person who embodies it. With Mrs. Obama, we have it both ways.

If George W. Bush was the president that Americans most wanted to have a beer with, then Michelle Obama is becoming the first lady we most want to have a laugh with. And that’s cool.

Here’s Mr. Herbert:

I wasn’t at all surprised at Rudy Giuliani. He couldn’t find his way off the low road with a handful of maps and a GPS device. But I was very surprised at Mayor Bloomberg.

One of the signal successes of Mike Bloomberg’s tenure is that during his two terms as mayor of a rough, tough, extremely contentious city, he has helped lower the racial temperature. You can say whatever you want about his policies, you can like him personally or not, but he has not played that cheap and tired game of ethnic politics. He has not tried to divide people along racial, ethnic or religious lines, exploiting fears and pitting groups against one another. And he has stood up against those who would do so.

The city has benefited from this. So it was truly disheartening, dismaying, to have the mayor turn his back on all that last Sunday during an appearance with Mr. Giuliani before an Orthodox Jewish group in Borough Park, Brooklyn.

Mr. Giuliani, campaigning on Mr. Bloomberg’s behalf, warned that if the mayor is not elected to a third term on Nov. 3, the city could become unsafe — a place of escalating crime and heightened tensions and fear.

Homing in with the instincts of a born divider, Mr. Giuliani suggested that an environment filled with danger might be right there on the next horizon if the voters were to elect “the wrong political leadership.” The “wrong” leadership in this case would be Mr. Bloomberg’s opponent, the City Comptroller William Thompson, who is black.

Giuliani said he worries daily that the city might revert “to the way it was before 1993,” the year he was elected mayor. He then pointedly added, so that no one within earshot could mistake his not-so-coded meaning: “And you know exactly what I’m talking about.”

It was vintage Giuliani, as subtle as a heart attack, deliberately fanning the fears of a community that has long been the locus of tensions between blacks and Jews. And Mayor Bloomberg sat there, allowing that lousy message to be delivered on his behalf.

Mr. Bloomberg has had many opportunities to disavow Mr. Giuliani’s remarks, to say that as a city we’re better than that, to repudiate (as he has before) the very idea that exploiting fear and division for political gain is acceptable in this great city. But he has chosen not to. He chose instead, later that same day, to raise the specter of one of the worst big-city tragedies in American history: Detroit, which was laid low by every ill you can imagine, including a catastrophic race riot in 1967.

Detroit, said Mr. Bloomberg, “went from a great city with lots of good-paying jobs to a city that’s basically holding on for dear life.”

Well, that’s true. But what’s that got to do with New York City, or this year’s mayoral election? New York is not an incipient Detroit. New York will not become Detroit if Mike Bloomberg is not re-elected.

The mayor disingenuously said that Detroit’s decline was more about economics than “some other things.” But anyone who knows the sad history of Detroit knows about those “other things.”

This had all the appearance of Mayor Bloomberg piggybacking on Giuliani’s fear-mongering. He picked the worst-case urban scenario available, a crime-ridden, destitute city from which most whites have long since fled, and offered it as a suggestion of what might be in store for New York, a thriving metropolis filled with people from virtually every ethnic group on the planet.

Open a window, please. Some fresh air is in order.

The Mike Bloomberg that New Yorkers came to know during his first two terms as mayor was not the same man who remained shamefully silent last Sunday, willing to benefit politically from Mr. Giuliani’s toxic remarks.

Many of us have seen New York convulsed over the decades by one racially charged controversy after another, sometimes violently convulsed. They come easily to mind: The Central Park jogger case, the police killings of Eleanor Bumpurs, Amadou Diallo and Patrick Dorismond, the vicious racial attacks in Howard Beach and Bensonhurst, the Tawana Brawley affair, the Crown Heights riot and on and on and on.

The Bloomberg administration has helped shield the city from similar convulsions. That the mayor is now willing to lock his principles in a safe deposit box and start riding the broomstick of ethnic politics suggests that he’s worried about the outcome of his race against Mr. Thompson (even though public opinion polls and most of the people I talk to expect Bloomberg to win).

One of the ironies at work here is that it is during the toughest economic times that a city, more than ever, needs a mayor who is committed to bringing people together, not playing them off against one another for short-term political gain. This is absolutely the worst time for that point to have slipped Michael Bloomberg’s mind.

Collins, Blow and Herbert

In “The Eye of the Beholder” Ms. Collins says in New Jersey’s gubernatorial race, a candidate’s weight is now an issue. As Americans get fatter, who will be qualified to run for office?  That won’t be a problem here in Savannah — our former mayor was separated at birth from Jabba the Hut.  Mr. Blow, in “No More Suffering in Silence,” says we must do a better job of helping children who are sexually assaulted realize they are not alone, not at fault and not powerless.  In “Igniting the Growth of Jobs” Mr. Herbert says the government must develop creative approaches and make the investments necessary to start putting people back to work.  Here’s Ms. Collins:

Our question for today is whether it’s fair for a politician to point out that his opponent is fat.

This involves the New Jersey gubernatorial race, where Gov. Jon Corzine has been running ads showing extremely unflattering shots of the Republican contender, Chris Christie, and claiming that Christie “threw his weight around” when he was stopped for traffic infractions.

While Christie is certainly a large guy, the more interesting factoids in the ad would seem to be that he is a large guy who is a bad driver. A bad driver who was given to loudly pointing out that he was the U.S. attorney when he was stopped for things like speeding, driving without a car registration, or — whoops! — running into a motorcyclist while going the wrong way on a one-way street.

However, the weight issue is the one that has caught all the attention. Patrick Murray, the poll director at Monmouth University, told David Halbfinger of The Times that he thought Corzine was trying to send a “subliminal message” that Christie was reckless about his health and, therefore, might be reckless about, say, the state budget.

During a debate among candidates for N.J. lieutenant governor, the Democrat, State Senator Loretta Weinberg, was asked whether she felt Christie is overweight. “I don’t think that there are too many of us in this race who could make it into ‘The Bachelor’ or ‘The Bachelorette,’ ” she responded.

This was an extremely discreet answer, although now that we have seen how much attention Tom DeLay got for “Dancing With the Stars,” I suspect that the networks would have no hesitation whatsoever in tossing a couple of lieutenant governors into a serial dating show.

It is definitely true that you do not see many overweight people in Washington these days. The Obama administration is so pathologically fit that I have developed a truly unexpected affection for Larry Summers.

But I would really hate to see national anti-fat standards move into state government. For one thing, it would totally ruin my hopes of becoming the next person to be appointed lieutenant governor of New York when something untoward happens yet again in Albany.

Also, one of the best things about state capitols is that they are places where people who have most of their teeth and some of their hair can count on feeling pretty darned attractive.

Some commentators have come down hard on Corzine for the “weight” ad. However, it’s hard to blame his campaign for focusing on matters of girth. The state is a mess, his party members keep getting indicted and his personality is what we always like to politely term “abrasive.” All he’s really got is his ability to run a 10K. Corzine can’t even dwell on Christie’s terrible driving record given the fact that he spent the first part of his administration incapacitated because of an unfortunate decision to mix speeding with failure to buckle one’s seat belt.

Other people have argued that the ad will backfire and elicit sympathy for Christie among the multitudes of overweight voters even in the relatively fit state of New Jersey. (And God help the candidate who tries to pull this kind of thing in Mississippi.)

That’s happened in the past. Like the time Mitt Romney ran against Ted Kennedy for the Senate during one of Kennedy’s particularly unslender periods. The Romney camp ran film of Kennedy struggling to squeeze behind a table. (Subliminal message: Too much fat in the budget.) Kennedy responded with workers who had been laid off after a factory takeover engineered by Romney’s firm. (Subliminal message: How do you like downsizing?)

Of course, Kennedy cleaned his clock. This is my second-favorite Mitt Romney story. I couldn’t figure out any way to bring up the one about him driving to Canada with the family dog strapped to the car roof.

I think we can all agree that William Howard Taft would not have made it into the White House if there had been YouTube in 1908. But George W. Bush gave fitness such a bad name I really expected the next president to be someone like Hillary Clinton, who does not seem to regard her treadmill as an integral part of the family circle. Instead, we elected a guy who’s so attractive that the Nobel committee couldn’t resist giving him a Peace Prize before he ever did anything. It was sort of like one of those greeting cards that say: “Thank you for being you.”

If the anti-fat bias among voters gets too intense, we are going to get in trouble eventually. The number of overweight Americans keeps going up, and pretty soon there are only going to be about six people in each state who are qualified to run for the U.S. Senate. The presidency may have to become a monarchy.

Here’s Mr. Blow:

Last Saturday, actor, playwright and impresario Tyler Perry posted a heart-rending message on his Web site recounting the abuses of his childhood. It was hard to read it without welling up.

His father had constantly belittled and savagely beaten him. Perry wrote that one beating was so merciless that “the skin was coming off my back.” When he was about 10 years old, while trying to leave a friend’s house, Perry wrote that the friend’s mother made lewd and disgusting suggestions and pulled him on top of her.

At another point, Perry wrote about a man from church who had molested him.

Coming on the heels of the arrest of Roman Polanski for his 1977 crime of plying a 13-year-old girl with Champagne and Quaaludes before raping and sodomizing her, and the revelation from Mackenzie Phillips that she had had a 10-year “consensual incestuous” relationship with her own father that she believes began when she was a teenager, it raises the question: How pervasive is child sexual abuse and how often do these crimes go unreported?

The statistics are sobering.

According to a 2000 report by the Bureau of Justice Statistics, nearly 70 percent of all sexual assaults are committed against children. While the age with the greatest proportion of assaults reported was 14, more than half of all child victims were under 12. And of those under 12, 4-year-olds were at the greatest risk.

According to a Unicef report released this week, “5 to 10 percent of girls and up to 5 percent of boys suffer penetrative sexual abuse.” Up to three times of those numbers experience some type of sexual abuse.

The good news: Reports of sexual abuse in the United States seem to be sliding. The not-so-good news: Reports and prevalence are not the same, and it’s not conclusive that they move in concert. The bad news: If up to 3 in 10 girls and 3 in 20 boys are still being assaulted, these are epidemic proportions. And, if most cases are never reported, it’s a silent epidemic.

Like Perry, most child victims — scared, confused and ashamed — tell no one. Instead, they shunt the unsavory secret into a dark corner of the mind, where they try, alone, for years to make sense of it.

We must do a better job of helping these children realize that they are not alone, not at fault and not powerless, that there is hope and help and healing.

We need a public education campaign that speaks directly to children — on Nickelodeon and Cartoon Network, at the beginning of G-rated movies, on classroom bulletin boards, everywhere. Nothing graphic, just something simple: “If it feels wrong, it’s wrong. Say something. It’s your body.”

And now here’s Mr. Herbert:

Think of this recession as a monstrous hurricane that swept through the job market and is still wreaking havoc. The latest unemployment rate for California is a knee-buckling 12.2 percent, the highest since World War II.

The job market nationwide is the worst it has been in 70 years, noted Robert Reich, the former labor secretary, during one of several conversations that I had with him over the past week. He dismissed the upbeat talk of “green shoots” sprouting in the devastated economic landscape and the dreamy notion that recovery is no longer just around the corner, it’s here.

The economy may have recovered technically, he said, “but this is not a real recovery.”

The Obama administration’s stimulus package has mitigated the damage, but it was not big enough or targeted enough toward job creation to halt the continued hemorrhaging in employment. (Incredibly, some 40,000 teachers have lost their jobs over the past year, according to the Center for Economic and Policy Research.)

Without jobs, you don’t have a genuine recovery. And with consumers tapped out and business investment hamstrung, it’s up to the government to develop creative approaches and make the investments necessary to start putting people back to work in large numbers.

There are plenty of serious proposals available that are both doable and affordable.

Mr. Reich, who teaches at the University of California, Berkeley, is among those who favor a tax credit for small businesses that create jobs. This is tricky. Policy makers have to make sure that the credit is given only for net new hires, as companies will attempt to get a tax break for hires they would have made anyway.

“Under normal circumstances,” said Mr. Reich, “I would never recommend this. It’s a very blunt instrument. But these are not normal circumstances.”

A virtue of the tax credit, which reportedly is being considered by the administration, is that it could get significant Republican support.

Another promising approach is substantially increased federal aid to state and local governments, above and beyond what is already occurring. Local governments from one coast to the other are facing budget meltdowns and are slashing services and personnel.

“When states cut programs or raise taxes, that slows the economy down,” said Lawrence Mishel, president of the Economic Policy Institute in Washington. “You can prevent that if you give them aid, and that means state employees, and employees of local governments that depend on state assistance, don’t get laid off.”

That’s the beginning of an important ripple effect that spreads to the private sector jobs in firms that do business with state and local governments. The federal aid can help keep these folks on the job and contributing to the economy until a real turnaround occurs.

“We estimate that half the jobs that are created by fiscal relief to the states are private-sector jobs,” said Mr. Mishel. “No one thinks about that.”

More controversial but increasingly important is the idea of direct government job creation. The recession has absolutely crushed employment opportunities for unskilled, undereducated young people — not just in big cities and rural areas, but in suburban communities as well. Without direct government intervention, the recession is never going to end for them.

During the first half of this year in Illinois, to take one wretched example, just one in four black men in the age group of 20 through 24 had a job.

Nationally during that period, according to the Center for Labor Market Studies at Northeastern University in Boston, “the employment rate of males 16-19, 20-24, and 25-29 were at their lowest values over the past 61 years for which national employment data are available.” That’s for men of all ethnic groups.

“The past,” as William Faulkner told us, “is not dead. It’s not even past.” The lessons of the Works Progress Administration and the Civilian Conservation Corps of the 1930s are right in front of us, ready to be studied, analyzed, updated and applied to the present-day needs of the country.

If we’re serious about getting the U.S. back on track economically, we will have to take our heads out of the sand at some point with regard to the nation’s infrastructure. America has to be rebuilt, modernized and re-energized — from its water and sewer systems to its schools to the smart grid and the alternative energy sources that so many are talking about and beyond. That’s where the jobs are for the long term, and that’s the only route to a truly flourishing future.

These investments would be costly and require vision. Seeing them through would take an enormous collective effort by politicians and the public alike. But some variation on these themes is absolutely essential if the U.S. is to pull itself out of the economic quicksand and its long-term, potentially very tragic consequences.

Collins and Cohen

Mr. Kristof is off.  Ms. Collins, in “So Much for Civility,” says most of the Republicans listening to Barack Obama’s health care address sat in stony silence, but there were a few exceptions, and honestly, guys, she thinks you can do better.  Mr. Cohen, in “New Tweets, Old Needs,” says Twitter is a formidable new tool for communication, but it is not journalism. In fact, journalism in many ways is the antithesis of the deluge of raw material that new social media deliver.  Here’s Ms. Collins:

Let me go out on a limb and say that it is not a good plan to heckle the president of the United States when he’s making a speech about replacing acrimony with civility.

Most of the Republicans listening to Barack Obama’s health care address Wednesday night followed the normal rule about sitting in stony silence while the president’s party leaps up and down in rapturous applause. But there were a few exceptions, notably Joe Wilson, a member of Congress from South Carolina who loudly called the president a liar.

This was when Obama said illegal immigrants would not be covered by health care reform. It seemed like a pretty tame remark for so much disrespect, given all the recent uproar over the president’s alleged ability to brainwash elementary school students.

You might have expected Wilson to hold his tongue and wait to see if Obama would yell “Marxism is a good thing!” and send the commerce committee racing off to give workers control over the means of production.

I always wonder what the members of Congress are actually thinking while they listen to a presidential address. Maybe Senator Max Baucus, the chairman of the Finance Committee, was thinking about the health care reform bill he has yet to pass, although it is equally possible that he was just daydreaming about his recipe for huckleberry pie or that time he walked all the way across Montana, just because it was there and he was running for re-election.

Baucus has become central to health care reform, through the classic dithering technique. Finance has been so slow off the dime that in his speech, Obama gave it kudos for having announced “it will move forward next week.” The problem, according to Baucus, is that he wants a bipartisan bill that meets the cost-control demands of his favorite Republican colleagues.

Sure, Obama talked the fiscally responsible talk last night. But he cannot hold a candle to Baucus and Chuck Grassley, the committee’s lead Republican. These guys are really, really, really concerned about balancing the budget. And that seems only fair since they were basically the ones who unbalanced it in the first place when they worked in splendid bipartisan concert in 2001 to pass George W. Bush’s first $1.6 trillion in tax cuts.

We do not know exactly what Grassley was thinking while the president was talking. Perhaps he was mentally composing a twitter about the speech. The senator has been tweetless since last weekend, when he recorded the memorable: “Saw Ia U beat my school 17/16. UNI played best I proud of my team Pres Mason came up 22pts short of her prediction 4 victory. She good Prez.”

All summer we have heard reports that a special bipartisan group of six senators, including Baucus and Grassley, were working on a health care reform deal. Having a conversation. Talking on the phone. Posting on each other’s Facebook wall. Still, no bill and the definition of “bipartisan” shrank from 70 votes in the Senate to “Olympia Snowe seems to like it.”

We do not know exactly what Senator Snowe of Maine was thinking during the president’s speech. Probably about the president’s speech. She is really, really diligent.

It’s always possible that the Republicans will realize that their virulent opposition is not doing the country any good, and at least be obstructionist in a more cheerful way. Although Wednesday night, when the TV cameras caught the House minority leader, John Boehner, he looked as though he had just swallowed a cough drop.

Boehner got the day off to a fine start by telling reporters he expected the president would “try to put lipstick on this pig and call it something else.” It was a stunning development, suggesting that a new page in American politics was turning, one in which members of both parties could once again come together and toss around that lipstick-pig metaphor without being accused of a sexist attack on Sarah Palin.

The speech sounded fine to me, although I have to admit I’m still disappointed that Obama’s people have not done enough to start interesting rumors on their side of the debate. “Security and stability” is not quite as exciting as stories about old people being executed or registered Republicans being stripped of their Medicare.

So, I was hoping that the reform side would do some groundwork before the big address and start floating stories about how universal health care would save the car industry or combat hair loss.

I envisioned Robert Gibbs getting up at the next press conference and saying: “Look, I know it’s all over the Web that under health care reform every family will get a new wide-screen plasma TV. It’s just not so. That provision was merely proposed by the House Commerce Committee.

“However, I can confirm that the public option has been renamed the Captain Sully Sullenberger Julia Child Oprah option.”

Here’s Mr. Cohen:

Two mullahs gaze out on a crowd of protesters in Tehran. The one says, “Arrest the correspondents.” To which the despondent reply is: “But they’re all correspondents!”

This story, recounted by Mahasti Afshar, an Iranian-American scholar, during a debate at the University of Southern California, captures the post-election coming-of-age of new social media like Twitter that have provided critical information and images on the post-electoral upheaval even as the authorities have driven out mainstream networks and newspapers.

Iranian citizen-journalists have tweet-transformed the American image of their country (online youth have supplanted mad mullahs); globalized the protest movement by drawing a vast and previously apathetic Iranian diaspora into the struggle (albeit with still debilitating divisions); and provided an effective organizing tool in the absence of strong leadership (Mir Hussein Moussavi, thy name is meekness). These are not small achievements.

Still, the mainstream media — expelled, imprisoned, vilified — is missed. Iran has gone opaque. Its crisis is seen through a glass darkly. Its cries are muffled, its anguish subdued. President Mahmoud Ahmadinejad rides roughshod. Nuclear calculus silences Western capitals.

After I left Iran, in early July, I wrote that Iranians “have borne witness — with cellphone video images, with photographs, through Twitter and other forms of social networking — and have thereby amassed an ineffaceable global indictment of the usurpers of June 12.

“Never again will Ahmadinejad speak of justice without being undone by the Neda Effect — the image of eyes blanking, life abating and blood blotching across the face of Neda Agha-Soltan.”

We now know that the 26-year-old student was among more than 70 people killed in the post-election violence. But who is there to investigate these deaths — or allegations of wholesale rape of hundreds of arrested men and women — and so shed light?

In the same column, I wrote that “To be a journalist is to bear witness. The rest is no more than ornamentation. To bear witness means being there — and that’s not free. No search engine gives you the smell of a crime, the tremor in the air, the eyes that smolder, or the cadence of a scream.”

This was too much for Arianna Huffington of the eponymous Post who fumed that I had chosen “to attack the tools of new-media-fueled reporting by citing the very event that highlights the power of those tools” and opined: “The truth is, you don’t have to ‘be there’ to bear witness. And you can be there and fail to bear witness.”

Huh? You can’t bear witness from afar any more than you make an omelet without cracking eggs. Seeing is different and has a price, sometimes even the ultimate price. As for being there and failing to bear witness, well, yes, you might be in a Hafez-induced trance or off climbing the Alborz mountains, if so inclined, but that’s hardly material.

Twitter’s pitch is “Share and discover what’s happening right now, anywhere in the world.” That’s what it does — up to a point. It’s many things, including a formidable alerting system for a breaking story; a means of organization; a monitor of global interest levels (Iran trended highest for weeks until Michael Jackson’s death) and of media performance; a bank of essential links; a rich archive; and a community (“Twitter is my best friend.”)

But is it journalism? No. In fact journalism in many ways is the antithesis of the “Here Comes Everybody” — Clay Shirky’s good phrase — deluge of raw material that new social media deliver. For journalism is distillation. It is a choice of material, whether in words or image, made in pursuit of presenting the truest and fairest, most vivid and complete representation of a situation.

It comes into being only through an organizing intelligence, an organizing sensibility. It depends on form, an unfashionable little word, without which significance is lost to chaos. As Aristotle suggested more than two millennia ago, form requires a beginning and middle and end. It demands unity of theme. Journalism cuts through the atwitter state to thematic coherence.

In the making of the choices I have described, presence is required. Because part of the choice lies in something ineffable — the air you breathe, the sounds you hear, the shadow light as a bird’s wing that falls across fearful eyes — something that cannot be seized or rendered at a distance.

Technology has enriched journalism by expanding the means to deliver it and the raw material on which it is based. But technology has also diminished the incentive — and the revenue — to get out of the office. Understanding without the trained “view from the ground” (Martha Gellhorn) remains impossible. Nature abhors a vacuum, journalism even more so, and so it fills absence with windiness.

Iran expelled or imprisoned the mainstream media for a reason: to blind the world, to bewilder it, to make it forgetful.

But do not forget. Newsweek’s Maziar Bahari still languishes incommunicado in prison more than two months after his arrest. The dead are still dead. The seething still seethe. Ahmadinejad will address the United Nations in New York on Sept. 23. He must be reminded that the world demands the truth as seen and distilled from the ground.

Friedman and Kristof

MoDo and Frank Rich are off today.  The Moustache of Wisdom, in “From Baby-Sitting to Adoption,” says after eight years of work in Afghanistan, we still do not have a reliable Afghan partner to hand off to. It’s time to discuss if nation building is still worth doing and at what cost.  Mr. Kristof, in “The Afghanistan Abyss,” says sending more American troops into ethnic Pashtun areas in the Afghan south may only galvanize local people to back the Taliban.  Here’s The Moustache of Wisdom:

On Aug. 29, this newspaper carried a front-page headline that should make your blood boil: “Karzai Using Rift With U.S. to Gain Favor.” The article said that Obama officials were growing disenchanted with the Afghan president, Hamid Karzai, whose supporters allegedly stuffed ballot boxes in the recent elections, while Mr. Karzai struck deals with accused drug dealers and warlords, one of whom is his brother, for political gain. The article added, though, that in a feat of political shrewdness, Mr. Karzai “has surprised some in the Obama administration” by turning their anger with him “to an advantage, portraying himself at home as the only political candidate willing to stand up to the dictates of the United States.”

If this is how our “allies” are treating us in Afghanistan, after eight years, then one really has to ask not whether we can afford to lose there but whether we can afford to win there.

It would be one thing if the people we were fighting with and for represented everything the Taliban did not: decency, respect for women’s rights and education, respect for the rule of law and democratic values and rejection of drug-dealing. But they do not. Too many in this Kabul government are just a different kind of bad. This has become a war between light black — Karzai & Co. — and dark black — Taliban Inc. And light black is simply not good enough to ask Americans to pay for with blood or treasure.

This is the most important and troubling fact about Afghanistan today: After eight years of work there, we still do not have a reliable Afghan partner to hand off to. And it is not all our fault. Lord knows, Iraq still has problems. The outcome there remains uncertain. But the reason Iraq still has a chance for a decent future is because a critical mass of Kurds, Sunnis and Shiites were ready to take on their own extremists and hold reasonably fair elections. The surge in Iraq started with key Iraqi communities wanting to liberate themselves from their own radicals. Our troops helped them do that.

The strategy that our new — and impressive — commander in Afghanistan, Gen. Stanley McChrystal, is pursuing calls for additional troops to create something that does not now exist there — a reasonably noncorrupt Afghan state that will serve its people and partner with America in keeping Afghanistan free of drug lords, warlords, the Taliban and Al Qaeda. His plan calls for clearing areas of Taliban control, holding those areas and then building effective local, district and provincial governments — along with a bigger army, real courts, police and public services. Because only with all that can we hold the support of the Afghan people and avoid a Taliban victory and a return of Al Qaeda that could threaten us. That is the theory.

And it may, indeed, be the only way to go, but we should have no illusions: We’re talking State Building 101 in the most inhospitable terrain and in one of the poorest, most tribalized, countries in the world.

As the military expert Anthony Cordesman, who has advised the U.S. Army in Afghanistan, explained in The Washington Post recently, it requires “a significant number” of U.S. reinforcements and time to do what the Kabul government has failed to do, because it remains “a grossly overcentralized government that is corrupt, is often a tool of power brokers and narco-traffickers, and lacks basic capacity in virtually every ministry.”

To put it another way, we are not just adding more troops in Afghanistan. We are transforming our mission — from baby-sitting to adoption. We are going from a limited mission focused on baby-sitting Afghanistan — no matter how awful its government — in order to prevent an Al Qaeda return to adopting Afghanistan as our state-building project.

I recently looked back at Stephanie Sinclair’s stunning 2006 photograph in The Times of Ghulam Haider, an 11-year-old Afghan girl seated next to the bearded 40-year-old man she was about to be married off to. The article said Haider had hoped to be a teacher but was forced to quit her classes when she became engaged. The furtive sideways glance of her eyes at her future husband said she was terrified. The article said: “On the day she witnessed the engagement party. … Sinclair discreetly took the girl aside. ‘What are you feeling today?’ the photographer asked. ‘Nothing,’ the bewildered girl answered. ‘I do not know this man. What am I supposed to feel?’ ”

That is the raw clay for our state-building. It may still be worth doing, but one thing I know for sure, it must be debated anew. This is a much bigger undertaking than we originally signed up for. Before we adopt a new baby — Afghanistan — we need to have a new national discussion about this project: what it will cost, how much time it could take, what U.S. interests make it compelling, and, most of all, who is going to oversee this policy?

I feel a vast and rising ambivalence about this in the American public today, and adopting a baby you are ambivalent about is a prescription for disaster.

And here’s Mr. Kristof:

President Obama has already dispatched an additional 21,000 American troops to Afghanistan and soon will decide whether to send thousands more. That would be a fateful decision for his presidency, and a group of former intelligence officials and other experts is now reluctantly going public to warn that more troops would be a historic mistake.

The group’s concern — dead right, in my view — is that sending more American troops into ethnic Pashtun areas in the Afghan south may only galvanize local people to back the Taliban in repelling the infidels.

“Our policy makers do not understand that the very presence of our forces in the Pashtun areas is the problem,” the group said in a statement to me. “The more troops we put in, the greater the opposition. We do not mitigate the opposition by increasing troop levels, but rather we increase the opposition and prove to the Pashtuns that the Taliban are correct.

“The basic ignorance by our leadership is going to cause the deaths of many fine American troops with no positive outcome,” the statement said.

The group includes Howard Hart, a former Central Intelligence Agency station chief in Pakistan; David Miller, a former ambassador and National Security Council official; William J. Olson, a counterinsurgency scholar at the National Defense University; and another C.I.A. veteran who does not want his name published but who spent 12 years in the region, was station chief in Kabul at the time the Soviets invaded Afghanistan in 1979, and later headed the C.I.A.’s Counterterrorism Center.

“We share a concern that the country is driving over a cliff,” Mr. Miller said.

Mr. Hart, who helped organize the anti-Soviet insurgency in the 1980s, cautions that Americans just don’t understand the toughness, determination and fighting skills of the Pashtun tribes. He adds that if the U.S. escalates the war, the result will be radicalization of Pashtuns in Pakistan and further instability there — possibly even the collapse of Pakistan.

These experts are not people who crave publicity; I had to persuade them to go public with their concerns. And their views are widely shared among others who also know Afghanistan well.

“We’ve bitten off more than we can chew; we’re setting ourselves up for failure,” said Rory Stewart, a former British diplomat who teaches at Harvard when he is not running a large aid program in Afghanistan. Mr. Stewart describes the American military strategy in Afghanistan as “nonsense.”

I’m writing about these concerns because I share them. I’m also troubled because officials in Washington seem to make decisions based on a simplistic caricature of the Taliban that doesn’t match what I’ve found in my reporting trips to Afghanistan and Pakistan.

Among the Pashtuns, the population is not neatly divisible into “Taliban” or “non-Taliban.” Rather, the Pashtuns are torn by complex aspirations and fears.

Many Pashtuns I’ve interviewed are appalled by the Taliban’s periodic brutality and think they are too extreme; they think they’re a little nuts. But these Pashtuns also admire the Taliban’s personal honesty and religious piety, a contrast to the corruption of so many officials around President Hamid Karzai.

Some Taliban are hard-core ideologues, but many join the fight because friends or elders suggest it, because they are avenging the deaths of relatives in previous fighting, because it’s a way to earn money, or because they want to expel the infidels from their land — particularly because the foreigners haven’t brought the roads, bridges and irrigation projects that had been anticipated.

Frankly, if a bunch of foreign Muslim troops in turbans showed up in my hometown in rural Oregon, searching our homes without bringing any obvious benefit, then we might all take to the hills with our deer rifles as well.

In fairness, the American military has hugely improved its sensitivity, and some commanders in the field have been superb in building trust with Afghans. That works. But all commanders can’t be superb, and over all, our increased presence makes Pashtuns more likely to see us as alien occupiers.

That may be why the troop increase this year hasn’t calmed things. Instead, 2009 is already the bloodiest year for American troops in Afghanistan — with four months left to go.

The solution is neither to pull out of Afghanistan nor to double down. Rather, we need to continue our presence with a lighter military footprint, limited to training the Afghan forces and helping them hold major cities, and ensuring that Al Qaeda does not regroup. We must also invest more in education and agriculture development, for that is a way over time to peel Pashtuns away from the Taliban.

This would be a muddled, imperfect strategy with frustratingly modest goals, but it would be sustainable politically and militarily. And it does not require heavy investments of American and Afghan blood.

Everyone in the current administration should be forced to read “Kim” and “Three Cups of Tea.”

A lonely Sunday for Kristof

Dowd, Friedman and Rich are all off today.  Mr. Kristof, in “Until Medical Bills Do Us Part,” has a question:  How do those who fear death panels feel about a health care system that breaks apart families?  Here he is:

Critics fret that health care reform would undermine American family values, not least by convening somber death panels to wheel away Grandma as if she were Old Yeller.

But peel away the emotions and fearmongering, and in fact it is the existing system that unnecessarily takes lives and breaks apart families.

My friend M. — you’ll understand in a moment why she’s terrified of my using her name — had to make a searing decision a year ago. She was married to a sweet, gentle man whom she loved, but who had become increasingly absent-minded. Finally, he was diagnosed with early-onset dementia.

The disease is degenerative, and he will become steadily less able to care for himself. At some point, as his medical needs multiply, he will probably need to be institutionalized.

The hospital arranged a conference call with a social worker, who outlined how the dementia and its financial toll on the family would progress, and then added, out of the blue: “Maybe you should divorce.”

“I was blown away,” M. told me. But, she said, the hospital staff members explained that they had seen it all before, many times. If M.’s husband required long-term care, the costs would be catastrophic even for a middle-class family with savings.

Eventually, after the expenses whittled away their combined assets, her husband could go on Medicaid — but by then their children’s nest egg would be gone, along with her 401(k) plan. She would face a bleak retirement with neither her husband nor her savings.

A complicating factor was that this was a second marriage. M.’s first husband had died, leaving an inheritance that he had intended for their children. She and her second husband had a prenuptial agreement, but that would not protect her assets from his medical expenses.

The hospital told M. not to waste time in dissolving the marriage. For five years after any divorce, her assets could be seized — precisely because the government knows that people sometimes divorce husbands or wives to escape their medical bills.

“How could I divorce him? I loved him,” she told me.

“I explored a lot of options with an attorney here in town,” she added. “The attorney said, ‘I don’t see any other options for you.’ It took about a year for me to do the divorce, it was so hard.”

So M. divorced the man she loves. I asked him what he thought of this. He can still speak, albeit not always coherently, and he paused a long, long time. All he could manage was: “It’s hard to say.”

Long-term care constitutes a difficult and expensive challenge in any health system. But the American patchwork, full of cracks through which people fall, has a special problem with medical expenses of all kinds bankrupting couples.

A study reported in The American Journal of Medicine this month found that 62 percent of American bankruptcies are linked to medical bills. These medical bankruptcies had increased nearly 50 percent in just six years. Astonishingly, 78 percent of these people actually had health insurance, but the gaps and inadequacies left them unprotected when they were hit by devastating bills.

M. still helps her husband and, quietly, continues to live with him and care for him. But she worries that the authorities will come after her if they realize that they divorced not because of irreconcilable differences but because of irreconcilable medical bills. There were awkward questions from friends who saw the divorce announcement in the newspaper.

“It’s just crazy,” she said. “It twists people like pretzels.”

The existing system doesn’t just break up families, it also costs lives. A 2004 study by the Institute of Medicine, a branch of the National Academy of Sciences, found that lack of health insurance causes 18,000 unnecessary deaths a year. That’s one person slipping through the cracks and dying every half an hour.

In short, it’s a good bet that our existing dysfunctional health system knocks off far more people than an army of “death panels” could — even if they existed, worked 24/7 and got around in a fleet of black helicopters.

So, for those of you inclined to believe the worst about President Obama, think it through. Suppose he is indeed a secret, foreign-born Muslim agent who is scheming to undermine American family values while killing off as many grandmothers as possible.

If all that were true, why on earth would he be trying so hard to reform our health care system? We already know how to prod families into divorce and take a life unnecessarily every 30 minutes — all we need to do is reject reform and stick with exactly what we have.