TIme Magazine Health Care Excerpt

I like this. Why, because it is proactive and logical. The system we are running now by expanding health care coverage is a bit like helping hunger by giving everyone a twinkie. Unless we think about what the real costs are we can't find an effecient solution to achieving our goal of improving the health of the american people, and therefore, in many ways not extending care (I mean checkups nonewithstanding) but reducing it.

The Link: http://www.time.com/time/nation/article/0,8599,1902708-4,00.html

The Author: Karen Tumulty Friday, Jun. 05, 2009

The Excerpt:

"5. How will we bring down costs?
The problem with American health care, those who have studied the system will tell you, is not that we get too little care but that we use too much. By some estimates, as much as 30 cents of every health-care dollar is spent on medical treatment that is unnecessary, ineffective, duplicative or even harmful. Changing all that is going to require revamping health care from top to bottom, starting with the way health-care providers are reimbursed. While the current system pays them for the amount of care they provide, real reform would put more emphasis on the quality of that care and the outcomes it achieves.

If there is an ideal out there, Baucus says, it can be seen in the kind of medicine already being practiced by Kaiser Permanente, the Mayo Clinic, Intermountain Healthcare and Geisinger Health System, which manage to hold down costs and get better results. Their operations have fostered closer teamwork among care providers. Also important will be electronic record-keeping that saves time and avoids errors, and comparative-effectiveness research that gives doctors and patients a better sense of which treatments work best. And a reformed health-care system would put more emphasis on preventive care and managing such chronic conditions as asthma, heart disease and diabetes that now account for 75 cents out of every medical dollar spent."

Excusing the Elderly

I used to excuse the elderly their prejudice as the last of a dying breed, hardened by years when any critical thinking (however un-applied) had peaked and been solidified by its decline and perpetuated by either habit or a sense of comfort in a changing world. Yet today after reading the news of the 88 year old white supremacist (i would say ethnic supremacist) who opened fire and killed a security guard at the DC holocaust memorial, I realize prejudice is serious and inexcusable at any age. While the battles to open a mind may be more hard won, they are necessary and cannot be ignored. I am shocked by what people do with guns and the power with which they give over to the weapon. It is a weak human that crutches the gun, and a sick one who shoots it, but I lived in my own delusion that with age came a reinstatement of innocence, (or at least a harmless arrogance that passed for it). My deepest sympathies for the guard and his family. I am forever grateful to his commitment to freedom, expressed in his committed defense. It is strange that holocaust deniers who like to claim horrific acts against the minority never occurred make their claim with a horrific act against the same minority. But then if reason were ever applied to violence there would be none. So we as a people still have much more to teach.

Do-Gooder Doctors?

An article in the Sunday Washington Post yesterday (May 31,2009) by Harlan Krumholtz discussed how more doctors are likely to report turning to medicine for job stability than to fulfill a need to "do-good" and help people. The author goes on to report that doctors in job interviews now look for opportunities to have time to go to a child's soccer game and he reports that a survey asking if doctor's would be willing to work more hours even for more money received few affirmative responses.

I may be missing the boat here, but that seems like nothing to complain about at all. It seems that more doctors each focused on fewer hours would prevent burnout and delay the glossing over of one's eyes from seeing too many patients and problems in a day, month, year. It would allow different perspectives and opinions into the hospitals and clinics, so a patient could perhaps easily seek two great minds instead of one, for what is to them their ultimate concern of their health. It also seems to me, that greater social networking of doctors with society in their free time may enhance their empathy. Even the author of the post article, had framed the discussion the in context of a friend seeking medical advice. Perhaps if doctors engage in their children's schools, community picnics or recreational activities they will come into contact with more of those real world problems in people that inspire their work and put a face with a diagnosis.

I ought to note that the article did not focus on these points above for long and overall brought to bare a great discussion on accountability measures for doctors and hospitals. It suggested that by collecting and reporting on patient data/doctor success we would allow patients to choose based on quality care, which is how we are accustomed to choosing even the most trivial things like hair cuts. So there is no need to be left high and dry when trying to choose in whose hands to place our safety. Accountability is the way to discover which successful practices to propagate and which failing practices to abort, it is the way to progress to a stronger medical system, and yet he notes, there is little incentive to become accountable. The article itself is insightful and important and by nitpicking my few points, I don't mean to appear to disagree.

I guess it's just after seeing how hard my do-gooder doctor friends work in their fields, that I need to suggest a more sensitive system to them as people. As their happiness and health, like an another, should not be disregarded lightly.

Pirates

NPR says the somali pirates do it out of necessity, as they have no other work, so one of the options was to recruit these people as paid members of a coast guard, impressive way to think outside the box!

Flu Stuff

Some author/ historian (John Berry - the Great Influenza) on NPR today (May 5th) talking about the 1918 flu claims that the government tried to hide the epidemic to keep up moral for the war effort - that once people were lied to they had no trust, to the point where fear kept neighbors from bringing each other food in cities and rural areas and some died from starving to death. It is these messages of history that can teach us more in a moment that without record we could perhaps ever understand in a lifetime. Let us study history to learn why we value truth!

Supreme Choices

Here's one on the appointee for Justice Souter's Supreme court seat (too bad my 3 hour wait on the steps of the Court last tuesday didn't earn me a seconds viewing time at the last of these 9 together...)From the Washington Post article (Sunday May 3rd) by Christina Boyd - Washington U, and Lee Epstein - Northwestern Law, "When Women Rule, It Makes a Difference"

"In research that we conducted with our colleague Andrew D. Martin, we studied the votes of federal court of appeals judges in many areas of the law, from environmental cases to capital punishment and sex discrimination. For the most part, we found no difference in the voting patterns of male and female judges, except when it comes to sex discrimination cases. There, we found that female judges are approximately 10 percent more likely to rule in favor of the party bringing the discrimination claim. We also found that the presence of a female judge causes male judges to vote differently. When male and female judges serve together to decide a sex discrimination case, the male judges are nearly 15 percent more likely to rule in favor of the party alleging discrimination than when they sit with male judges only. This holds true even after we account for judges' ideological leanings."

The Interdisciplinary Approach

In college I was a major advocate for the interdisciplinary approach. It is silly to believe life acts in the same isolation as a college major. In studying economics we did not stoop to consider human behavior or psychology, in studying public speaking we did not discourse on the morality of truth and deception, in political science we did not discuss natural resources.

I remember trying to work out with my school administration a program that would take a current events topic and present it before a panel of academics from various disciplines so they could offer a picture of how their like-minded peers would see the problem and then broaden the discussion to how those of the panel working in a cross-disciplinary manner could brainstorm a solution. I graduated before the project went anywhere.

Today I read an article where a professor suggested grad school become more interdisciplinary with students taking on a more broad and inclusive focus for their studies. Funny how I can admire an interdisciplinary approach to problem solving, yet I still hold to the value of specialization. In our current world we have an abundance of information, to expect each person to specialize in it all is unrealistic. I do not mind human beings splitting up the work to focus on parts. There is a certain fear that in looking at too small a piece of a picture you cannot find a real solution, the same way NASA has outsources pieces of its shuttles only to bring them all together to find it cannot make a working rocket. But as humans, I think we can be privy to coordination and specialization, I like to call the plan "society by posse".

If we can aggregate groups of experts targeted to specific problems with the open-mindedness to respect each others professional expertise, we can still have people with finely detailed knowledge but an overall collective which can problem solve towards the big picture. I think the National Science Foundation in its reports does a good job of this type of aggregation. It is just like I envisioned back in college. We do not need people to become generalists, we need people to communicate and coordinate, but that comes with certain costs arising from the difficulty of organization and as such must be arranged by an outside source. So those who don't want to specialize can be among the big picture generalists who aggregate specialists.

So, I have to disagree with the author of the article who wants all graduate education to become broad. After all it was a woman collecting the cute little pterapods of the sea for some completely unrelated scientific experiment who noticed they were all killed in transport due to the acidification of the small container's water with the output of their own CO2. It was she who in reporting that occurrance discovered how current CO2 emissions could acidify the ocean to the point where these creatures, the food base for the whole food chain of the sea would disappear. And that's just one of the many examples of how a focused and seemingly obscure scientific interest has re-directed the course of knowledge by accident! I simply cannot say if a group of generalists would have been able to discover that at all.

The Supreme Court Strip Search

The case is whether schools ought to be allowed to ask students to strip to their underwear if the school has ANY reason to believe the student might be concealing illegal and dangerous items, mainly drugs. In my mind, like all American freedoms, the onus should be on the school. If a student has drugs we can assume a few things: 1. that they might at some point need to distribute them 2. that they might consume them, ir 3. that somebody else knows about it. In each case we could expect to see a change in physical or physiological aspects, such as their need to congregate with other students or a change in behavior. Unless we are willing to make all innocent students feel like criminal victims of a police state which in my mind will make them more vulnerable to crime, we must provide them as a whole with respect, love and trust. We must allow those who have information about dangerous activities to come safely forward including where and when they might be trading, selling and taking the drugs, but we must not victimize the innocent simply because we lack the resources to be more thorough in our investigation. Yes I want our schools to be safe but if we behave as though every student has drugs, then I fear students too will believe that is the norm.

Death Penalty

I'll admit, and I know this will get me into trouble: I am having the hardest time with waterboarding. I know the answer I want is the one aligned with the people I most respect, the sensitive peacemakers and humanitarians that can see it is so morally wrong. But I admit, I am plagued by ignorance, I have a fear and isolation from the world of the military and penal justice and because of that all my judgments are shallow and incomplete. I am haunted by the fact that I don't naturally see waterboarding as a moral wrong. I ask myself, what if it worked? What if it gave information we could use to protect our society, and I realize that then the moral weight I might balance with a different view, although the hardliners I respect, the Ghandi's, the Churchill's, the people I strongly value can see through this false gold and realize it would still be wrong.

For me, it is a punishment, however terrible that people have inflicted upon themselves, and though they would never ask to have it happen again and afterwards strongly sympathize with the captured parties and recognize it as the most intense form of torture, it still seems to me that in such a response it has performed its exact designed function --To elicit a non-deforming punishment so horrid it would induce captives to look for any alternative to its repetition. In real life we are fortunate to know that the alternative is often simply lying, and because it doesnt work, again, it is easy for me to denounce the activity. However, it is hard to believe that I in such a situation would continue to lie and so it is hard for me to believe it will always be revealed as unsuccessful. So long as the facts say it is no more useful than other kinder forms of information gathering, I am content, but I fear my moral certitude if evidence were to emerge that it did in fact work. Also because it is such a unique form of torture (how many people would saw off their leg as an experiment to see if it might induce them to "crack" compared to how many are willing to undergo waterboarding-at least that first time) it is so hard to relate to and I fear I don't have the creativity to imagine how horrendous it is or that non-deforming torture can be equally bad and even as some have suggested exceedingly worse then the conventional (movie horror flick) forms.

Luckily I feel this is why I am not yet ready to be a policy maker. If I am ever to be one, such immature and under informed sentiments would be unacceptable. What is interesting is my belief that most of my opinions on the potential usefulness of the torture (which i do conceed to be torture- but in a more digestible form) are purely philosophical and stem from me believing I must play a role in the security of my nation. On a personal level, I wonder if I could really follow through. Perhaps I compare it to an obscure parallel to give me doubt, for I am of the weak condition of one of those who has thus far been willing to eat meat but not to kill it.

It has taken all this mental discourse just to get toward the title of this essay/blog/diary which is what seems strangest of all. We deny waterboarding because it creates a sensation of drowing so real that it is mentally equated with the act itself, a horrendous physical experience with loss of all control and who knows what else. Yet, as a nation we still have the death penalty! What is the cost of giving a person an actual set day for their murder. Whereas waterboarding carries out a close-to-reality event at some time but doesn't actually follow through, the death penalty does. Sure one is the full physical sensation, and the other supposedly painless, but this mental torture to a person as retribution, not even due to a "ticking time bomb" senario where information procurement is seen as necessary for the sustained survival of the innocent seems absolutely ludicrous in light of this whole torture discussion. With the death penalty there is nothing to gain from the murder, no new information to glean and moreover, there is not just a perceived threat of killing, but the actual thing! I know states' rights have been a vestige of our nation since the foundation, but how can we discuss these two issues as if they had a right to be disconnected. My logic and imagination are already strained in contemplating captives, waterboarding and torture, I don't have the creativity left to reconcile our national views on the death penalty as well.

Enhanced Interrogation

"Those who give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety." - Benjamin Franklin

Finally, the torture debate brought fully to a head. It it time to have a frank discussion about the practicality of torture. I am working in a school right now and compare it, however roughly to behavior management in children. Some parents hit, some don't. Sometimes the child stops, sometimes the child doesn't. It is not that hitting is completely ineffective, it is that it is brute and unnecessary. The different approaches may yield the same outcomes in the short term, a momentary cessation of unwanted behavior. The difference is the long term, children raised in a culture of physical threats and violence may be more likely to perpetuate those ideas and even incorporate them into a set of values and expectations. A child raised in an environment of thoughtfulness, discussion, and mediation may be more likely to perpetuate those values instead. Because there is no current evidence that strongly proves torture has had any efficacy beyond other tactics, we have not only a moral choice, but an easy choice. Obama in his address to the nation tonight referred to Churchill and his response to national threats which protected the ideals of his nation before bowing them to momentary fears. In the same way our justice system has idealistically been designed to allow the guilty to go free before the innocent must suffer for wrongly accused crimes, perhaps we as a nation must realize that all decisions require some form of sacrifice. As the Israeli High Court wrote in a famous decision:
"This is the destiny of a democracy—it does not see all means as acceptable, and the ways of its enemies are not always open before it. A democracy must sometimes fight with one hand tied behind its back. Even so, a democracy has the upper hand. The rule of law and the liberty of an individual constitute important components in its understanding of security. At the end of the day, they strengthen its spirit and this strength allows it to overcome its difficulties."

Here is some of the media on the topic:

From the Economist April 23, 2009

A pointed objection to George Bush’s policies is not just that they crossed a moral line but that they crossed it to no purpose. Mr Bush’s critics were not confined to bleeding-heart liberals who are even now making a fuss about the rights of a captured Somali pirate. They included a legion, from high-ranking commanders to military lawyers to intelligence operatives, who argued that the techniques were counterproductive.

“Enhanced interrogation” acted as a potent recruitment tool for terrorist organisations. It made it more difficult for America to co-operate with allies, particularly in Europe. It imposed personal burdens on front-line workers who found their values compromised. Dick Cheney points out that the techniques yielded some useful information. But the same information might have been obtained by less controversial means. Torin Nelson, a veteran interrogator, says the administration made a fundamental mistake in focusing on how far it could push detainees, not least because people who are tortured will often confess to anything. It would have been better off recruiting and training more skilled interrogators who knew how to win the trust of their subjects.

From an old Article in the Washington Post:

5 Myths About Torture and Truth
Myths About Torture and Truth

By Darius Rejali
Sunday, December 16, 2007; B03

So the CIA did indeed torture Abu Zubaida, the first al-Qaeda terrorist suspect to have been waterboarded. So says John Kiriakou, the first former CIA employee directly involved in the questioning of "high-value" al-Qaeda detainees to speak out publicly. He minced no words last week in calling the CIA's "enhanced interrogation techniques" what they are.

But did they work? Torture's defenders, including the wannabe tough guys who write Fox's "24," insist that the rough stuff gets results. "It was like flipping a switch," said Kiriakou about Abu Zubaida's response to being waterboarded. But the al-Qaeda operative's confessions -- descriptions of fantastic plots from a man who intelligence analysts were convinced was mentally ill -- probably didn't give the CIA any actionable intelligence. Of course, we may never know the whole truth, since the CIA destroyed the videotapes of Abu Zubaida's interrogation. But here are some other myths that are bound to come up as the debate over torture rages on.

1 Torture worked for the Gestapo.

Actually, no. Even Hitler's notorious secret police got most of their information from public tips, informers and interagency cooperation. That was still more than enough to let the Gestapo decimate anti-Nazi resistance in Austria, Czechoslovakia, Poland, Denmark, Norway, France, Russia and the concentration camps.

Yes, the Gestapo did torture people for intelligence, especially in later years. But this reflected not torture's efficacy but the loss of many seasoned professionals to World War II, increasingly desperate competition for intelligence among Gestapo units and an influx of less disciplined younger members. (Why do serious, tedious police work when you have a uniform and a whip?) It's surprising how unsuccessful the Gestapo's brutal efforts were. They failed to break senior leaders of the French, Danish, Polish and German resistance. I've spent more than a decade collecting all the cases of Gestapo torture "successes" in multiple languages; the number is small and the results pathetic, especially compared with the devastating effects of public cooperation and informers.

2 Everyone talks sooner or later under torture.

Truth is, it's surprisingly hard to get anything under torture, true or false. For example, between 1500 and 1750, French prosecutors tried to torture confessions out of 785 individuals. Torture was legal back then, and the records document such practices as the bone-crushing use of splints, pumping stomachs with water until they swelled and pouring boiling oil on the feet. But the number of prisoners who said anything was low, from 3 percent in Paris to 14 percent in Toulouse (an exceptional high). Most of the time, the torturers were unable to get any statement whatsoever.

And such examples could be multiplied. The Japanese fascists, no strangers to torture, said it best in their field manual, which was found in Burma during World War II: They described torture as the clumsiest possible method of gathering intelligence. Like most sensible torturers, they preferred to use torture for intimidation, not information.

3 People will say anything under torture.

Well, no, although this is a favorite chestnut of torture's foes. Think about it: Sure, someone would lie under torture, but wouldn't they also lie if they were being interrogated without coercion?

In fact, the problem of torture does not stem from the prisoner who has information; it stems from the prisoner who doesn't. Such a person is also likely to lie, to say anything, often convincingly. The torture of the informed may generate no more lies than normal interrogation, but the torture of the ignorant and innocent overwhelms investigators with misleading information. In these cases, nothing is indeed preferable to anything. Anything needs to be verified, and the CIA's own 1963 interrogation manual explains that "a time-consuming delay results" -- hardly useful when every moment matters.

Intelligence gathering is especially vulnerable to this problem. When police officers torture, they know what the crime is, and all they want is the confession. When intelligence officers torture, they must gather information about what they don't know.

4 Most people can tell when someone is lying under torture.

Not so -- and we know quite a bit about this. For about 40 years, psychologists have been testing police officers as well as normal people to see whether they can spot lies, and the results aren't encouraging. Ordinary folk have an accuracy rate of about 57 percent, which is pretty poor considering that 50 percent is the flip of a coin. Likewise, the cops' accuracy rates fall between 45 percent and 65 percent -- that is, sometimes less accurate than a coin toss.

Why does this matter? Because even if torturers break a person, they have to recognize it, and most of the time they can't. Torturers assume too much and reject what doesn't fit their assumptions. For instance, Sheila Cassidy, a British physician, cracked under electric-shock torture by the Chilean secret service in the 1970s and identified priests who had helped the country's socialist opposition. But her devout interrogators couldn't believe that priests would ever help the socialists, so they tortured her for another week until they finally became convinced. By that time, she was so damaged that she couldn't remember the location of the safe house.

In fact, most torturers are nowhere near as well trained for interrogation as police are. Torturers are usually chosen because they've endured hardship and pain, fought with courage, kept secrets, held the right beliefs and earned a reputation as trustworthy and loyal. They often rely on folklore about what lying behavior looks like -- shifty eyes, sweaty palms and so on. And, not surprisingly, they make a lot of mistakes.

5 You can train people to resist torture.

Supposedly, this is why we can't know what the CIA's "enhanced interrogation techniques" are: If Washington admits that it waterboards suspected terrorists, al-Qaeda will set up "waterboarding-resistance camps" across the world. Be that as it may, the truth is that no training will help the bad guys.

Simply put, nothing predicts the outcome of one's resistance to pain better than one's own personality. Against some personalities, nothing works; against others, practically anything does. Studies of hundreds of detainees who broke under Soviet and Chinese torture, including Army-funded studies of U.S. prisoners of war, conclude that during, before and after torture, each prisoner displayed strengths and weaknesses dependent on his or her own character. The CIA's own "Human Resources Exploitation Manual" from 1983 and its so-called Kubark manual from 1963 agree. In all matters relating to pain, says Kubark, the "individual remains the determinant."

The thing that's most clear from torture-victim studies is that you can't train for the ordeal. There is no secret knowledge out there about how to resist torture. Yes, there are manuals, such as the IRA's "Green Book," the anti-Soviet "Manual for Psychiatry for Dissidents" and "Torture and the Interrogation Experience," an Iranian guerrilla manual from the 1970s. But none of these volumes contains specific techniques of resistance, just general encouragement to hang tough. Even al-Qaeda's vaunted terrorist-training manual offers no tips on how to resist torture, and al-Qaeda was no stranger to the brutal methods of the Saudi police.

And yet these myths persist. "The larger problem here, I think," one active CIA officer observed in 2005, "is that this kind of stuff just makes people feel better, even if it doesn't work."

From the Guy standing behind me in line to watch a hearing at the Supreme Court:

The last administration wanted to torture because they wanted validation for their war on terror, they did not mind false or misleading information as much as they valued perpetuating the idea that these were dangerous masterminds in need of the harshest of treatments in a valid war.

Things that make you go hmmmm......

Global Warming

Speaker from the Heinz Center today a U Maryland- reminded us all about the 350 parts per million of CO2 that can sustainably exist in our atmosphere without catastrophic changes and damages. Also mentioned we are already at 390 and with all the commitments currently in place by various world states we are headed for 700! Turns out lots of the CO2 is going into the water and acidifying it all destroying the calcium carbonate shells of pteropods, the necessary creatures known as the Sea Butterfly which exist at the bottom of the food chain and thus are essential to all other life. Turns out sea life and the rest of us must need to adjust to carbonic acid -yum. The speakers main goal is reforestation, he rejects the geo-engineering solutions which simply replace one giant unknown with the next and its repercussions. Reforestation is a wonderful goal. I wonder how much to distribute focus between re- and de forestation, i wonder if some of the micro-climates in current forests once obliterated can still sustain the same life they once did, or how many places will take a much more energy intensive effort to bring back an ecosystem than simply letting the trees grow back. With water shortages, invasive species, with bugs that live too long with warmer temps and destroy too much, there is still so much more to understand, But perhaps it does start with something simple we all can visualize like defining a place where trees want to grow and planting more. The lecturer mentioned that deforestation is as responsible as all the world's transportaiton for CO2 emmissions, including forest fires. So there are many ways to fight this front, I guess it's time to start my summer garden.

Cleaning the Election System

Dr. Gerken speaking at the Brookings Institute on April 7, 2009

She wants to create a democracy index to rank states on voting and election details. She explains that the international environmental index permitted a ranking that embarrassed the last place into action and inspired the number two to work to be number 1. By ranking we can easily see a mess of complicated concerns and have a definitive action we can demand our politicians take, bring us higher on the rank.

"The democracy index would help harness partisan
incentives and local competition in the service of reform because right now
voters don't even see the problem, and even when they think that there is
a problem, they have no metric for refereeing the inevitable fights that take
place between reforms and election officials because those fights involve
details about counting ballots and jargon-filled evaluations of election
machinery and nitty-gritty registration requirements." Dr. Gerken

The News

This Weeks Articles in the News......

From the New York Times Report on the G20 summit:
“Unless we are concerned about the education of all children and not just our children, not only may we be depriving ourselves of the next great scientist who’s going to find the next new energy source that saves the planet, but we also may make people around the world much more vulnerable to anti-American propaganda.”

In a rare show of emotion from the international press, many in the room stood up and cheered after Mr. Obama was done.

On China Vying to be the Leader in Electric Cars (NYT):
Electric cars have several practical advantages in China. Intercity driving is rare. Commutes are fairly short and frequently at low speeds because of traffic jams. So the limitations of all-electric cars — the latest models in China have a top speed of 60 miles an hour and a range of 120 miles between charges — are less of a problem.

First-time car buyers also make up four-fifths of the Chinese market, and these buyers have not yet grown accustomed to the greater power and range of gasoline-powered cars.

But the electric car industry faces several obstacles here too. Most urban Chinese live in apartments, and cannot install recharging devices in driveways, so more public charging centers need to be set up.

Rechargeable lithium-ion batteries also have a poor reputation in China. Counterfeit lithium-ion batteries in cellphones occasionally explode, causing injuries. And Sony had to recall genuine lithium-ion batteries in laptops in 2006 and 2008 after some overheated and caught fire or exploded.

These safety problems have been associated with lithium-ion cobalt batteries, however, not the more chemically stable lithium-ion phosphate batteries now being adapted to automotive use.

The tougher challenge is that all lithium-ion batteries are expensive, whether made with cobalt or phosphate. That will be a hurdle for thrifty Chinese consumers, especially if gas prices stay relatively low compared to their highs last summer.

From Senator Webb on Our Prisons From Parade Magazine - March 28, 2009

The United States has by far the world's highest incarceration rate. With 5% of the world's population, our country now houses nearly 25% of the world's reported prisoners. We currently incarcerate 756 inmates per 100,000 residents, a rate nearly five times the average worldwide of 158 for every 100,000. In addition, more than 5 million people who recently left jail remain under "correctional supervision," which includes parole, probation, and other community sanctions. All told, about one in every 31 adults in the United States is in prison, in jail, or on supervised release. This all comes at a very high price to taxpayers: Local, state, and federal spending on corrections adds up to about $68 billion a year.

According to data supplied to Congress' Joint Economic Committee, those imprisoned for drug offenses rose from 10% of the inmate population to approximately 33% between 1984 and 2002. Justice statistics also show that 47.5% of all the drug arrests in our country in 2007 were for marijuana offenses. Additionally, nearly 60% of the people in state prisons serving time for a drug offense had no history of violence or of any significant selling activity. Indeed, four out of five drug arrests were for possession of illegal substances, while only one out of five was for sales. And although experts have found little statistical difference among racial groups regarding actual drug use, African-Americans--who make up about 12% of the total U.S. population--accounted for 37% of those arrested on drug charges, 59% of those convicted, and 74% of all drug offenders sentenced to prison.