
Nikki Haley: A Leader of Courage and Conviction
I was already inclined to support her, but after last night’s debate, I am firmly behind the candidacy of Nikki Haley. In addition to her executive experience as the Governor of South Carolina and her foreign policy knowledge as the United States Ambassador to the United Nations, Haley strikes me as the most balanced, the […]

Sex, Doubt, and Regret
Despite a lack of evidence, it is possible that some youths who undergo gender-affirming care find themselves in an improved condition. But, certainly not all are. Those who begin an early stage of transitioning, but don’t proceed to the next step, are known as “desisters”, as opposed to those who do, the “persisters”. Detransitioners proceeded […]

Sex and Science
The modern era of medical transitioning for transgender youths began in the Netherlands sometime in the late 1980s, when a 13 year old natal female, FG (identified as B in the medical literature), who identified as male, became the first adolescent to be treated with a puberty blocker for gender dysphoria (then known as gender […]

Sex and Youths
If the care of transgender youths seems like a new issue, that’s because it is. And, if it feels as if it has also been a rapidly growing one, that’s because that is also true. In part because of this newness and rapid expansion, but also due to a lack of scientific rigor in the […]

Sex is Messy
Transgender issues are a hot political topic these days, and I think that is both understandable and appropriate. The first time I remember thinking much about this issue was in 2016, when I first ran for Congress, and bathroom bills were a particularly pressing concern. Since then, this brave new world has expanded exponentially, and, […]

Happy Birthday, America!
Like many Americans, I greatly enjoyed Top Gun: Maverick. Apart from the acting and the action, which I thought were quite good, I appreciated the sense of optimistic patriotism, of a can-do Americanism, that the movie inspired. And, it appears I was not alone in recognizing this sentiment. Furthermore, this appreciation largely seems to have […]

Healthcare Reform Obstacles
Every time I write about healthcare reform, I receive at least one comment about the need to get the government out of healthcare entirely. I’m not unsympathetic to this argument, but it’s unrealistic. It is true that industries which have seen the largest increases in costs over the past few decades, such as healthcare and […]

A Time To Live
Last night, I listened to Matthew McConaughey’s speech from the White House this week regarding the the mass shooting at Robb Elementary in Uvalde, Texas, and thought it was quite powerful. If your immediate response to that sentence was, “liberal Hollywood actor wants to take away our guns”, then think again. Like me and many of […]

Healthcare Models Around the Globe
Our current healthcare system is so costly, and access to care and coverage so unequal, that I think simple continuation of the status quo is indefensible. At the same time, I believe that simplistic approaches to reform, such as Medicare for All, are unrealistic and would prove inadequate. At this point, my friends on the […]

It’s Time for a Healthcare Reform Checkup
It is impossible for me to imagine that we will see any meaningful healthcare reform in the near future. Nothing substantive has been offered by the Biden administration, despite earlier declarations that “Obamacare” would be extended as “Bidencare”. And, given the logjam in the Senate, thanks in large part to Senators Manchin and Sinema, any […]

Beyond Afghanistan
Twenty years ago yesterday, the United States was attacked by al-Qaeda terrorists who had received training and refuge in Taliban-controlled Afghanistan. Twenty years ago next month, the U.S. and the U.K. launched Operation Enduring Freedom, and the Afghanistan war was begun. Over 80% of Americans supported the war effort in the beginning. But, the war went […]

Turn Off, Tune Out, Drop In
It’s been over four months since I posted here? That’s pretty awful, but I have some reasons. A couple of weeks after my last post, at the end of March, I came down with COVID-19, a couple of weeks after my first dose of the Pfizer vaccine. I didn’t require hospitalization, and actually had very […]

Healthcare as Stimulus and Infrastructure?
Since Biden’s inauguration, the administration has reversed some of the healthcare policy decisions enacted under the Trump administration. This has included attempting to boost enrollment in ACA marketplace plans through advertising and outreach. It also opened a special ACA marketplace enrollment, which began on February 15th and will run until May 15th. And, it has […]

Competition in Politics
We held a Zoom book review last evening of The Politics Industry: How Political Innovation Can Break Partisan Gridlock and Save Our Democracy (2020), by Katherine Gehl and Michael Porter. The book was based on an earlier paper by the same authors, published by the Harvard Business School, titled, Why Competition in the Politics Industry is Failing America: […]
The Wisdom and Madness of Crowds
One of my favorite books from a few years ago is The Wisdom of Crowds (2004), by James Surowiecki. Subtitled, Why the Many Are Smarter Than the Few and How Collective Wisdom Shapes Business, Economies, Societies and Nations, the book begins with a story from 1906, in which the British scientist Francis Galton was surprised […]

The Near-Term Future of Healthcare Reform
With the Biden administration now in place, but faced with razor-thin Democratic majorities in Congress, what might we expect in the realm of healthcare reform in the near future? Probably not much. Democrats maintained their majority in the House, but their advantage is much diminished, down to 10 seats, with three vacancies yet to be […]

An Electoral College Addendum
Despite disruption at the Capitol last week, and challenges from some Republican members of the House and Senate, Congress managed to certify the electoral college victory of Biden/Harris by a vote of 306 to 232. With that formality completed, I thought I’d briefly revisit one of my previous posts, questioning whether the electoral college is […]

The Peril and Promise of Populism
Like most Americans, I’m heartbroken by what happened at the U.S. Capitol on Wednesday. It was an assault on our democratic institutions, seriously damaged one of our two major political parties, and laid bare the deep divisions in our populace. I was a “Never Trump” Republican from the beginning, even as a candidate for U.S. […]

Is The Electoral College Unfair and Anticompetitive?
I don’t recall ever watching the electoral college voting returns before last week, which I suppose is just another indication of how weird this election, and 2020 generally, has been. Still, the fact that I was watching them bothered me. Hadn’t America already voted, over a month before? While we didn’t know the projected electoral […]

Who Did You Vote For?
I have a special guest contributor for this entry, Drew Sherman. I didn’t know Drew previously, but am friends with his brother, Steve. Drew also didn’t know of me, or my interests in reducing political polarization and promoting civil discourse. Drew wrote the following editorial, and shared it with his brother. Steve thought I would be […]

What is the Future of Healthcare Policy?
NB: This is the first in a planned series of posts about healthcare reform. I’ll continue my general political posts, particularly about political reform, as well. In last week’s presidential debate, former Vice President Biden said that he would not only work to preserve the Affordable Care Act (ACA), also known as “Obamacare”, but to […]

We’re Doing Politics Wrong
There is no doubt about it; we are doing politics wrong. Specifically, I think we’re failing to appreciate three things; that issues are complex, that collaboration is rewarding, and that we are remarkably privileged. My research on recycling led me to the conclusion that whether recycling makes sense depends on two main factors; what you are trying […]

Trash Talk
Here’s a brief, and hopefully final, update on my recent two posts about recycling. My overall conclusion remains the same; that whether recycling makes sense depends in large part on what you are attempting to recycle, and where you reside. I have learned some new information, to include what has changed regarding the recycling infrastructure […]

Garbage In, Garbage Out
I usually write about politics, so I was surprised at how much feedback I received following my last post, “Is Recycling Even Real?”. From responses on social media to email replies, it seems that many people have been asking the same questions, regardless of their political leanings. I have tried to get some answers, but thus […]

Is Recycling Even Real?
Recent reporting reveals that plastic recycling isn’t working as advertised. And, indeed, that it never has. According to those reports, less than 10% of plastic products have been recycled, ever. And, interviews with former insiders reveal that the plastics industry has been aware of the problems with recycling plastic for decades. Plastic is not one […]

Happy Independence Day!
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. Declaration of Independence, 1776 These are the times that try men’s souls. The summer soldier and the sunshine patriot will, […]

Good Mask Discipline
There is considerable debate in the public sphere about whether or not we should be wearing masks to help prevent the spread of COVID-19, and for good reason. We have no large prospective trials that have clearly demonstrated the efficacy of mask use in slowing a pandemic spread. The scientific literature that does exist reveals […]

Reimagining the Future
The premise of this post is simple: The future is going to look different than the past, and maybe a lot different. It’s possible that things will go more-or-less back to normal once this pandemic ends, but I suspect there will be many changes, some good and perhaps some not. It’s even possible that this […]

Seeking a New Path
We need to find a way to move forward. We can’t stay in this place forever. Where we end up won’t be what we remember as normal, at least not at first. And, it may end up being very different. We also have an opportunity to end up somewhere better than where we started. Still, […]

On Modeling
It’s more difficult than it may appear. There’s tremendous pressure to get it right. And, it’s nearly impossible to predict whether it will be successful. I’m not actually writing about fashion modeling, but scientific modeling. If your social media feed is at all like mine, many of your friends who were recently experts […]

Coronavirus Update
I underestimated the seriousness of this pandemic when I first wrote about it just over two weeks ago in a newsletter and blog post. Two days later, I had already grown more concerned, and updated my Coronavirus blog post, but did not send out a second newsletter until now. I don’t have any good […]

Coronavirus
I’ve updated this entry from a couple of days ago, with some additional resources, and a few new personal refections:I made a rather flippant post about the current coronavirus pandemic on Facebook last week, which some people appreciated for my attempt at humor, but others thought was being too dismissive of a potentially serious […]

One Republican’s Take on the Democratic Candidates
To state the obvious, this is shaping up to be another contentious election. President Trump has low approval and high disapproval ratings among the general population, but these have remained remarkably stable over time. And, his approval among Republican voters remains very high. Thus far, the impeachment proceedings seem to be pretty much a wash; […]

Happy New Year!
Julie prepared a delicious New Year’s Eve dinner for our family prior to working a 12 hour overnight shift at the University of Iowa Hospital. 2019 Recap I’ve been so busy with on-the-ground Better Angels activities that I haven’t had time to update this blog in over two months. I apologize for that, and thought […]

Iowa Ridiculous
I wasn’t going to write about the whole Carson King / Anheuser-Busch / Des Moines Register fiasco, but given the aftershocks that are still reverberating here in Iowa, I feel I must. I have readers from outside Iowa who may have no idea what I’m talking about, so a brief recap is in order. Way […]

Be Kind To Everyone
This is nearly old news by now, but Ellen DeGeneres attended a Cowboys football game the weekend before last (she was rooting for the Packers), and had to defend her friendship with President George W. Bush, who was sitting next to her. If you were living under a rock in the past week, you can catch […]

Iowa Outreach Project Update
Since our Iowa Outreach Project launched a month ago, we’ve held six public viewings of the Better Angels: Reuniting America documentary. The first one was at Graceland University in Lamoni, and we’ve since held screenings at public libraries in Polk City, Newton, Dubuque, Eldridge, and Burlington. The viewing in Newton was jointly cosponsored by the Jasper County Republicans and the Jasper County […]

Remembering 9/11
Like most Americans above a certain age, I remember that morning in 2001 vividly. I was in my thoracic surgery clinic in Indiana when the first two planes hit. I watched the news coverage along with clinic staff and patients in the waiting room. It brought back memories of watching the opening salvos of Operation Desert Storm […]

Gun Violence
I’ve been away from this website for several months, as I’ve been focusing most of my efforts on reducing political polarization and restoring civil discourse through my role as the state coordinator for Better Angels in Iowa. Today, though, I feel I have to post something, if only for myself. Read at your own […]

Better Angels
After all the rather depressing news I’ve shared recently about political polarization and corruption, I’m eager to begin writing about some positive subjects! Today, I’m going to be sharing some of my recent experiences, and after a short vacation, I’ll be introducing new ways of looking at politics and public policy, and then begin diving […]

Odds and Ends
I want to add a few comments and links regarding my recent several posts on political polarization and corruption. Some of these came to my attention after my posts, others were actually released after my posts, and a few I just couldn’t find a good place for at the time, so I am adding this […]

Political Corruption, Part 3
As I hope I’ve successfully laid out in the past few posts, I think we face some serious threats to the future of our Republic. These include polarization and disengagement by a large section of voters at the grassroots level, and systemic corruption of our politics, particularly at the federal level. These are much more […]

Political Corruption, Part 2
I received a lot of feedback on my last post about political corruption, most of it positive and encouraging. But, based upon a few of the comments, I think I need to better clarify what I mean by political corruption in the broadest sense, which is corruption of our political system. Hence, this particular series […]

Political Corruption, Part 1
In my last post, on political polarization, I claimed that while polarization is harmful in and of itself, it is not a primary problem. Rather, it is a symptom of an underlying disease; namely, political corruption. Again, not so much of individual politicians, but corruption of our system. This is not in dispute by those […]

Political Polarization
Probably like everyone else, I have a diverse group of acquaintances. Family, friends, neighbors, colleagues, patients, and a load of people I’ve met during my forays into politics. Not everyone agrees entirely with my political views; in fact, only a minority even come close. That doesn’t mean that they’re wrong and I’m right, just that […]

New Year, New Website!
We made it through an enjoyable holidays, and then I became very ill for a couple of weeks. I’m well on the mend now, but behind in what I’d hoped to accomplish by now. We’re in the process of revamping my old campaign website, so pardon the dust, as the saying goes. The new website […]

Are You The Doc Who Saved My Life?
Twenty-five years ago, I was a chief general surgery resident at Tripler Army Medical Center in Honolulu. Early on Christmas Eve morning in 1993, I was called to the Emergency Room to see a young soldier who had fallen several stories from a hotel balcony in Waikiki. Lee had multiple injuries, to include a closed […]

Snowflakes and Deplorables
Jasper County Last night, I attended the 2nd Annual Jasper County Bipartisan Community Feed, sponsored by the Jasper County Republican and Democratic parties. In the photo above is a representative from the Salvation Army and the chairs of the two parties. As it was last year, the attendees tended to segregate based upon party, which always […]

Happy Thanksgiving!
The photo above is from 24 years ago, when Julie and I celebrated our first Thanksgiving as a couple. We had gotten married only a few months earlier, I had completed my general surgery residency and was now a staff surgeon at Fort Stewart, and we had purchased our first home together. Thanksgiving is my […]