I’m reading all sorts of breathless and, in my view, unreasonably confident claims about what has been officially dubbed COVID-19 but which, until that catches on, I will continue to call the Wuhan coronavirus. There have now been 60,000 cases diagnosed. There have been 1,100 deaths. How do we know? The Chinese authorities continue to demur from allowing foreigners to review their numbers. I don’t think we know whether there have been 60,000 cases in China, 600,000, or 6 million. We don’t know whether the mortality rate is 2%, .2%, or 20%.

Judging from the pictures of deserted streets in multiple cities I have seen the Chinese people are reacting with substantially more concern than would seem to be warranted by 60,000 cases, an insignificant number in a country of over a billion individuals.

There is an old rabbinic saying—when a woman country comes from a far country and tells you she’s divorced, believe her. Translation: when you can’t verify the actual facts, additional credence should be placed on claims, especially when they do not portray the individual in a completely favorable light. Conversely, when you can’t verify the facts, you’re told that your concern is insignificant, but the ones making the claim are acting as though it were the apocalypse, taking the claim with a generous dose of salt would seem to be prudent.

With the news of an asymptomatic Brit who spent a couple of days in Singapore spreading the virus to 11 others, hopes that we can avoid a pandemic would appear to be fading. Much, much more stringent measures than those already put in place would be required and, frankly, I just don’t believe we will put those measures in force.

So it looks as though Wuhan coronavirus may well be in your future, mine, and that of many, many others.

At The Atlantic David Brooks pronounces the nuclear family dead and, indeed, a terrible mistake:

“In my childhood,” Levinson told me, “you’d gather around the grandparents and they would tell the family stories … Now individuals sit around the TV, watching other families’ stories.” The main theme of Avalon, he said, is “the decentralization of the family. And that has continued even further today. Once, families at least gathered around the television. Now each person has their own screen.”

This is the story of our times—the story of the family, once a dense cluster of many siblings and extended kin, fragmenting into ever smaller and more fragile forms. The initial result of that fragmentation, the nuclear family, didn’t seem so bad. But then, because the nuclear family is so brittle, the fragmentation continued. In many sectors of society, nuclear families fragmented into single-parent families, single-parent families into chaotic families or no families.

If you want to summarize the changes in family structure over the past century, the truest thing to say is this: We’ve made life freer for individuals and more unstable for families. We’ve made life better for adults but worse for children. We’ve moved from big, interconnected, and extended families, which helped protect the most vulnerable people in society from the shocks of life, to smaller, detached nuclear families (a married couple and their children), which give the most privileged people in society room to maximize their talents and expand their options. The shift from bigger and interconnected extended families to smaller and detached nuclear families ultimately led to a familial system that liberates the rich and ravages the working-class and the poor.

This article is about that process, and the devastation it has wrought—and about how Americans are now groping to build new kinds of family and find better ways to live.

The problem with his article is that it is historically, anthropologically, and psychologically ignorant. Let’s start with the history. He claims that the absolute nuclear family only prevailed in the United States between 1950 and about 1965. That’s untrue.

Anthropologists have done quite a bit of analysis of family structures. It’s one of the central topics of the field. There are many, many different family structures around the world. In Europe four different family structures prevailed: the absolute nuclear family, the egalitarian nuclear family, the stem family, and the communitarian family. Here are their definitions:

These can be organized along two axes like this:

There is evidence that these family structures have been in place throughout Europe for thousands of years and it has been suggested that differences in outcomes throughout Europe may be attributed to the types of family structures that prevailed in different places. Short version: the absolute nuclear family was emphatically not invented in 1950. Brooks is simply wrong.

I became interested in this subject through my family’s history. Although I was reared in an absolute nuclear family, I knew my father was not. I learned in my studies that he was reared in a variant of the communitarian family that prevailed where my ancestors in Switzerland originated. In that variant siblings could marry, all property belonged to the patriarch and was inherited by the eldest son. My great-grandfather Schuler attempted, unsuccessfully, to continue that in the United States.

I don’t know what family structure is best-suited to modern life in America. I’m pretty confident that grandparent-headed or single parent-headed families are not it. The one thing that should be kept in mind: places where the absolute nuclear family prevailed created liberal democracy and market economies. Our notions of individual freedoms arose from the soil of the absolute nuclear family. Whether they can survive the death of the absolute nuclear family is a gamble.

At Politico Ryan Lizza has some words of encouragement for the Democrats. Sort of. Your field is so screwed up that even Joe Biden could ultimately prevail:

Democrats don’t have an obvious candidate who they can rally around. Indecision is the most common theme I encountered among voters at more than a dozen events in New Hampshire since Friday. (Perhaps this should have been more obvious when even The New York Times editorial board couldn’t pick a single candidate.) There’s no reason to think the choice will get easier after Tuesday.

What’s driving the indecision is not a plethora of great choices, but the fact that there are seven candidates in the mix, each of whom has at least one very serious flaw.

There is no candidate who can deliver the kind of knockout punch that defined some previous Democratic primary races, such as Al Gore’s 2000 win and John Kerry’s 2004 win, when they each won Iowa and New Hampshire and never looked back. There’s some chance the race could gradually narrow to a two-person fight, as happened in 2008 (Obama vs. Clinton) and 2016 (Sanders vs. Clinton), but New Hampshire is unlikely to clarify who those two candidates are.

After sketching just what some of those flaws are he concludes:

And so Biden will get a second chance if he passes the one 2020 test he set for himself long ago: winning South Carolina. Plausible!

He’s actually making the argument for a convention in which the party leadership discards the primary results and selects the party’s presidential candidate. Plan C!

Under Plan C the 2020 Democratic presidential candidate wouldn’t even need to be someone who actually ran in any primaries. It could be but it wouldn’t need to be. It could be Hillary Clinton. It could be Oprah. It could be practically anybody.

At The Week Matthew Walther muses about the Democrats’ predicament:

Unlike Gaul, the Democratic primary electorate is divided into only two parts. Bernie Sanders’s victory in Tuesday’s New Hampshire primary reminded observers of what we have known for a long time, namely that the smaller of these two parts remains united in favor of his candidacy for the Democratic presidential nomination. The larger moderate one remains split, not quite evenly, between Pete Buttigieg, Amy Klobuchar, Elizabeth Warren, and Joe Biden.

We know which side the Democratic National Committee, the party’s leadership in Congress, wealthy mega-donors, and luminaries like the Obamas and the Clintons are on. We also know that they are willing to do pretty much anything to prevent Sanders from winning the nomination in 2020. The question is whether they will be able to.

I am not so sure the answer is yes.

I don’t think that’s “the question”. I think the question is whether they will be willing to. Rahm Emanuel articulated the choice that the Democrats face pretty well. They can run Bernie Sanders as their presidential candidate and in all likelihood lose in the general election or they can split the party.

The party nomenklatura can do pretty much anything they care to. They could simply ban Sanders from being put on the ballot as a Democrat. He isn’t one, after all. They could alter their present rules and just award his delegates to other candidates on those grounds or some other they come up with. There are all sorts of things they can do. But will they? Frankly, I doubt it.

There are several different ways of looking at the general election. Plan A has already failed. Plan B operates under the theory that anyone running on the Democratic ticket will beat Trump in November. I would have thought that 2016 would have persuaded the Democrats otherwise but apparently not.

If Biden continues to tank, Democrats are left with the following alternatives

• An elderly “democratic socialist” whose preferred policies actually resemble those of much more radical regimes than they do those of the Scandinavian social democracies he claims to admire.
• A Red Diaper baby who has never held anything other than local office and whose primary vote counts are more votes than he’s ever received before.
• Hillary v2.0
• Amy Klobuchar who, apparently, is mean to her staff
• A billionaire former New York mayor

They’d best hope that Plan B will work.

If you dance with the devil, then you haven’t got a clue, for you think you’ll change the devil, but the devil changes you.

New Hampshire’s presidential primary results are in and CNN has them:

The New Hampshire primary is over and Sen. Bernie Sanders has been named the victor with 26% of the vote with 94% of precincts reporting.

Pete Buttigieg received 24% of the vote, Amy Klobuchar 20%, Elizabeth Warren 9%, and Joe Biden 8%, with other candidates receiving much smaller percentages of the vote. I wouldn’t be surprised if this is the end for Andrew Yang and Tulsi Gabbard’s campaigns. According to party rules, neither Biden nor Warren will receive any delegates from New Hampshire (that requires 15% of the vote).

Neither Iowa nor New Hampshire look a great deal like the United States and even less like the Democratic Party. For that we’ll need to wait for South Carolina which heightens the importance of the state’s primary on February 29. If Elizabeth Warren captures no delegates there or Joe Biden craters, it’s hard to see how their campaigns can carry on. Much of Biden’s appeal resides in a) name recognition and b) that elusive quality of electability.

The state that comes closest to a microcosm of the whole country from the standpoint of racial demographics is, of course, Illinois, where the primary is on March 17. I would not be a bit surprised if brawls broke out in Southwest Side polling places. Have you ever been on the Southwest Side of Chicago on March 17? I have.

Molly Ball’s article at Time.com gave me the giggles:

“I am very, very worried,” says Marianne Burke, a 62-year-old special-ed teacher. “I’m terrified. We’ve got to get it together as Democrats.” But she can’t make up her mind either: Buttigieg is inspiring but inexperienced; Klobuchar’s debate closing was powerful, but does she have a chance? She worries that the strong economy is giving Trump a boost and doesn’t understand why no one seems bothered by his outrageous behavior.

“I just want to be inspired,” she says. “I’m so tired of Trump and everything he represents. We need somebody who’s going to bring out the best in all of us.”

Perhaps Buttigieg, who’s elevated inoffensiveness to an ideology, is the right vessel for this yearning for unity. But these days Democrats don’t feel like they can trust their own instincts. There’s a pervasive longing for a deus ex machina—something to free them from the pain of making this decision, with its awful weight. Won’t someone just figure it out for them?

If New Hampshire voters are concerned about making “the right choice”, they should worry no longer. They will make the wrong choice. There is no right choice. There are likes and dislikes but there is no one right choice. Where did they ever get that idea?

I hate to be judgmental but a very large number of people in New Hampshire, particularly southern New Hampshire, are actually tax refugees from Massachusetts. There is a characterization for fleeing higher taxes and then voting in support of them: cognitive dissonance. They should change the license plates from “Live Free or Die” to “The Cognitive Dissonance State”.

In an op-ed at the Wall Street Journal health care policy expert Sally Pipes argues that Medicare for All could have some unforeseen deleterious effects on care in the United States:

Some doctors evidently believe Medicare for All would deliver better health care for Americans. Some no doubt think more insurance would mean more patients. But it would also force physicians to work longer hours for less pay.

A single-payer program would pay doctors at rates similar to Medicare reimbursement levels, already at least 25% less than private insurance pays, according to estimates by Charles Blahous of the Mercatus Center. Under the current legislative drafts of Medicare for All, government rates over the first decade would be 40% lower than those paid by private insurers.

That amounts to an enormous pay cut for doctors. U.S. physicians earned on average $313,000 in 2019, according to Medscape’s international physician compensation report. The average physician in the U.K. earned only $138,000. The Commonwealth Fund reports that American general practitioners earned a little more than $218,000 on average in 2016, compared with $146,000 in Canada and $134,000 in the U.K.

Drastic pay cuts would inevitably drive physicians to give up the practice. Patients can’t afford an exodus of doctors. Nearly 80 million people live in areas with too few primary-care professionals, the Kaiser Family Foundation reports. Even under current policies, the country may face a shortage of as many as 120,000 doctors in a decade, according to the Association of American Medical Colleges.

The prospect of lower pay and stressful work would also discourage young people from entering the profession. Medical school is expensive; the median graduate takes on $200,000 in debt. It’s time-consuming, too. The typical doctor spends four years in medical school, followed by three to seven years in residency and fellowship. Lucrative jobs in finance, technology and law require far less preparation time.

I’m not a health care expert but I do understand our policies pretty well. Let me make a few observations.

First, the difference between $218,000 and $146,000 per year looks suspiciously like the difference between health care costs in the U. S. and those in the rest of the developed world. Maybe it’s just a coincidence. Second, she’s not just making a case against Medicare for All. She’s making a case against reducing U. S. health care costs. Everything to which she points applies equally well to reducing costs in the sector which necessarily means reducing compensation. Anyone who claims that we will be able to control not just health care costs but the increase in health care costs without reducing health care compensation probably also has a bridge they’d like to sell you.

Let’s examine her claims one by one. They are:

• Physicians would leave the practice of medicine for some other field.
• Fewer students would apply to medical school.
• Students would be drawn to specialties more lucrative than general practice.

The incomes of full-time practicing physicians place them somewhere between the top 5% of income earners and the top 1% of income earners, depending on specialty, and there are roughly a half million practicing physicians. There is no job other than the practice of medicine that those fleeing the practice of medicine could take that would provide that level of income. That’s the reality of work in the U. S. If a newly-minted anything (other than physician) walks into the typical American business, demanding a job that will pay over $200,000 per year, they’ll be laughed out of the place.

Some of those physicians might return to their home countries. It might also have an impact on the life decisions of women who are more likely to work part-time as physicians than their male counterparts. That’s not misogyny. It’s just a recognition of the facts of employment in the health care sector.

Over the period of the last 20 years, the number of students applying to medical school has grown from around 40,000 to around 50,000 for about 20,000 positions. Young people, too, recognize that no field other than the practice of medicine offers the opportunity of “doing good and doing well”, as the NEJM put it some years ago. If that number fell by 20% it would just be what it was 20 years ago.

You might wonder why, given the enormous increases in physician pay over the last 50 years, far more than any other profession, why the number of med school slots isn’t twice or even three times what it was then? The Medicare system pays a stipend for each and every medical resident in the country of around $80,000 per year (the last time I checked) and meters the number of graduates accordingly. I can discern no benign reason for that. It’s just what’s being done.

However, that tells us that the number of medical school slots and the number of graduates entering each specialty is actually under our control. If we reform the formula by which stipends are awarded, it will change the number of med school slots and the number of those entering various different specialties.

As you know, I love a good polemic. Although I don’t necessarily endorse it, I wanted to bring a passage from Andy Kessler’s most recent Wall Street Journal column to your attention:

Is he a disease or a cure? Like him or hate him, there’s tons of spilled ink trying to assess President Trump’s governing style. To me, the key to understanding Trumpism is remembering why he was elected.

What do I mean? Voters chose Donald Trump as an antidote to the growing inflammation caused by the (OK, deep breath . . .) prosperity-crushing, speech-inhibiting, nanny state-building, carbon-obsessing, patriarchy-bashing, implicit bias-accusing, tokey-wokey, globalist, swamp-creature governing class—all perfectly embodied by the Democrats’ 2016 nominee. On taking office, Mr. Trump proceeded to hire smart people and create a massive diversion (tweets, border walls, tariffs) as a smokescreen to let them implement an agenda of tax cuts, deregulation and originalist judges.

I’m not entirely convinced that Trump’s bluster is a strategy. I think it’s Trump being Trump. I also think he’s giving increased investment following the cut in the personal and corporate income taxes more credit than they deserve. He may be right about deregulation. I wish that better statistics were kept about the effects of specific regulations and their removal. Most of what we have now is just partisan bickering.

I continue to hold the naive beliefs that persuasion is better and longer-lasting than power politics, that honesty is the best policy, that you catch more flies with honey than with vinegar, and you should model in your own behavior the behavior you’d like to see from others. It’s sad that those homely policies don’t attract bands of ardent followers.