Obama weakened as US passes debt bill

The immediate crisis has been averted, but the president has capitulated on nearly all of his key de

Hours ahead of the Treasury deadline that could have seen the US default for the first time in its history, the House of Representatives voted overwhelmingly in favour of a deal to raise the debt ceiling.

Reluctantly, both Democrats and Republicans voted the legislation through, although there were significant revolts on each side. It passed by 269 to 161 votes.

It will now be voted on by the Senate, although this is largely a formality as it has a Democratic majority. The House, which since November's mid-terms has been made up of many hardline Tea Party Republicans, was the main problem. Although the bill is seen by many as a complete capitulation by the president, many Republicans are still angry that the cuts outlined in the legislation do not go far enough.

While there is a sense of relief that the crisis has been ended without a potentially catastrophic default, Democrats are understandably frustrated as they have emerged from weeks of stand-off with little to show for it. Not only has Barack Obama surrendered on most of the key points, promising more than $2tn in spending cuts over the next ten years, but because a deal was reached so close to the deadline, the bill has not undergone the normal scrutiny.

It is a significant shift in fiscal policy at a time when economic recovery is fragile. Unemployment remains above 9 per cent, growth is slowing, and there is now no scope for any economic stimulus. Democrats also fear that it is the poor who will lose the most. In one of his main surrenders, Obama has agreed not to seek extra tax revenue. Given that George Bush's tax cuts for the rich are the main cause of the deficit (see this chart), this means the deficit will stay sky-high. Democrats hope to re-open this debate at a later stage.

The sense that Obama has caved in to the unreasonable voices on the right is also a cause of frustration. Writing last night, the Nobel-winning economist Paul Krugman criticised Obama for refusing to consider tabling the 14th Amendment to push his version through:

Those legal options are still there. Obama can move now; and even if he eventually loses in the courts, that gives him time.

Sure, it's risky. But the whole situation is immensely risky, thanks to the extremism and bloody-mindedness of the right. There are no safe options, and trying to play it safe when there is no safety lands you, well, where Obama is right now.

While laudable in theory, Obama's wish to seek reasonable, bipartisan solutions in the most partisan, extreme era the White House has seen for decades makes him a hostage to fortune.

The immediate crisis may have been averted, but this stand-off has shown how drastically the mainstream debate has been pulled to the right. It has also given a hint of the lines along which the next election will be fought -- drastically differing views on the size and scale of the state. Obama would do well to find his voice and be more assertive by then, if he does not want to lose the support of his own party.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear