The KHIT Blog: The Donroe Doctrine

Friday, January 9, 2026

The Donroe Doctrine

NY Times article photo

“We live in a world, the real world, Jake [Tapper/CNN], that is governed by strength, that is governed by force, that is governed by power. These are the iron laws of the world since the beginning
of time.” —Stephen Miller

...On Tuesday, giddy after the success of a daring weekend raid to capture the Venezuelan dictator Nicolás Maduro, Trump’s White House put out a statement threatening Denmark, a nato ally, with military action if it did not hand over Greenland—a threat so reminiscent of Vladimir Putin’s bald demands in the run-up to his invasion of Ukraine that it had Russian officials openly cheering. In the days since, Trump has insisted that the United States simply must have the vast, sparsely populated, and resource-rich territory. Secretary of State Marco Rubio is set to meet with Denmark’s leaders next week to present terms. Seven European nations put out a joint statement condemning the threats, leading to yet another Trump statement claiming that it was the Europeans who could not be trusted to defend their fellow alliance members.

What some of Trump’s own senior officials once viewed as the delusional musings of a dilettante have now become a genuine international crisis, one that could lead—or maybe it already has led—to the effective end of nato. After this week, is there anyone who can credibly claim to be sure that the United States, under Trump, would honor the commitment to mutual defense that is the foundation of the alliance?

Greenland, it turns out, is not a punch line but a template that explains much about Trump’s foreign policy: it’s about a power-grabbing President who looks at territory on a map and says he wants to own it. Trump could not articulate a rationale for acquiring Greenland—“from a strategic standpoint, from a locational standpoint, from a geography standpoint, it’s something that we should have,” he told us—any more than he can elaborate on what his plan is for Venezuela now that he’s toppled the country’s leader and seized some of its oil. Asked by reporters from the Times, on Wednesday, why he couldn’t just settle for the terms of the existing 1951 treaty with Denmark, which grants the U.S. military nearly unlimited use of Greenland’s territory, Trump replied, “Ownership is very important.” He added, “because that’s what I feel is psychologically needed for success.” There are no limits to his global powers, Trump said, except one thing: “My own morality. My own mind. It’s the only thing that can stop me.”

In light of all of this stuff (including the ICE agent killing of Renee Nicole Good in Minneapolis this week forward one day later by new federal CBP agent shootings in Portland, Oregon), igs it hyperbolically unwarranted at this point to wonder whether Insurrection Act martial law may soon arrive?

Susan Glasser concludes.

Welcome to 2026. Trump’s apologists may be right when they say that the martial bluster is no more than a bargaining tactic. It appears that’s what Maduro thought, too, right up until the moment Trump sent the Delta Force into his bedroom in the middle of the night.

ON DECK

Now running on NetFlix. A film production of the live Broadway play. Could scarcely be more timely. Brilliantly done. George Clooley!

From his closing speech:

These instruments can teach, they can illuminate, they can even inspire, but they can do so only to the extent that humans are determined to use them to those ends. Otherwise, they're merely wires and lights in a box.

There is a great and perhaps decisive battle to be fought against ignorance, intolerance, indifference. It's a fight for the very soul of this republic.

And so the question is a very simple one. Not what power unchecked can do. We have seen that answer. No. The question is what are you prepared to do?

The fault, dear Brutus, is not in our stars, but in ourselves.

Good night and good luck.

Selected Murrow quotes.

JANUARY 10TH UPDATE

It has been a very bad week, on a number of exigent fronts. Seems like it's always Miller Time of late.

More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
___

"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Friday, January 9, 2026

The Donroe Doctrine

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