Occasional blogging, mostly of the long-form variety.

Wednesday, April 28, 2010

Across Three Aprils

April is National Poetry Month, which is appropriate, considering how many poets and authors have been inspired to use April and spring to open their works. We'll take a look at three visions of April. (I'm only posting selections; you can read more at the links.)

We'll kick it off with one Geoffrey Chaucer, and a bit of his Prologue from The Canterbury Tales:

Whan that Aprille, with hise shoures soote,
The droghte of March hath perced to the roote
And bathed every veyne in swich licour,
Of which vertu engendred is the flour;
Whan Zephirus eek with his swete breeth
Inspired hath in every holt and heeth
The tendre croppes, and the yonge sonne
Hath in the Ram his halfe cours yronne,
And smale foweles maken melodye,
That slepen al the nyght with open eye-
So priketh hem Nature in hir corages-
Thanne longen folk to goon on pilgrimages
And palmeres for to seken straunge strondes
To ferne halwes, kowthe in sondry londes;
And specially, from every shires ende
Of Engelond, to Caunturbury they wende,
The hooly blisful martir for the seke
That hem hath holpen, whan that they were seeke.

Everything is springing to life and full of energy. (The site above provides a modern translation if you want one, or you can go here for this section.)

Next up is T.S. Eliot, who opens his epic poem "The Waste Land" with a very different vision of April:

APRIL is the cruellest month, breeding
Lilacs out of the dead land, mixing
Memory and desire, stirring
Dull roots with spring rain.
Winter kept us warm, covering
Earth in forgetful snow, feeding
A little life with dried tubers.
Summer surprised us, coming over the Starnbergersee
With a shower of rain; we stopped in the colonnade,
And went on in sunlight, into the Hofgarten,
And drank coffee, and talked for an hour.
Bin gar keine Russin, stamm' aus Litauen, echt deutsch.
And when we were children, staying at the archduke's,
My cousin's, he took me out on a sled,
And I was frightened. He said, Marie,
Marie, hold on tight. And down we went.
In the mountains, there you feel free...
I read, much of the night, and go south in the winter.

In some circumstances, stirring memory and desire might not be so pleasant.

Lastly, we'll take a look at the opening to George Orwell's 1984:

It was a bright cold day in April, and the clocks were striking thirteen. Winston Smith, his chin nuzzled into his breast in an effort to escape the vile wind, slipped quickly through the glass doors of Victory Mansions, thought not quickly enough to prevent a swirl of gritty dust from entering along with him.

The hallway smelt of boiled cabbage and old rag mats. At one end of it a colored poster, too large for indoor display, had been tacked to the wall. It depicted simply an enormous face, more than a meter wide: the face of a man of about forty-fiver, with a heavy black mustache and ruggedly handsome features. Winston made for the stairs. It was no use trying the lift. Even at the best of times it was seldom working, and at present the electric current was cut off during daylight hours. It was part of the economy drive in preparation for Hate Week. The flat was seven flights up, and Winston, who was thirty-nine, and had a varicose ulcer above his right ankle, went slowly, resting several times on the way. On each landing, opposite the lift shaft, the poster with the enormous face gazed from the wall. It was one of those pictures which are so contrived that the eyes follow you about when you move. BIG BROTHER IS WATCHING YOU, the caption beneath it ran.

Inside the flat a fruity voice was reading out a list of figures that had something to do with the production of pig iron. The voice came from an oblong metal plate like a dulled mirror which formed part of the surface of the right hand wall. Winston turned a switch and the voice sank somewhat, thought the words were still distinguishable. The instrument (the telescreen, it was called) could be dimmed, but there was no way of shutting it off completely. He moved over to the window: a smallish, frail figure, the meagerness of his body merely emphasized by the blue overalls which were the uniform of the Party. His hair was very fair, his face naturally sanguine, his skin roughened by coarse soap and blunt razor blades and the cold of the winter that had just ended.

Outside, even through the shut window pane, the world looked cold. Down in the street little eddied of wind were whirling dust and torn paper into spirals, and though the sun was shining and the sky a harsh blue, there seemed to be no color in anything except the posters that were plastered everywhere. The black mustachio'd facer gazed down from every commanding corner. There was one on the house front immediately opposite. BIG BROTHER IS WATCHING YOU, the caption said, while the dark eyes looked deep into Winston's own. Down at street level another poster, torn at one corner, flapped fitfully in the wind, alternately covering and uncovering the single word INGSOC. In the far distance a helicopter skimmed down between the roofs, hovered for an instant like a bluebottle, and darted away again with a curving flight. It was the Police Patrol, snooping into people's windows. The patrols did not matter, however. Only the Thought Police mattered.

Something is rotten in the state of Oceania.

The Canterbury Tales-Waste Land connection is a pretty standard observation. But one of many great things about poetry, theater and literature is that authors borrow from and build on one another. Sometimes an author will try to refute another writer or start a quarrel. However, in the Arts, more often authors riff on one another, building a web of connections and continuing a dialogue that stretches back decades, centuries or even millennia. Chaucer picks April deliberately for evoking his opening images. But then Eliot plays on this. And surely Orwell plays on both in that meticulously crafted first sentence of 1984. Robert Frost riffs on William Blake. John Donne references Shakespeare, and both are referenced yet again by Eliot. Composers, musicians, painters, sculptors, playwrights and artists of all sorts do the same dance (and you may have your own favorite examples). On one level, it's all a very clever game. But on another, it's an expression of deep love.

Tuesday, April 27, 2010

National Poetry Month 2010

(Walt Whitman.)

April is National Poetry Month. I'll once again link my too-meager poetry category and promote the wonderful Favorite Poem Project.

I recently re-watched Ken Burns' documentary The Civil War. Some of the most moving sections feature words by Walt Whitman, read by Garrison Keillor. Many of Whitman's best poems are quite long, but can be read here and elsewhere on the web. Here's a selection from one of them, in one of the Favorite Poem Project videos:

And here's another, short Whitman poem:

Oh Me! Oh Life!
By Walt Whitman

O Me! O life!... of the questions of these recurring;
Of the endless trains of the faithless—of cities fill’d with the foolish;
Of myself forever reproaching myself, (for who more foolish than I, and who more faithless?)
Of eyes that vainly crave the light—of the objects mean—of the struggle ever renew’d;
Of the poor results of all—of the plodding and sordid crowds I see around me;
Of the empty and useless years of the rest—with the rest me intertwined;
The question, O me! so sad, recurring—What good amid these, O me, O life?


That you are here—that life exists, and identity;
That the powerful play goes on, and you will contribute a verse.

Whitman's verses often capture nature, explore connection with others, and ponder his place in the world. I sometimes think of his work when I read this Wallace Stevens piece:

The Idea of Order at Key West
By Wallace Stevens

She sang beyond the genius of the sea.
The water never formed to mind or voice,
Like a body wholly body, fluttering
Its empty sleeves; and yet its mimic motion
Made constant cry, caused constantly a cry,
That was not ours although we understood,
Inhuman, of the veritable ocean.

The sea was not a mask. No more was she.
The song and water were not medleyed sound
Even if what she sang was what she heard,
Since what she sang was uttered word by word.
It may be that in all her phrases stirred
The grinding water and the gasping wind;
But it was she and not the sea we heard.

For she was the maker of the song she sang.
The ever-hooded, tragic-gestured sea
Was merely a place by which she walked to sing.
Whose spirit is this? we said, because we knew
It was the spirit that we sought and knew
That we should ask this often as she sang.
If it was only the dark voice of the sea
That rose, or even colored by many waves;
If it was only the outer voice of sky
And cloud, of the sunken coral water-walled,
However clear, it would have been deep air,
The heaving speech of air, a summer sound
Repeated in a summer without end
And sound alone. But it was more than that,
More even than her voice, and ours, among
The meaningless plungings of water and the wind,
Theatrical distances, bronze shadows heaped
On high horizons, mountainous atmospheres
Of sky and sea.

It was her voice that made
The sky acutest at its vanishing.
She measured to the hour its solitude.
She was the single artificer of the world
In which she sang. And when she sang, the sea,
Whatever self it had, became the self
That was her song, for she was the maker. Then we,
As we beheld her striding there alone,
Knew that there never was a world for her
Except the one she sang and, singing, made.

Ramon Fernandez, tell me, if you know,
Why, when the singing ended and we turned
Toward the town, tell why the glassy lights,
The lights in the fishing boats at anchor there,
As the night descended, tilting in the air,
Mastered the night and portioned out the sea,
Fixing emblazoned zones and fiery poles,
Arranging, deepening, enchanting night.

Oh! Blessed rage for order, pale Ramon,
The maker's rage to order words of the sea,
Words of the fragrant portals, dimly-starred,
And of ourselves and of our origins,
In ghostlier demarcations, keener sounds.

Thursday, April 22, 2010

Miranda Lee Richards - "Lifeboat"

This other live performance isn't bad and has a better camera angle, but the version above has better sound quality.

Eclectic Jukebox

Earth Day 2010

If you missed it, Ken Burns' documentary on America's national parks featured some stunning footage:

You can see a extended 27 minute preview as well.

When I was in high school, for Earth Day a teacher drove some of us over to a nearby college to hear a speaker. I can't remember who it was, but he said one thing that's always stuck with me about activism in general. He said it was important to fight for the environment, but also essential not to forget to take a break and enjoy it. It could be hiking, canoeing, or a simple walk, but make sure to make time to enjoy what you're fighting for, too.

One of the best things about my childhood was having a creek and woods right behind my house, and a nature center about a ten minutes' hike away. The cultural opportunities from living near Washington, D.C. were great as well. But we spent hours, fairly unsupervised, down by the creek. We took nature classes in the summer at the center (although they did get a bit repetitive). The last time I went back I saw a family of deer. Our family also made a fair number of trips out to the Blue Ridge Mountains. There are plenty of day hikes there, but the coolest ones are probably to some of the falls and bridges. One year we briefly hung out with some rangers checking out a nest of peregrine falcons.

Spelunking with the Boy Scouts was a different side of nature, but it's pretty wild (unless you're claustrophobic), basically rock-climbing underground. We'd go in winter, and had to stay quiet, so as not to wake the hibernating little brown bats, sometimes hundreds of them, sleeping about a foot from our faces as we'd wriggle through a tight passage.

During my brief teaching stints, we'd occasionally take the kids on wilderness trips, normally hiking, but occasionally canoeing. I still remember a canoe trip staying on an island for a couple of days, going out late at night, when the water was much more still, and phosphorescent lichen would make tiny sparks off the paddles. Somehow, my groups drew Mahoosuc Notch twice, sometimes called the toughest mile of the Appalachian Trail. It and the connecting trails aren't the easiest things with a full pack, because some of the rock-face climbs are fairly steep, and the shortest students would struggle to reach the best holds and ledges. Still, there was a great, exhilarating feeling in getting to the top of the toughest rise, and one year the clouds (nice for actual hiking) parted right when we hit the peak. It was lovely. We generally gave the kids some journal time, and other solo time. There are few things like a little solitude in nature for centering and reflecting.

Nature comes in different flavors. I hit the parks and canyon trails fairly regularly here in Los Angeles when I first moved out, but there's less time now and it's easy to let it fall by the wayside. Some people prefer beaches, and I like them too, but I prefer the less crowded kind (one near a theater center in Connecticut was wonderful in that respect). The Grand Canyon is an awesome sight. A body of water is always nice. Still, there's something special to trees and hills and mountains, or at least a proper woods. Growing up in a city can help you learn to run down an escalator or swim through a crowd on a street, but there's also a certain joy in bouncing across the stones in a familiar stream without a second thought.

I've waxed nostalgic here. Earth Day is a great day for activism and community, and there's always the weekend for a hike - as long it's not perpetually sidelined. Because while there are good environmental policies to champion and important battles to fight, one of the best ways to respect nature is simply to take a moment and enjoy it.

Edited for clarity.


Sunday, April 18, 2010

McArdle as One of Austen's Twits

Growing out of this thread, Susan of Texas has penned "The Role Of Women In Society by Mrs. Suderman, A Lady." It borrows from Jane Austen to satirize one of the biggest class-obsessed twits of our own era, one Megan McArdle (she's shortly to marry one Peter Suderman, hence the title). Check it out. The arts are probably the best way to capture the venal, shallow nature of our ruling class.

Thursday, April 15, 2010

Bomba Estéreo

Here are three "electro-tropical" songs from Columbian band Bomba Estéreo's KCRW session.

Eclectic Jukebox

The One Drop Rule

Ta-Nehisi Coates has been on fire recently, with a series of extremely thoughtful posts on the Civil War. Check out his recent archives. I want to do a more comprehensive post on the Civil War later this month, but Coates' "Honoring CHM: One Drop" features some stories about recently freed slaves in a photograph. Here are three of the most striking tales:

Charles Taylor is eight years old. His complexion is very fair, his hair light and silky. Three out of five boys in any school in New York are darker than he. Yet this white boy, with his mother, as he declares, has been twice sold as a slave. First by his father and "owner," Alexander Wethers, of Lewis County, Virginia, to a slave-trader named Harrison, who sold them to Mr. Thornhill of New Orleans. This man fled at the approach of our army, and his slaves were liberated by General Butler.The boy is decidedly intelligent, and though he has been at school less than a year he reads and writes very well. His mother is a mulatto; she had one daughter sold into Texas before she herself left Virginia, and one son who, she supposes, is with his father in Virginia. These three children, to all appearance of unmixed white race, came to Philadelphia last December, and were taken by their protector, Mr. Bacon, to the St. Lawrence Hotel on Chestnut Street. Within a few hours, Mr. Bacon informed me, he was notified by the landlord that they must therefore be colored persons, and he kept a hotel for white people. From this hospitable establishment the children were taken to the "Continental," where they were received without hesitation.

Augusta Boujey is nine years old. Her mother, who is almost white, was owned by her half-brother, named Solamon, who still retains two of her children. Mary Johnson was cook in her master's family in New Orleans. On her left arm are scars of three cuts given to her by her mistress with a rawhide. On her back are scars of more than fifty cuts given by her master. The occasion was that one morning she was half an hour behind time in bringing up his five o'clock cup of coffee. As the Union army approached she ran away from her master, and has since been employed by Colonel Hanks as cook.

Wilson Chinn is about 60 years old, he was "raised" by Isaac Howard of Woodford County, Kentucky. When 21 years old he was taken down the river and sold to Volsey B. Marmillion, a sugar planter about 45 miles above New Orleans. This man was accustomed to brand his negroes, and Wilson has on his forehead the letters "V. B. M." Of the 210 slaves on this plantation 105 left at one time and came into the Union camp. Thirty of them had been branded like cattle with a hot iron, four of them on the forehead, and the others on the breast or arm.

It's difficult to to imagine the horrible reality behind these tales. It's staggering and humbling.

I'm glad that some bloggers writing on the Civil War, including Coates, Dennis G and Hart Williams, have discussed class in addition to race and region. I wish more people looked at the class issues in the Civil War, and up to the present day. However, Coates' post is a stark reminder that, as crappy as being a mill worker or dirt farmer or conscript could be - and those experiences matter, too - slavery wins the prize for exploitation and cruelty.

Thomas Jefferson, a man of many contradictions (as was his fellow Virginian and fellow slave owner General Robert E. Lee), once said, in reference to slavery: "I tremble for my country when I reflect that God is just, that his justice cannot sleep forever."


Tuesday, April 13, 2010

Health Care Around the World

One of the more bizarre aspects of the health care "debate" was the strident insistence by reform opponents – and some supposedly objective reporters – that American health care was/is the best in the world. The truth is, many industrialized nations provide better overall health care for far less money than the United States. Many Americans don't know this – and some American corporations and politicians have worked very hard so that they don't know it.

The health care reform bill that passed is flawed, but is still a major step forward and should ensure basic care for millions of Americans who had none before. We'll see how the reality matches the plan and the promises. Still, the American health care system will continue to need improvement, and it would be foolish to ignore successful ways other nations have dealt with the same problems.

It's also valuable to examine what our old system really entailed and how it measured up. (Parts of the new health care law take effect this year, while other measures won't apply until 2014, so in several cases the "old system" is what we still currently have.) In the old system, if you had health insurance, and if you were given care, it could be good and even excellent. But the old system was unsustainable, and for all its cost, had major gaps. Under the old system, about 46 million Americans, or roughly 1 in 6, did not have health insurance. Other Americans with health insurance could be denied essential care. Currently, every year, many Americans die from lack of health care. Exact numbers are elusive, but studies estimate that number as anywhere from 22,000 to 45,000 deaths per year. (See the Remote Area Medical Care story for how dire it's been.) Reform should provide health care for those who don't have it now, and will actually save money in the long run – in theory, the new law will cover 95% of the population and cut the deficit by 1.3 trillion over 20 years. We'll see how it all actually plays out, but that sounds like a big improvement.

World Health Studies

There are a few different world health studies, but one of the more user-friendly I've found comes from the Organisation for Economic Co-Operation and Development (OECD). Their Health Data page has a publications tab that lists their most recent major report, "OECD Health Data 2009: Statistics and Indicators for 30 Countries." You can view web versions of its charts or download PDF versions here. Most of the charts link Excel sheets which provide further data.

The most staggering statistic is probably health expenditure per capita:

(Click for a larger view.)

The United States' cost is a staggering $7,290 per capita, while the next most expensive, Norway, is $4,763, and they cover everybody. France is at $3,601 and Britain is at $2,992, even though they cover everybody and their overall care is typically rated better than that in the United States.

Next up, here's health expenditure in relation to GDP:

(Click for a larger view.)

The United States spends 16% of its Gross Domestic Product on health care, and the OECD puts the number at 19.5% for "actual final consumption." The next closest country is France, at 11% of GDP, and again, it covers everybody and is consistently ranked near the very top for overall health care.

Here's a chart on coverage (the old system):

(Click for a larger view.)

The United States hasn't stacked up well in life expectancy, either:

(Click for a larger view.)

There are many other charts to peruse. The United States does fairly well with cancer. Some forms of cancer are much more treatable now, and it doesn't hurt that, in America, there's been a overall decline in smoking and thus lung cancer (the most common cancer worldwide). The United States doesn't measure up too well in heart disease and stroke, though, or infant mortality. We'll see how these statistics change in the coming decades.

The World Health Organization of the United Nations also puts out useful reports, their most recent major one being The World Health Report 2008. Their World Health Statistics 2009 has some more recent data. The site compiles other data, which can be searched, sorted and exported (you can make your own Excel charts). The focus of the health report has varied over the years. Their World Health Report 2000 focused more on comparative health care systems:

The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan...

The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18th. Several small countries – San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy.

The World Health Organization's reports focus a great deal on malaria, tuberculosis and diarrhoeal diseases (cholera, dysentery, typhoid, contaminated food and water) that tend to be less prevalent in the United States. But for those interested in statistics and learning more about health issues around the world, it's a good place to look. As for health care in the United States, we'll see how much it can improve its standings in coming years.

Sick Around the World

I've been reading T.R. Reid's 2009 book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, which is a well-written, fairly short survey of the major health care models around the world. Reid asks about treatment for his stiff shoulder, and looks at costs to patients and the benefits of each system. He also asks about flaws in each system and examines their cost controls.

Reid's book grew from an excellent 2008 Frontline episode, "Sick Around the World." You can watch it online. If your time is limited, it may be the best single introduction to how other countries approach health care and how the United States stacks up in comparison. The site also offers several helpful links. Here are the four basic models used around the world, a Q&A with Reid, and a Washington Post discussion with Reid (all from 2008). He also discussed his book on Fresh Air and C-Span. A 2009 article he wrote, "5 Myths About Health Care Around the World," covers many of the basics.

As Reid writes in his book, many of these other systems will be familiar to Americans already. The four main models are the Beveridge Model (Great Britain, Scandinavia, Cuba), the Bismark Model (Germany, France, Japan, Switzerland), the National Health Insurance Model (Canada, Taiwan) and Out-of-Pocket (rural areas of Africa, India, China and South America). Reid explains these in more depth in his book, but as he points out, they should all be somewhat familiar to Americans:

These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we're Britain or Cuba. For Americans over the age of 65 on Medicare, we're Canada. For working Americans who get insurance on the job, we're Germany.

For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.

The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it's fairer and cheaper, too.

Sick Around America

Frontline also did a 2009 episode, "Sick Around America," but it's a mixed bag and disappointing in some major respects. It does a good job of documenting health care insurance woes, but does a poor and even deceptive job on solutions. It features many health insurance executives and lobbyists, which wouldn't necessarily be bad, but there's little to no skeptical, critical treatment of their claims. Basic, core issues raised in "Sick Around the World" are ignored. Reid was also involved in "Sick Around America." However, as Counterpunch reported:

But even though Reid did the reporting for the film, he was cut out of the film when it aired this week.

And the film didn't present Reid's bottom line for health care reform – don't let health insurance companies profit from selling basic health insurance.

They can sell for-profit insurance for extras – breast enlargements, botox, hair transplants.

But not for the basic health needs of the American people.

Instead, the film that aired Monday pushed the view that Americans be required to purchase health insurance from for-profit companies.

And the film had a deceptive segment that totally got wrong the lesson of Reid's previous documentary – Sick Around the World...

The Counterpunch piece next quotes claims from "Sick Around America" featuring insurance lobbyist Karen Ignagni, who favors a mandate for citizens to buy health insurance, but leaves something crucial out from her claims:

Other countries do not require citizens buy health insurance from for-profit health insurance companies – the kind that Karen Ignagni represents.

In some countries like Germany and Japan, citizens are required to buy health insurance, but from non-profit, heavily regulated insurance companies.

And other countries, like the UK and Canada, don't require citizens to buy insurance. Instead, citizens are covered as a birthright – by a single government payer in Canada, or by a national health system in the UK.

The producers of the Frontline piece had a point of view – they wanted to keep the for-profit health insurance companies in the game.

TR Reid wants them out.

Reid also said that “I don't think they deliberately got it wrong, but they got it wrong.” Frontline has contested that Reid played a big role in "Sick Around America." Regardless, I can't see how someone could see "Sick Around the World," let alone help make it, and then ignore its central finding in the companion piece: For-profit insurance companies should not be in charge of basic, essential care.

For-profit health insurance companies are parasitic, providing no actual health care, which is provided by doctors. Insurance is merely a payment mechanism, and the industry is responsible for much (but not all) of the colossal waste in the American system. Most American politicians view eliminating private health insurance entirely and moving to a single payer system as too radical and impractical. That's why health care reform took the shape it did. The new law leaves for-profit health insurance companies in place, and doesn't regulate them as strongly as other countries do. However, in theory the new law will curb price-gouging somewhat, and end rescission and other abusive practices by health insurance companies. Future fixes to health care could push this dynamic further, as needed. Health insurance companies could continue to exist, but could operate more like they do in Germany, France and Switzerland.

Administrative costs for government, not-for-profit program Medicare are normally estimated at 2-3% (although it may slightly higher). In comparison, the costs of private, for-profit insurance for administration, advertising and profit run at 12% on average, can be pushed as low as 7%, yet can run as high as 26% or even 30% (risk pool size is a major factor). The executive compensation at large insurance companies is staggering – and many industry practices are appalling. As DDay chronicled this past October,

Anthem Health Plans of Maine, a subsidiary of WellPoint, is suing the state because they want to increase premium rates by 18.5% on their 12,000 individual insurance policy holders, so they can guarantee themselves a 3% profit margin...

Like many other states, Anthem Health Plans hold a monopoly on the individual insurance market in Maine, controlling 79% of all the plans. Also like many other states, they are licensed to sell insurance through the Department of Insurance, who must clear all rate increases prior to implementation. Originally, Anthem Health Plans were a nonprofit Blue Cross and Blue Shield corporation licensed to practice in Maine since 1939. In 1999, Anthem bought the business and began to operate it as a for-profit company. Since that point, Anthem has raised premium rates 10 times, and 8 of those times have been double-digit rate increases...

The average individual Maine rate-payer is paying four times as much for insurance than they did ten years ago.

But this isn't good enough for Anthem Health Plans...

The details get even uglier. WellPoint is the same company being investigated by Congress after it announced in February that it would raise premiums on some California customers by a whopping 39%. It's not the only company doing this sort of thing, either. The new law may help, but it would be wonderful to end these sort of abuses altogether.

Many of the problems in the old system – and the new system going forward – are simply unnecessary. In Sick Around America, Part 5, roughly 49 minutes in, "Healthcare Industry Consultant" Robert Laszewski says:

We have 2.2 trillion dollar health care system full of vested interests, stakeholders, and lobbyists, and I have yet to meet a doctor who thinks he should take less. Every doctor I meet thinks he's underpaid. I have yet to meet a hospital executive who thinks he can operate, he or she can operate, on less. I have yet to meet a patient who is willing to sacrifice care. Every patient I've ever met in the United States equates quality care with access to whatever they want. I haven't met anybody that's willing to take less. And until we have that conversation, we're just sort of nibbling around the edges.

Laszewski has a point, but given that other countries do much better at much lower cost, his implied suggestion about sacrifice ignores a great deal. The 'hard truths' aren't primarily about doctors or patients accepting less. The hard truths involve not defending a broken system rife with unnecessary waste and inefficiency. Let's take Laszewski's examples one at a time.

Doctors in the United States are paid much better than most doctors around the world. However, in the countries Reid examines, doctors are still generally well paid if not as exorbitantly, and the position still carries great status (and sometimes other perks). These foreign doctors spend a minimum of time on paperwork and billing, whereas American doctors face a crushing load on that front. The foreign doctors carry malpractice insurance, but most pay in a year what American doctors pay in a single month – and the foreign doctors are rarely sued. Many other nations also pay for medical educations at least partially, in contrast to the high debt American medical students incur. One idea suggested for the U.S. is to invest more money into medical students' educations, in return for stints at public hospitals or working as general practitioners. These and other reforms would ease burdens on doctors, allowing them to spend more time actually practicing their profession. Many of them would find that appealing.

Many of these factors apply to running a hospital, too. Providing basic care for the entire populace would also mean far fewer costs incurred by people using emergency care for routine treatment. Standardizing medical forms and using electronic records would cut many costs across the nation. Meanwhile, elimination (or tight regulation) of for-profit insurance companies would massively cut administrative costs for hospitals, because they would have much less paperwork and wouldn't have to fight for reimbursement as much (if at all).

As for the claim "Every patient I've ever met in the United States equates quality care with access to whatever they want," I seriously doubt that's true – or it dodges the point with the term "quality care." Laszewsk's hypothetical patient is one with money and/or health insurance. People who lack any health care now would be thrilled to get basic, essential care. As for those who currently have health insurance, when they're sick, most patients simply want to get better, not necessarily to run a series of extra tests or a specific one. Patients generally trust their doctors and their recommendations. One solution is to have basic care completely covered, and if patients want something more exotic, they can pay out of pocket or with supplemental insurance, as is currently the case under many plans in the U.S. (and also France and other nations). As Reid shows, there are several successful models around the world, and while all have their drawbacks as well, it would be foolish not to study them for ideas.

T.R. Reid isn't the only good health care reporter out there, of course, nor is he flawless. Bob Somerby has criticized Reid and other reporters for not clearly explaining how wasteful the American system is. I agree that coverage should emphasize the key statistics, because they're essential to understand. It's harder for a politician to oppose any sort of health care reform when the public knows that other countries get good or better results, with a massively lower price tag: France at $3,601 per capita and Britain at $2,992, compared to the United States at a staggering $7,290. (We'll see if that number goes down, and by how much.)

However, I also think Reid does a splendid job overall. "Sick Around the World" consistently shows that there are better, cheaper and less wasteful ways to deliver health care. If we had politicians whose primary goal was to improve the system, they'd do want Taiwan does in the show: examine the major countries of the world, see what works best, and adapt that for America.

Saturday, April 10, 2010

Bet Against the American Dream

Ever hear about a company named Magnetar? No? ProPublica has a good piece on their role in the financial collapse:

...A few savvy financial engineers at a suburban Chicago hedge fund helped revive the Wall Street money machine, spawning billions of dollars of securities ultimately backed by home mortgages.

When the crash came, nearly all of these securities became worthless, a loss of an estimated $40 billion paid by investors, the investment banks who helped bring them into the world, and, eventually, American taxpayers.

Yet the hedge fund, named Magnetar for the super-magnetic field created by the last moments of a dying star, earned outsized returns in the year the financial crisis began.

How Magnetar pulled this off is one of the untold stories of the meltdown...

Read the rest (via). Felix Salmon has more.

What Magnetar did was legal at the time. But there will always be greedy people who don't mind screwing over others, or their own entire country, or the entire world, for short-term personal profit. It's folly – or irresponsibility, or further greed and corruption - not to address this. Our financial system still allows and even encourages a sort of reckless, sociopathic, narcissistic, nihilistic greed. It's not that nobody knew that this mindset was extremely dangerous, but the folks running the show wanted the party to continue. And the global economy tanked as a result. It's the same greed, vanity, corruption, narcissism and recklessness that's interfering with efforts to prevent another collapse and other acts of financial destruction.

This weekend's This American Life episode "Inside Job" covers ProPublica's work. They also commissioned this nifty little song:

Bet Against the American Dream from Alexander Hotz on Vimeo.


Thursday, April 08, 2010

Wednesday, April 07, 2010

Hot for Teachers

This one was passed on by a friend of mine - it was shot, directed and produced by the parents and kids at her son's school here in the Los Angeles area. (That's the real principal at the start.) You can see the full credits if you click the tab here.

As Robert Cruickshank notes at Calitics:

What the video shows, once again, is that Californians do not support Arnold Schwarzenegger or his budget cuts. They just don't. The polls that have been done so far indicate that the public prefers higher taxes to cutting K-12 budgets, and while nobody seems to have asked "do you support the $17 billion in education cuts made since 2008?" such a poll would likely find widespread public opposition and outrage. There's a reason Arnold's disapproval rating is at a record level of over 70%.

David Dayen has a few more California stories.

In California, two-thirds of the legislature is needed to raise taxes, and a zealous minority won't, regardless of the circumstances. Meanwhile, many in the same crowd are always eager to cut education, the arts and social services. I heard from another friend about cuts at UCLA, and people who'd worked there for 30 years being let go. It's horrible. Ask any police chief about the value of after-school programs, and how they're much cheaper than prisons. Ask the experts on the value of a good education on brain development, life skills, earning potential, citizenship and creativity. The K-12 years are the most important, but Californians used to take a great deal of justifiable pride in the state university system. These cuts will cost California a great deal in the future.

The Republican candidates for governor are running non-stop TV ads decrying "liberal failure" in Sacramento. While California Democrats certainly have their faults, California is basically Reaganomics in action – deficit spending and decreased taxes on the wealthy. Everyone tightening their belts would be one thing, but for the most part, it's those who can least afford it that are getting hit the hardest.

Here's the Say No to Cuts petition.


Sunday, April 04, 2010

Theocracy is Authoritarian

(It's the weekend for another Blog Against Theocracy blogswarm. Blue Gal has more information. The twitter category is here. Here are my previous entries for Blog Against Theocracy and religion.)

As First Freedom First points out, Freedom of Religion means "the freedom to worship – or not." The essence of theocracy isn't religion per se; it is power over others and authoritarian rule. In America, people are free to practice religion as they choose, but their religion does not allow them to break the law, nor may they impose their religious beliefs on others through the government. Those opposed to theocracy include both religious and non-religious people. They are united by their recognition of the theocrats' dangerous goal - using the government to acquire power and privilege based on religious beliefs (specifically, theirs).

Normally I've discussed religion in more general terms for the Blog Against Theocracy. However, thinking of theocracy and authoritarianism this year, I couldn't help but think of all the recent news about the Catholic Church – and some of the more noxious apologists for it. Nearly every problem of theocracy can be illustrated by looking at news this past year about the Catholic Church as an institution. Some of these issues are not unique to the Catholic Church, and I'm merely using it as an example. In other cases, the problems are more particular to the Catholic Church specifically, even if they illustrate the greater perils of theocracy. I'm thinking about the office of faith-based initiatives, religious organizations lobbying Congress, religious organizations setting public policy, and religious figures punishing political figures for disobedience. I'm also thinking of the widespread, long-standing sexual and physical abuse of children, the cover-up of that, and the infuriating apologists for that. Almost everything centers on sex and power, and the domination of women and children.

Obviously there are good people who identify as Catholic. There are Catholic churches that do valuable work for their communities. There are Catholic charities that likewise do useful work around the world. Bill Donohue and Ross Douthat, among others, probably don't speak for the majority of American Catholics. Nor does the Pope speak for most American Catholics, at least on some issues – for several decades, roughly 80% of American Catholics have favored the use of birth control (Catholics for Choice puts the number far higher). There are Catholics who have criticized some or all of the actions and abuses I'll be discussing.

However, all this still leaves us with the institution that is the Catholic Church. Just as I'd love it if conscientious, "reasonable" Eisenhower Republicans (those few that are left) took over the Republican Party, I'd love it if those more conscientious, practical Catholics took over the Catholic Church. The problem is, the Catholic Church is by its nature extremely hierarchical and authoritarian. Catholics can send messages to their bishops or the Vatican, but they don't get to elect their pope, who is supposedly infallible and God's emissary on Earth. There is a firm power structure in place, and it's extremely unlikely that will ever change. Even if papal infallibility and other matters of church dogma are sometimes debated internally, the fact remains that the pope or others of high rank issue orders to those below and expect obedience. The Catholic Church is not a democratic institution; it is an authoritarian one. It can do some good when well led, but is prone to the abuses encouraged by authoritarianism and unaccountable power.

Americans United for Separation of Church and State has a whole section on the Office of Faith-Based Initiatives, started under Bush and unfortunately further funded by Obama. The big issue is that the Office gives money to religious organizations who violate federal discrimination laws in hiring, most often by only hiring members of their religion, or by banning homosexuals. Additionally, some religious charities proselytize and seek to convert others to their religion. As private entities they're entitled to keep doing both these things, but shouldn't be given taxpayer money to do so; it's unconstitutional. In contrast, Habitat for Humanity is a Christian organization that does public charity building homes, and has long been given government money because (to my knowledge) it's avoided crossing either of those lines.

In Washington, D.C., gay marriage was legalized. As a result, the organization Catholic Charities decided to drop spousal benefits for its employees so it wouldn't have to give benefits to gay couples. Otherwise, Catholic Charities would have run afoul of anti-discrimination laws, because they receive "$22 million from the city for social service programs." They had previously transferred their foster care program to another organization, presumably because gay couples would have been eligible to participate. But if these are essential social services, why give $22 million in funds to a religious charity in the first place? Why not expand the public systems for these services instead, and avoid these theocracy issues altogether? Similarly, why grant government funds to a proselytizing religious group to run a homeless shelter when secular organizations are also available?

On the lobbying front, we've previously covered how some Catholic organizations opposed health care reform while others supported it. However, there's the question of their tax status, and that applies to other religious organizations as well. Individual can of course speak out, and organizations can as well – but this becomes more problematic if they are tax-exempt. (The big no-no is endorsement or opposition of a specific candidate.) Religious organizations can do some limiting lobbying. I'm not an expert on tax exemptions and lobbying restrictions, so I don't know about the precise legal lines on lobbying by the U.S. Conference of Catholic Bishops and other organizations on health care reform. However, it is troubling if members of Congress are effectively giving veto power over legislation to a religious organization (or any organization, for that matter). That flies in the face of John Kennedy's famous speech on his religion and the importance of the separation of church and state. America is not a theocracy. Effective government should respond to all constituents, but represent the public interest – which is not necessarily the same as those of any specific religious organization.

Catholic officials have been most vocal about opposing and punishing abortion. Ironically enough, it was Kennedy family member Patrick Kennedy who Roman Catholic Bishop Thomas Tobin banned from receiving communion. This was because, as one account puts it, "Kennedy criticized the nation's Catholic bishops for threatening to oppose an overhaul of the nation's health care system unless lawmakers included tighter restrictions on abortion." Chris Matthews, also a Catholic, had Tobin on, and quoted John Kennedy's speech to him. Watch it for yourself - but Tobin truly doesn't seem to understand Matthews' point that Tobin was violating the principles expressed by JFK. Tobin's action was theocratic, and it'd be naïve to think he has no influence on Catholics in his diocese. John Kerry ran into similar issues during his presidential run, being denied communion because he is pro-choice. Again, it would be naïve to think this had no effect on Catholic voters – or that such an edict wasn't designed to influence them.

The Church's opposition isn't solely to abortion – it's to any form of reproduction control other than abstinence. A bishop barred an Oregon hospital from calling itself "Catholic" anymore because it performed tubal ligations on women. For years, the Catholic Church has inexcusably lied about condoms preventing the spread of STDs, including AIDS. Sometimes the children of disobedient Catholics are punished as well. Mary Ann Sorrentino writes that she was excommunicated because she worked with Planned Parenthood, but the Church threatened to deny her daughter's confirmation as well. Sorrentino claims she replied:

"Let me understand this, Father. Because of my work with women at Planned Parenthood, you don't want me to come to the rail and take communion from the hands of a man who sexually abuses children? Is that what you're telling me, Father?"

Meanwhile, in one of the more infamous recent cases, in Brazil the Catholic Church excommunicated the doctor who performed an abortion on a 9-year old rape victim. The mother and the rest of the medical team were excommunicated, too. At least one bishop has since questioned this action. However, if your morality leads you to harshly condemn the people helping an abused child, it's time to re-examine your morality.

It's the children that have suffered the most, from an institution that has systematically raped and tortured children, and then systematically covered it up. Newly revealed incidents of abuse, and the news that the current pope may have known about some of these abuses, reveal an even deeper level of corruption than was previously known. The Catholic Church denies that Ratzinger knew, but there have been so many allegations of sexual abuse in Germany this strains credulity, and at best it shows a horribly dysfunctional system. However, questions are not limited to the current pope; Raw Story reports on the Vatican knowing about widespread sexual abuse of children by at least 1963. Rather than tending to the children, the victims, church officials sought to protect the priests involved and protect the institution. Guilty priests have generally not gone to jail.

After such revelations, it's rather bad form to compare outrage toward the Catholic Church to the persecution of the Jews (as a senior Vatican spokesman did) or to claim that the Pope faced 'some of the same unjust accusations once faced by Jesus' (as Archbishop of New York Timothy Dolan did). As John Cole remarks, "Can someone show me in the bible where Jesus was unjustly accused of covering up systematic pedophilia?"

Bullying blowhard Bill Donohue of the Catholic League claimed molesting priests weren’t pedophiles because most boys were post-pubescent. (Yeah, he really did.) If this is your best argument, you're in serious trouble. Donohue then doubled down on this claim, and ran an ad in the New York Times claiming Catholics were being persecuted. Michael Tomasky (among others) pointed out the biggest flaw in Donohue's argument – it was still illegal, and still wrong. This scandal belongs to the Catholic Church, not the gay community. (Update: Pharyngula also posted on Donohue.)

Meanwhile, Ross Douthat's column "A Time for Contrition" received plenty of just criticism, particularly for the first two of these paragraphs:

This hasn’t prevented both sides in the Catholic culture war from claiming that the scandal vindicates their respective vision of the church. Liberal Catholics, echoed by the secular press, insist that the whole problem can be traced to clerical celibacy. Conservatives blame the moral relativism that swept the church in the upheavals of the 1970s, when the worst abuses and cover-ups took place.

In reality, the scandal implicates left and right alike. The permissive sexual culture that prevailed everywhere, seminaries included, during the silly season of the ’70s deserves a share of the blame, as does that era’s overemphasis on therapy. (Again and again, bishops relied on psychiatrists rather than common sense in deciding how to handle abusive clerics.) But it was the church’s conservative instincts — the insistence on institutional loyalty, obedience and the absolute authority of clerics — that allowed the abuse to spread unpunished.

What’s more, it was a conservative hierarchy’s bunker mentality that prevented the Vatican from reckoning with the scandal. In a characteristic moment in 2002, a prominent cardinal told a Spanish audience that “I am personally convinced that the constant presence in the press of the sins of Catholic priests, especially in the United States, is a planned campaign ... to discredit the church.”

Douthat is a Catholic, and the third quoted paragraph makes a decent point. He does criticize the Catholic Church at other points in the op-ed. However, this doesn't excuse his attempts to spread the blame. He loves playing the mushy argument and false equivalency games, but these charges are just infuriatingly dishonest or dim-witted – not to mention whiny. Yes, the Catholic Church's well-known hang-ups about sex, including celibacy for priests, probably did contribute to some of the problems - because the priesthood has been more likely to attract people with unresolved sexual issues. However, the real problem isn't celibacy; it's (duh) that Catholic priests raped and tortured children, and rather than turning those priests in to the police, the Catholic Church covered it up. This is not a mystery that passeth all understanding, or a series of crimes that can only be seen through a glass darkly.

Meanwhile, blaming "moral relativism" is pathetic and laughable. Is Douthat seriously arguing that the Catholic Church was sexually permissive in the 1970s? Even if that preposterous claim were true, what about the many cases of sexual abuse that occurred before and since? What about the Toledo police colluding with the Catholic Church to cover up sexual abuse in the 1950s? Douthat tries to shill two false notions here – that the media have been incorrect, and that any conservatives blaming culture have a point. (Apparently, they're blaming the culture of several countries, too, since it wasn't just in America.)

No, the scandal in no way "implicates left and right alike." If ever proof was needed Douthat was a hack, this is it. The scandal implicates Catholic priests who abused children, and the Catholic officials who covered it up. This isn't hard. Even Catholic doctrine holds that human beings are free to choose between sin and virtue. The demon rock 'n' roll did not drive them to molest children. While I'm sure there are Catholics who wish Douthat was not representing their faith, his arguments are poor, ass-covering, unconnected with reality and unconscionable. It's outrageous that he tries to lay the blame on anybody else but the perpetrators. Yeah, he bemoans what the church has done, but in his ridiculous arguments he also becomes a disingenuous, whiny, apologist scumbag for horrible abuses. He ends his column talking about "repentance," and maybe Douthat can repent for bearing false witness against his neighbors.

Other responses to Douthat include Truth Wins Out, TBogg, Sadly No and Susan of Texas. (Update: I forgot Non Sequitur.) The thing is, Donohue and Douthat actually think they're helping the Catholic Church. There are responsible, honest ways for Catholics to respond to these newly-reported scandals – but Donohue and Douthat's infuriating, blame-shifting responses just make things worse.

Plenty more needs to be uncovered. But keeping with the theme of the weekend, the Catholic Church can be viewed as a theocracy, because the Vatican City is technically a nation. The Catholic Church is also extremely hierarchical and authoritarian. It has abused power and covered up those abuses, as is the nature of authoritarian groups. Of course non-religious groups can abuse power as well. But the essence of authoritarianism is obedience to those in power, and the enforcement of dogma – which inevitably extols the righteousness of the group, and particularly its leaders. Organized religion fits in very easily with those dynamics, and gives an even greater dose of righteousness to the whole endeavor. We don't have to imagine the dangers of theocracy and authoritarianism in America. We can study history, or we can just read the news.

Again, there are plenty of individual Catholics who are good people, and worthy of respect. I hope they can reform their church, to the degree that it's possible. However, maybe they'd be better off starting their own. And given recent (and past) revelations, if anyone church-shopping decides to forego the Catholic Church, it would be hard to blame him or her. Meanwhile, I really have no patience for the Donohues, Douthats and high-ranking Catholic officials of the world complaining their church is being unfairly criticized. This one's pretty easy - stop the systematic rape and torture of children, expose the truth, and punish the guilty – and then you won't be criticized. Taking ownership is a step in the right direction; trying to blame others is maddening and unconscionable. There can be no forgiveness without confession and repentance, correct?

For more, check out Richard Dawkins on the Pope, Katha Pollitt, Ed Brayton, The Daily Show, John Amato, DougJ at Balloon Juice, Amanda Marcotte and a personal response to the scandal. DeDanaan has posts on the Pope's cover-up of the priest who molested about 200 boys, as well as Christopher Hitchens and Sinead O'Connor.

Finally, from the public debate "Is the Catholic Church a Force for Good in the World?" I thought Stephen Fry was easily the most persuasive speaker:

The Intelligence² Debate - Stephen Fry (Unedited)
Uploaded by Xrunner17. - Classic TV and last night's shows, online.

(Added the pic and fixed some typos.)

Easter 2010

skippy reminded me of this one (slightly NSFW):

Thursday, April 01, 2010

Tom Lehrer - "The Elements"

A little fun foolishness for the First of April...

Eclectic Jukebox

Fool's Day 2010

Happy Fool's Day! As usual, the Guardian has a good roundup of gags, although my favorite may be this one:

London Underground is in talks with the European Organisation for Nuclear Research (Cern) about the possibility of using the 23km tunnel of the Circle Line to house a new type of particle accelerator similar to the Large Hadron Collider in Geneva.

Inverse Square posted a wry video on "New Frontiers in Computer Security," and I may update this post with some other gags.

In the meantime, here's Robin Williams and George Carlin on golf - definitely NSFW: