Later On

A blog written for those whose interests more or less match mine.

Archive for July 29th, 2007

“Compassionate Conservatism” in re: children’s healthcare

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Krugman:

When a child is enrolled in the State Children’s Health Insurance Program (Schip), the positive results can be dramatic. For example, after asthmatic children are enrolled in Schip, the frequency of their attacks declines on average by 60 percent, and their likelihood of being hospitalized for the condition declines more than 70 percent.

Regular care, in other words, makes a big difference. That’s why Congressional Democrats, with support from many Republicans, are trying to expand Schip, which already provides essential medical care to millions of children, to cover millions of additional children who would otherwise lack health insurance.

But President Bush says that access to care is no problem — “After all, you just go to an emergency room” — and, with the support of the Republican Congressional leadership, he’s declared that he’ll veto any Schip expansion on “philosophical” grounds.

It must be about philosophy, because it surely isn’t about cost. One of the plans Mr. Bush opposes, the one approved by an overwhelming bipartisan majority in the Senate Finance Committee, would cost less over the next five years than we’ll spend in Iraq in the next four months. And it would be fully paid for by an increase in tobacco taxes.

The House plan, which would cover more children, is more expensive, but it offsets Schip costs by reducing subsidies to Medicare Advantage — a privatization scheme that pays insurance companies to provide coverage, and costs taxpayers 12 percent more per beneficiary than traditional Medicare.

Strange to say, however, the administration, although determined to prevent any expansion of children’s health care, is also dead set against any cut in Medicare Advantage payments.

So what kind of philosophy says that it’s O.K. to subsidize insurance companies, but not to provide health care to children?

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Written by LeisureGuy

29 July 2007 at 10:07 pm

Good mystery: The Grenadillo Box

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The Grenadillo Box is Janet Gleeson’s first novel, and it’s quite enjoyable. Set in mid-18th Century England, with a journeyman working in Thomas Chippendale’s shop as the protagonist, it bounces along quite well. I read it because her second novel is just recently out, and I like to begin at the beginning.

Written by LeisureGuy

29 July 2007 at 9:18 pm

Posted in Books

Maybe the problem is how US doctors are paid

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From the NY Times:

…  The way that doctors are paid may be an even more significant factor driving up costs and may lead to unnecessary care, said Dr. Peter B. Bach, a pulmonary physician at Memorial Sloan-Kettering Cancer Center and a former senior adviser to Medicare and Medicaid.

In the United States, nearly all doctors are paid piecemeal, for each test or procedure they perform, rather than a flat salary. As a result, physicians have financial incentives to perform procedures that further drive up overall health care spending.

Doctors are paid little for routine examinations and very little for “cognitive services,” such as researching different treatment options or offering advice to help patients get better without treatment.

“I don’t have a view on whether doctors take home too much money or not enough money,” Dr. Bach said. “The problem is the way they earn their money. They have to do stuff. They have to do procedures.”

Primary care doctors and pediatricians, who rarely perform complex procedures, make less than specialists. They are attracting a declining percentage of medical students, and some states are facing a shortage of primary care doctors.

Doctors are also paid whether the procedures they perform go well or badly, Dr. Bach said, and whether they are crucial to a patient’s health or not..

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Written by LeisureGuy

29 July 2007 at 6:28 pm

Posted in Business, Health, Medical

Building implosion

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Quick wrecking crew. The Landmark Tower (AKA Continental National Bank Building) was built between 1952 -1957 and stood 380-foot tall or 30-stories. At the time of this implosion (18 March 2006) the Landmark Tower was the second tallest building ever imploded. Via  Nicholas Maunder.

Written by LeisureGuy

29 July 2007 at 6:20 pm

Posted in Business, Daily life

White House for sale

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From the Watchdog Blog:

Welcome to White House for Sale 2008!

This new and revitalized destination site gives you the scoop on big bundlers who are powering today’s billion-dollar race to the White House.  Bundlers have enormous influence in determining election winners because they funnel huge sums from other people to candidates.  Candidates, for their part, often bestow cutesy titles on them (remember Bush’s “Rangers” and “Pioneers”?) and reward them with access and plum government positions if they win.

In the 2004 presidential campaign, more than 60 of Bush’s big bundlers were federal lobbyists, including disgraced lobbyist Jack Abramoff, whose influence-peddling scandal laid down breadcrumbs into several congressional offices as well as the Interior Department and landed Abramoff in prison.  Bush’s bundlers back in 2000 included former Enron CEO Ken Lay, who was subsequently allowed to help choose two of the five regulators charged with overseeing energy companies.  We all remember what happened there.

We think it’s long past time for the “For Sale” sign on the White House lawn to come down and stay down.  So, we are at it again for the 2008 campaign.  This time, the task is more challenging because most of the major candidates are opting out of public financing and being showered with cash collected by bundlers.

The current crop of White House hopefuls is actually worse than the very minimal disclosure standards set by Bush, Dean and Kerry.  In 2004, those candidates made bundlers’ names readily accessible and provided at least some insight into how much money bundlers raised.  So far in this election, only one 2008 candidate (Barack Obama) is disclosing anything about how much his bundlers are raising.

We don’t plan on letting that slide.  We are going continue to demand disclosure by bird-dogging the candidates and relentlessly pursuing better disclosure of the big donors.

The new and improved White House for Sale features a blog, a handful of RSS feeds and a place for video clips of your best bird-dogging.  You’ll find the most up-to-date information there is on bundlers and the money race.  Our RSS feature can send you updates whenever new bundlers are added to the candidates’ rosters.  Our blog provides space for an online conversation about money in presidential politics.  We will also roll out handy fact sheets – starting with a concise summary of candidates’ disclosure practices and a scorecard [pdf] showing which bundlers from past elections are busy bundling this time around.

Transparency is important, but the ultimate solution to the money in politics problem is to modernize the presidential public financing system so that ideas, character and leadership – and not merely dollars – can once again decide who wins the White House. Between 1976 and 1996, every winning presidential candidate participated in the public funding system, and the “money primary” was a far less decisive factor in our presidential campaigns. But that system was made virtually obsolete in 2000, when Bush showed a candidate could opt out and raise far more money than those who stayed in would be allowed to spend. A must-pass bi-partisan bill in Congress, the Presidential Public Funding Act of 2007 [pdf], would make public funding viable again.

Please look around the new Web site, let us know what you think, and come back often for the latest on who is bundling the candidates now – and which contenders are still covering up the sources of their campaign cash.

UPDATE: Listen to the press conference for White House for Sale [mp3].

Written by LeisureGuy

29 July 2007 at 4:16 pm

Posted in Election, Government

The center of Centaurus A

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Take a look. Beautiful.

Written by LeisureGuy

29 July 2007 at 11:57 am

Posted in Science

Fallows on email

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The invaluable James Fallows has some good observations on email:

Three years ago in the Atlantic, i wrote about the productivity expert David Allen, who offers both a high-road philosophy and a lot of nitty-gritty tips for “getting things done.”

One of the latter is Allen’s “two minute rule”: if a task comes up that you think you’re ever going to do (write a thank-you note, look up a reference, make a call), and if doing it will take less than two minutes, then you should always do it now. The rationale is that keeping track of it to do it later would take much more time than those initial two minutes, and delaying it will cause you mental friction in the meantime. If it’s more than a two-minute task, then it’s worth treating it as part of a longer-term system (which Allen also lays out) for keeping track of what to do when.

No kidding, Allen’s book Getting Things Done is very much worth the money it costs to buy and the time it takes to read.

Now another useful-gimmick in the same vein: a way not to go crazy in dealing with email. The policy ls laid out here (and I learned about it here). Like the two-minute rule, it probably is impossible to observe in all circumstances all the time. And applying the hard-core version of this productivity strategy, laid out here, would probably make people think you are crazy. But the general idea makes good sense.

Written by LeisureGuy

29 July 2007 at 11:23 am

Posted in Business, Daily life

Wonderful gifts

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One way to Leisureguy’s heart is to send him gifts. 🙂 A person in Ireland just sent me:

Patum

Patum Peperium: “A spiced anchovy relish that can be used to flavor food or spread on crackers or bread: delicious on hot toast with butter. A must for those who like it strong and spicy!” (And that’s Leisureguy to a T.)

J&E Atkinson I Coloniali shaving soap with mango oil (!), which comes in a wonderful little terra cotta pot. I made a lather as soon as I got it, and it smells divine. I’ll be using it in the Tuesday shave. Tune in for a full report.

Chocolates: quickly consumed because they were tiramisu truffles and I feared they would spoil.

Written by LeisureGuy

29 July 2007 at 11:19 am

Posted in Daily life, Food, Shaving

More on the pliability of the Mainstream Media

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In the comments to this post, I tried to explain what the problem is with the Beltway Media Elite, aka the Mainstream Media. And this morning as part of his column on how the NY Times is credulously passing along Administration handouts, Glenn Greenwald comments on the same problem:

What we have here, yet again, is the administration completely manipulating the NYT by selectively leaking previously “super-top-secret” information when doing so helps them politically. This, as always, is followed by the newspaper — desperate for “scoops” — outrageously granting anonymity to administration officials to do nothing other than disseminate pro-government propaganda, and turning its front pages over to the administration’s claims with very little critical analysis or real scrutiny.

It is obviously “news” that the administration was data mining and that this prompted strenuous objections, or at least it is news that anonymous administration officials claim this was so. So there is nothing objectionable per se about reporting this (though, given that these are plainly pro-administration leaks, it is inexcusable to grant them anonymity).

But, and this is the critical point, the leaked report, for so many reasons — see above — not begin to exonerate Alberto Gonzales or prove that he told the truth. Yet there is the NYT dutifully claiming that this leak “helps to clarify the clash this week between Attorney General Alberto R. Gonzales and senators who accused him of misleading Congress and called for a perjury investigation,” while the Post proclaims that “the report of a data mining component to the dispute suggests that Gonzales’s testimony could be correct.”

According to the administration, these are spying activities that ceased three years ago. According to the Bush DOJ’s emphatic conclusion, these spying activities were patently illegal — so illegal that they all threatened to resign if they continued. Putting those two premises together, why is it that we do not know what these activities are? What possible excuse exists now for continuing to keep them concealed? Now that the administration has leaked its own allegedly defunct and illegal program, there should a full airing of what they were doing that prompted the DOJ mutiny.

UPDATE: Here is a snapshot of the United States from 2000-present. The Bush administration whispers something to “journalists.” They repeat it uncritically on their front page. Other “journalists” read it. They believe it uncritically and then repeat it. With nothing else required, it becomes “fact” (that is the Jessica Lynch and Pat Tillman and Iraqi WMD Process, repeated over and over and over).

Hence, Time‘s Karen Tumulty this morning recites the storyline of the NYT and pronounces:

This distinction — one that Senators have not generally made when discussing the two programs —probably means that Gonzales did not commit perjury in last week’s testimony before the Senate Judiciary Committee.

And presto, just like that — from the administration’s anonymous lips to the American public, making a pit stop with leading journalists only to be amplified and bolstered but never examined or investigated — Alberto Gonzales is vindicated. Equally revealing, several regular Swampland commenters objected to her gullible ingestion of the NYT leak and “caution[ed] against taking the NYT story on its face.” To her credit, Tumulty notes that warning in an update, but this is how our country’s political press works. The administration secretly decrees. Their selected journalist passes it along, soaking up the rewards of their “scoop.” Other journalists believe it and disseminate it. And all administration problems are solved, painlessly fading away.

Written by LeisureGuy

29 July 2007 at 11:07 am

Bush and the GOP: Politics above science

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Look at this and think about what the real-world results are of deliberate blindness:

A surgeon general’s report in 2006 that called on Americans to help tackle global health problems has been kept from the public by a Bush political appointee without any background or expertise in medicine or public health, chiefly because the report did not promote the administration’s policy accomplishments, according to current and former public health officials.

The report described the link between poverty and poor health, urged the U.S. government to help combat widespread diseases as a key aim of its foreign policy, and called on corporations to help improve health conditions in the countries where they operate. A copy of the report was obtained by The Washington Post.

Three people directly involved in its preparation said its publication was blocked by William R. Steiger, a specialist in education and a scholar of Latin American history whose family has long ties to President Bush and Vice President Cheney. Since 2001, Steiger has run the Office of Global Health Affairs in the Department of Health and Human Services.

Richard H. Carmona, who commissioned the “Call to Action on Global Health” while serving as surgeon general from 2002 to 2006, recently cited its suppression as an example of the Bush administration’s frequent efforts during his tenure to give scientific documents a political twist. At a July 10 House committee hearing, Carmona did not cite Steiger by name or detail the report’s contents and its implications for American public health.

Carmona told lawmakers that, as he fought to release the document, he was “called in and again admonished . . . via a senior official who said, ‘You don’t get it.’ ” He said a senior official told him that “this will be a political document, or it will not be released.”

After a long struggle that pitted top scientific and medical experts inside and outside the government against Steiger and his political bosses, Carmona refused to make the requested changes, according to the officials. Carmona engaged in similar fights over other public health reports, including an unpublished report on prison health. A few days before the end of his term as the nation’s senior medical officer, he was abruptly told he would not be reappointed.

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Written by LeisureGuy

29 July 2007 at 10:40 am

Figuring out cats

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Megs in hall Megs in hallway

Here’s a little exercise for the reader. This is just going on right now: Megs sitting in the middle of the hallway, feet nicely tucked under. The door to the study is behind her and to the left in the photo. When I come out of the study to get my cereal, refill coffee, etc., I have to walk around her, and also walk around her when I return. There’s nothing really for her to do in the hall. She is right in the way of traffic, yet this particular patch of carpet seems to be just right.

It’s not just Megs. All cats will at times settle down in the same way—comfortable, feet tucked away—in a high-traffic spot and remain, oblivious to people walking around, stepping over, cursing under their breath, etc.

What’s up with that?

Written by LeisureGuy

29 July 2007 at 9:54 am

Posted in Cats, Megs

Pet people

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Some people like pets, some do not. I went from not liking to liking, and for the non-pet people among the readers, I thought I’d describe the transition. And I’ll talk about cats, since that’s my own pet preference—and in the US, the pet population currently is 90.5 million cats, 73.9 million dogs (and then a big drop to 16.6 million birds, though the African gray parrot seems to make a wonderful and long-lived pet). The biggest category is fish, but can fish in small aquaria count as pets? You don’t pet them, do you?

So the first thing I learned about cats is how to observe them—to watch them in their activities and try to understand what is going on in their tiny weird minds. (Dogs seem easier to understand in this regard, and they communicate better with humans—and are more interested in communication. Remember when Lassie was sent to fetch a C-clamp and came back with a cheese cutter? The right shape, but… Still, that was communication. You could never send a cat to get a C-clamp—or a cheese cutter, for that matter.)

As you’re observing the cat, it will suddenly come over and show some sign of affection—or at least, of wanting to be petted. But often it is a kind of affection: wanting to snuggle up beside you (for warmth), purring when you pet it. It may like you for what you can do for it, but it does like you. And the feeling that you are important to the cat is gratifying and justifies the feeling that the cat is important to you.

As I note in the post on selecting a cat, Roger Tabor’s books on cat behavior are extremely useful in helping you to understand what your cat is doing and why. This practice of simply watching the cat—a beast somehow predictable and unpredictable at the same time—provides the benefits of meditation and flow, in a way. You’re simply observing something, like observing a pebble or a waterfall, but something that also engages the mind in a non-stressful way: pondering the purposes the cat has in mind, the interplay between a general instinct—to hunt—and the particularities of its situation in your living room, with you there.

And quite clearly the cat comes not only to depend on you, but also to trust you—to know that you are safe. The Wife points out that you can tell when your cat has become fully comfortable with you and trusting of you because they’ll walk across you to get to something as though you were furniture—something stable that they don’t have to worry about and watch with suspicion.

Feeling fully accepted and trusted is gratifying and healthful, I believe. And you continue to be able to enjoy the pursuit of trying to understand your cat.

Written by LeisureGuy

29 July 2007 at 9:16 am

Posted in Cats, Daily life

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