Andrea and I saw the latest remake of Charles Dickens A Christmas Carol over the weekend with our little brother (through BBBS), and I have to say it was really well done. As we were leaving the theater however, it occurred to me that the Oklahoma public school system's language arts department really stinks.
I say that because if you are like me then you were never required to read anything by Charles Dickens so your only impression of A Christmas Carol has come through the filter of cinema. Walt Disney in particular.
It has been at least 20 years since the first time I saw the film so I can't really remember my thoughts, but I think my main takeaway was "Scrooge McDuck sure was mean to Mickey Mouse" (what can I say I liked Mickey) and unfortunately I haven't really thought much about it since.
Thankfully, Dr. Beck over at Experimental Theology took the time recently to explore the deeper meaning of Dickens' classic. Something that is perhaps best exemplified early in the film when Scrooge is visited by Jacob Marley's ghost:
Scrooge: But why do spirits walk the earth, and why do they come to me?'
Marley: 'It is required of every man,' the Ghost returned, 'that the spirit within him should walk abroad among his fellow-men, and travel far and wide; and if that spirit goes not forth in life, it is condemned to do so after death. It is doomed to wander through the world-oh, woe is me!-and witness what it cannot share, but might have shared on earth, and turned to happiness...'
Scrooge: But you were always a good man of business, Jacob,' faltered Scrooge, who now began to apply this to himself.
Marley: 'Business!' cried the Ghost, wringing its hands again. 'Mankind was my business. The common welfare was my business; charity, mercy, forbearance, and benevolence, were, all, my business. The dealings of my trade were but a drop of water in the comprehensive ocean of my business.'
I should also note that this post is meant primarily to be a personal warning since the inspiration came towards the beginning of the film when you see Scrooge hunched over his desk balancing what appears to be a General Ledger. Upon seeing this, Andrea jokingly leaned over and said, "look familiar?"
I can't say I'm surprised to see Dallas represented somewhere on this list. Perhaps we'll see the new Woodall Rogers Park on a future list, but for now the strangest road in Dallas is still The High Five Interchange:
Background: This five-level marvel of engineering can be found on the outskirts of Dallas, where Interstate 635 connects with U.S. 75. Construction crews, despite the project's enormous scope, were able to complete the labyrinth of lanes in December 2005, a full year ahead of schedule.
How It's Unique: As Mahmassani points out, building wider roads is just not feasible in most cities. The solution for Dallas? Go vertical. Certain points of the High Five are as tall as a 12-story building, and about 500,000 commuters pass through it daily. The project required 37 permanent bridges and six temporary bridges to be built. Additionally, 300,000 square feet of retaining wall and 74,000 square feet of drainage pipe run along the interchange. In 2006, the American Public Works Association selected the interchange as one of its "Public Works Projects of the Year."
A note from Matt Chandler
The last seven days have been some of the most interesting of my life. I have felt anxiety, fear, sadness and a deep and unmovable joy simultaneously and in deeper ways than I have felt before. I am grateful for this heightened sense of things. Today at 10:45 a.m. CST I will have a good portion of my right frontal lobe removed. I head into that surgery with a heart that is filled with gratitude and hope.
Labels: Parenting Tip of the Day
Image by Kuzeytac via FlickrMark Kleiman recently explored the concept of crime reduction in a book entitled "When Brute Force Fails."
I haven't read the book yet, but as best as I can tell it sounds pretty intriguing. I say this because the guys over at The Economist's blog Democracy in America recently took the book's advice and implemented one of Mr. Kleiman's tactics (on reducing gang violence) on their kids.
Parents take note:
In my case, my kids were waking up early on school-day mornings and sneaking downstairs to watch TV. Under Mr Kleiman's influence, I tried a new tactic: I announced that if both were found watching TV, only my daughter, the oldest, would be punished, because she was responsible. If only my son broke the rule, he would be the only one punished. Both kids are far more afraid of being punished disproportionately than of being punished equally. The school-day morning TV-watching has stopped.
Disproportionate punishment - coming soon to the next generation of Ivey children.
(Also see Parenting Tip of The Day I)
Now don't get me wrong, I am just as much for the profit motive as the next guy, but the question I keep coming back to is simply why is the United States health care system so expensive?
I mean $116,796k for a bypass operation here vs. $11,916 in France? Really? Are we 10x's better at it than the Frogs?
If so, great!
Well I certainly don't know the answer, but if you're interested in finding out more, here's the CEO of Kaiser Permanente attempt at answering this very question in a recent interview with the Washington Post.
(Highlights include, "Why do we need private insurance companies?" "Do we have a competitive market in the US?" "Why is the US system the most expensive?")
(Highlights include, "Do you believe that the problem is 'fee-for-service'?" "How will electronic medical records affect the delivery system?")
A number of the organizations that are considered the best and most cost-efficient in the United States – Kaiser, Mayo, the Veteran’s Health Administration – are integrated at a level that’s really quite rare. Normally, you’d expect that to give them a competitive advantage, and they’d eventually take over the market. But that doesn’t seem to happen. Why?Well, the VA has its own population. When you look at the Mayos of the world, they’re doing well. They have a good business model that’s working for them. But everyone else has a good business model that’s working for them, too. There are $2.5 trillion in this market. There’s no reason, if you have a comfortable cash flow, why would you do hard things and heavy lifting to get to a different model? That’s one reason I’ve been such a strong proponent of exchanges. I believe we need a truly competitive market for insurance.
Before heading out the door to start our Thanksgiving holiday, my plan was to spend a few seconds filing my annual vehicle registration renewal for the state of Texas. As I was about to pay the fee however, I stumbled across something that was too good NOT to pass along.
Keep in mind this is the cost to register ONLINE:
(A 38% tax rate on vehicle registration? Reflectorization? A mail-in fee for online
registration? Rick Perry has some splaining to do.)
Go ahead I'll wait...
That's right the Texas Government found the time to pass a budget resolution that tacked on $0.30 per vehicle for "Reflectorization." Not only does this seem like a complete waste of tax payer money, but as I finished typing the word reflectorization, my spell-check informed me that it is in fact NOT A REAL WORD!
If you're telling me that it costs $0.30 to add the reflective skin onto a window decal, shouldn't that be included in the cost of the decal? What am I missing here? Also, $1.00 "MAIL IN FEE" for an on-line payment? How is this legal?
And I feel as though I should inform you that the cost to file this IN-PERSON is $52.80, while the cost to MAIL-IN the form is $53.80. In other words, according the state of Texas, it is cheaper in the aggregate to staff a window full of people forced to interact with irritable (at the moment anyways) vehicle owners such as myself than it is for the US Postal Service or the Internet to consolidate each of these transactions.
It's as if the technological achievements of the past 20 years have only served to INcrease INefficiencies in delivering information to end users. Unbelievable!
Thanks for listening, now back to your regularly scheduled Thanksgiving holiday.
The holidays are quickly approaching, with Thanksgiving now only a few days away, which depending on who you are can mean a lot of time on the road.
Andrea and I for example will spend the first half of the week here in DFW and then head up to Tulsa, OK to see our new nephew for the first time as well as the rest of my family.
That's the good news.
The bad news is that we both love to eat. A lot.
Thankfully Andrea hates fast food due to the high calorie count and overall negative nutritional effects. I however love fast food due to its high levels of deliciousness. So naturally an argument or two is inevitable.
If you have similar conflicts arise during your holiday roadtrips, I thought I'd do my friendly blogger duty and pass along this helpful decision tree for you to take on your next roadtrip.
Today marks a "major" milestone in the Senate. Now I'm not sure why Congress is all about Saturdays lately, but to help explain the "" around major, here's Ezra Klein:
Little will illustrate the absurdity of the filibuster as neatly as tomorrow's vote. This is not the vote to pass the bill. It's the vote to begin considering the bill. Changing the bill. Amending the bill. Recall that the purpose of the filibuster is to protect debate and ensure that members can make their opinions heard and ensure they have an opportunity to add their ideas to the legislation. Tomorrow, however, 40 Republicans are expected to use the filibuster to close off debate and ensure that no more opinions are heard nor changes considered. The right to unlimited debate has become a tool for cutting it off.
Just in case you don't find that as noteworthy as I do, you might enjoy the fact that the Senate bill is described as a proposal “To amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes.”
Wording that seemed odd until the interwebs informed me that it is is a Constitutional requirement that these types of bills originate in the House of Representatives.
(Title Inspriation: The Bay City Rollers)
Undoubtedly goes to the GAP's GO HO HO:
I'm still trying to figure out whether it's the Joaquin Phoenix-esque rhyme scheme, the inclusion of "solstice" with the 3 other December holidays, or the guy doing the jump-shimi thing at the 0:17 mark that really gets under my skin, but feel free to leave your thoughts in the comments in the meantime.
Thankfully Greg Mankiw is here to help:
He goes on to conclude, "The Bottom Line: If you are poor, the government is inadvertently ensuring that you have little incentive to try to improve your condition." Of course one could also conclude that "The Bottom Line: If you are poor, the government will ensure that your family will not starve" but that retort only leads us into a means vs. ends conversation that I find extremely boring.
Not to mention the fact that I tend to agree with both assertions.
So instead I'll turn to a new book from the Brookings Institute entitled Creating an Opportunity Society, co-written by a former Bush adviser, that reveals one very sobering fact:
42% of American men with fathers in the bottom income quintile remain there as compared to: Denmark, 25%; Sweden, 26%; Finland, 28%; Norway, 28%; and the United Kingdom, 30%. They present a wealth of new and old research evidence to support the conclusion that if you're born poor in America, you're likely to remain poor.
The book ignores the traditional left-right divide to arrive at a set of policy recommendations that are novel only in the comprehensive and non-partisan way in which they are presented (via Pete Davis):
- We start out life with advantages and disadvantages which are hard to alter.
- We underinvest in the disadvantaged.
- Personal responsibility it very important.
- Promoting education, work, and family is very important. Convince disadvantaged kids at an early age that they need to go to college, develop a strong work ethic, and get married. Policy incentives aren't enough. Publicity campaigns are needed to change attitudes.
- Government should do more, but it can't do it all.
- Slow the growth of benefits for the elderly to fund a $20 billion per year program of specific policy changes, including some spending cuts.
But don't take my word for it, click here for the full summary. My intention here is simply to raise awareness to the fact that there are no easy answers, and that oftentimes it is the unintended consequences that can have the greatest impact. However with half of American kids set to live in households that receive food stamps by the age of 20 , this is a problem we cannot afford to ignore.
Let's hope the administration is paying attention.
"Dallas, where white people go to buy designer shoes."
(via: Travel and Leisure Magazine)
Continuing my "Best of Affiliates" series, which is featuring a few of the amazing musicians I have had the pleasure to play with that have recently released albums, including MK & The Gentlemen, Amy Stroup, Katie Warren, Manic Bloom, Andrew Greer, and Paul Banks & The Carousels, we hit upon the Nashville super-one-man-group Andrew Greer.
Nashville artist Andrew Greer will make you think. Nashville artist Andrew Greer will also make you forget.
With his most recent release, Open Book, this Azle, TX native brings in a feeling of nostalgic wonder and has really come into a great sound all his own. Andrew finds the perfect balance with hints of country, pop, contemporary and indie stylings that keeps you on your toes and provides a thoroughly enjoyable music listening experience.
Teaming with such heralded artists as Ginny Owens and a plethora of successful Nashville musicians backing him, Andrew's natural composing talents really shine. He seems to always find the common thread that ties all people together, be it through his writing, composing, producing, or interviewing. No matter what the medium, Andrew's true talent is making people feel comfortable and at peace. He comes from a place of selflessness, servitude, creativity and confidence, all of which are shown throughout the album.
I first crossed paths with Andrew after my sophomore year of college when a good friend (and former band-mate) (and crazy talented person), Julee Duwe - who produced Andrew's GREAT music video, which you can see below - called me up asking if I wanted to do a small summer tour playing bass with some classmates of hers from Nashville. I jumped at the opportunity and soon found myself cramped in a silver Durango pulling a U-Haul across 5 states, practicing every morning and playing most nights. It was a great time in my life and one that I am very thankful for having. It was the only time that I have been what would be considered a "full-time musician" on the road.
The next summer I landed an internship up in Nashville at EMI records and Andrew and I shared an apartment. He almost killed me one time. And I introduced him to tequilla shots. We were bosom buddies.
He frequents Texas and Nashville concert halls and if you have a chance definitely look him up.
"Learning To Live" by Andrew Greer
"Emmylou" by Andrew Greer
"Gone Are The Days" by Andrew Greer - Music video produced by Julee Duwe
GONE ARE THE DAYS Official Music Video from Andrew Greer on Vimeo.
Image via Wikipedi)((aHere is the Senator in a recent Op-Ed in the Dallas Morning News explaining why he voted against the Baucus Bill:
The nonpartisan Congressional_Budget_Office said the bill will cost $829 billion, but when it's fully implemented, the Senate Budget Committee estimates the real cost to be $1.8 trillion. Either way, it would still leave 25 million Americans uninsured, impose billions of dollars in new taxes and mandates, and cut more than $400 billion from Medicare. It would take away Medicare Advantage benefits from seniors, and make Medicaid the only option for 14 million Americans.Or in other words, he's against the whole thing. You should really read the whole thing before jumping to any conclusions (click here for the full article), but let's take these one at a time shall we?
(Feel free to disagree with me in the comments)
1. "The bill will cost $829 billion, but when it's fully implemented, the Senate Budget Committee estimates the real cost to be $1.8 trillion."
That sounds like a lot of money doesn't it? The problem with this figure is that it is highly misleading:
The bill received an important boost last week when the Congressional Budget Office estimated that it would cost $829 billion over the next 10 years — well under the $900 billion President Obama had suggested — and would reduce the deficit by $81 billion over that period.
Senator Cornyn and I have similar concerns in that many of the cost saving mechanisms seem like pipe-dreams, but there are some actual revenue generators (see below).
2. "Either way, it would still leave 25 million Americans uninsured..."
One conclusion I'm completely confident making here is that Republicans do not believe that 46 million people are currently uninsured because they are too poor. Senator Cornyn admittedly might, but here's the standard talking point from Philip Klein in the American Spectator who claims, "the ubiquitous figure is highly misleading":
When all of these factors are put together, the 2003 BlueCross BlueShield study determined that 8.2 million Americans are actually without coverage for the long haul, because they are too poor to purchase health care but earn too much to qualify for government assistance.Some are arguing that the Baucus bill doesn't go far enough to expand coverage, but that is primarily the result of lowering subsides to low income Americans in order to reduce the price tag. Here's a helpful breakdown of the two bill's in Congress:
Under the HELP Committee bill, 27 million people would buy insurance through an exchange, using subsidies that would cost the government $723 billion over 10 years. The Finance Committee bill would spend $461 billion for the 23 million people who would enroll in insurance through an exchange.
3. "...impose billions of dollars in new taxes and mandates"
One of the aforementioned revenue generators is the "excise tax" on Cadillac plans which would begin in 2013. Republicans oppose this measure, yet it is judged by some to be one of the best cost containment measures in the bill.
As for the mandates, it seem like a logical component when you consider the bill will also bar insurers from cherry-picking only the healthiest customers. Wouldn't a sensible compromise then be to require everyone to buy into the pool thereby lowering the overall risk, and provide subsidies to poor people to follow suit? Yes:
The HELP Committee bill includes an individual mandate that requires nearly everyone to obtain some form of health coverage or pay a $750 penalty, with a maximum of $3,000 for a family. The principles behind this policy are simple: Only by getting everyone covered can the cost of healthcare be spread more equitably and the health of Americans improved.
The Finance Committee started out with a very similar proposal, but it was watered down because of worries that people would be punished if they simply could not afford insurance. More people were exempted and penalties scaled back.
Or no, as Tyler Cowen explains in today's NY Times, "Why an insurance mandate could leave many worse off".
4. "and cut more than $400 billion from Medicare."
Looks like he's right on this one:
The Finance Committee, which has jurisdiction over Medicare and other health programs, identified $404 billion in spending cuts. Republicans have attacked those cuts as harmful to seniors, which could make them tough to keep.I'll only add that the recent news that Democrats lost the fight to raise Medicare reimbursement rates I think proves our government's bipartisan appreciation for budget gimmickry. Passing temporary fixes to the Medicare growth rate formula (which is what this was) began some time ago and is now a time honored tradition that serves one purpose; the deficit looks smaller by implicitly assuming that Congress will one day cut Medicare by ~30%. They won't.
I don't know who has less credibility here, Dems claiming the bill is paid for with magical cuts or Republicans obstructing the bill over the proposed magical cuts. It does beg the question though, what's the deal with Medicare reimbursement rates?
5. "It would take away Medicare Advantage benefits from seniors..."
I don't know about you but when I read reports indicating that for every dollar spent on the program, $.14 cents is returned in value while the remaining $.86 goes straight to the bottom line of an insurance company, I get suspicious.
6. "...and make Medicaid the only option for 14 million Americans."
Senator Cornyn is perhaps correct here, but that's because the bill will expand the Medicaid to include households up to 133% of the poverty line. Which is great news for the working poor who previously couldn't afford insurance. This will impose a larger burden on the states however, but that might be a reason to nationalize Medicaid rather than to deny poor people access to insurance.
Then again I'm not running for office in Texas.
The full 1500 page bill is here.
Kevin Drum passes along a helpful chart which explains why we spend $650 Billion more per year on health care than expected:
After a few week hiatus, the Friday Afternoon Song is back in full force.
In the past few weeks there has been an onslaught of great music coming out from some incredible musicians. And while they are all very different in style, they have one very important thread tying them together - me.
It was the plan to have a "Best of Affiliations" post, due to the massive amount of previous bandmates that are putting out records right now. MK & The Gentlemen, Amy Stroup, Katie Warren, Manic Bloom, Andrew Greer, and Paul Banks & The Carousels are all stellar, STELLAR, S-T-E-L-L-A-R musicians whom I have been lucky enough to play with at one time or another. But unfortunately all their albums aren't out yet for purchase, so instead I will push one a week.
This week's FAS comes from good friend, former band mate of Mick Kelleher and The Ray Smiff Project...
MK & The Gentlemen
That funky beard touting bard, Mick Kelleher, has done it again as he puts out his second EP, Mixed Tape EP.
Changing the moniker to "MK & The Gentlemen" (first coined on this poster), Mick's sophomore EP is a fantastic listen. The sound and writing have matured while still keeping the irreverant, tongue-in-cheek tales of bars, strippers and travels that promises a party where ever Mick plays. And the addition of horns and keys perfectly compliment the funky grooves and are reminiscent of Bob Schneider's early SCABS work (who he gives a subtle shout out to during "Kiss Kiss Bang Bang").
Mostly made of new work, he also brings back a remastered "Baby Come Back," a superbly remixed "Hollywood Hello," and redoes a WAAAAY early crowd favorite, "Go On." Those that have followed Mick from his beginnings opening up for College Station super-group Bobbing For Tucker will not be disappointed, while this album carries the momentum to pick up plenty of brand new listeners.
Also of important note, MK&G recently sold their souls to reality tv (we would all do the exact same thing if given the opportunity... but Kristi already shot down my goal of being of Real World/Road Rules Challenge). Be sure to catch Style Network's Dallas Divas and Daughters this week where the girls hit up a MK&G concert at the Dallas House of Blues. The song featured Mick and the song "Highland Park."
I had the pleasure to play with Mick during his start in College Station and travel back and forth to Los Angeles to record his first EP. I also got to work with him at Winter X Games, US Open of Surfing, and a few Dallas shows when he was still writing all the songs on the new release and he was just testing them out live.
There are too many to choose, and am tempted to put the whole album up, but I had to limit it. Take your pick below but be sure to pick up your own copy on iTunes.
"Tonight" by MK & The Gentlemen (explicit)
"Kiss Kiss Bang Bang" by MK & The Gentlemen
"Highland Park" by MK & The Gentlemen (featured this week on Dallas Divas & Daughters)
"Baby Come Back (Remastered)" by MK & The Gentlemen (featuring the bass stylings of yours truly)
** UPDATE - I just found out that AMY STROUP's song "Hold Onto Hope Love" will be featured this Sunday as well on ABC's "Brothers & Sisters" at 9PM CST. Man, two former band mates both on shows this Sunday... Be sure to check them both out.
Let me say two things about the new Woodall Rogers Park whose construction begins frustrating locals and tourists alike this weekend; first it's awesome, and second, Dallas Republicans now have two reasons to hibernate until 2012:
The Woodall Rodgers deck park may be beautiful when it opens in 2012, but for now it's going to mean traffic headaches in downtown Dallas.
This weekend, the Texas Department of Transportation will close the freeway in its entirety from 9 p.m. Friday until 5 a.m. Monday as work begins to prepare the corridor for the park, which will connect the Arts District to Uptown...
The park has sparked enthusiasm from nearby residents and downtown promoters alike.
In the meantime, however, Paul Dyer, director of the Dallas Park and Recreation Department, said drivers should expect to be inconvenienced while the deck is under construction.
"I think the closure of Woodall Rodgers is going to be a pretty common thing for the coming year," he said.
Which helps explain our new motto, "Dallas, we'll see you in 2012."
At least that seems to be the implication in Lt. Governor David Dewhurst's Op-Ed yesterday in the Statesman entitled, How Texas Lives Within Its Means:
“Given recent comments about our state’s budget, I feel it is time to separate fact from political fiction. The fact is, in stark contrast to the U. S. Congress, the Texas Constitution requires the Legislature to balance the state budget every two years, and that would have happened with or without any federal stimulus dollars. In 2007, I led the effort to save $7 billion to balance the revenue shortfall we anticipated this year. So it’s simply political fiction that stimulus dollars were necessary to balance our budget.”
Three cheers for fiscal sanity!
Immediately following his statement, the Statesman thought Mr. Dewhurst's claim seemed a little too convenient and embarked on some fact-checking:
“In order to balance the budget this biennium, which is $182 billion, we used $14 billion in federal stimulus money to balance it. We’re not expecting a similar amount of similar money to be available in the next two years because the federal government just doesn’t have it. So, assuming that’s true, you go into the next session with a $14 billion hole.”
That was Texas Republican Sen. Steve Ogden, or as you and I have come to know him Dewhurst’s chairman of the budget-writing Senate Finance Committee. It's refreshing to see that the gears of government are turning so efficiently down in Austin.
I’m afraid the President, who seems like a supremely rational being, is trying to find the most rational policy option on Afghanistan, without thinking about whether it is feasible given political conditions on the ground, as well as who is going to implement it and how. What seems the most rational option here could be likely unworkable over there.This is part of what happened to President Johnson during Vietnam. He relied exclusively on policy ‘experts’ who understood military and geopolitical strategy in the light of World War II and Korea, but who had no direct experience combating a ‘people’s war,’ while underestimating the North Vietnamese and misunderstanding the importance of the South Vietnamese, who were treated as bystanders....
The outcome of the Afghan struggle is ultimately going to be determined not by our unilateral actions or geopolitical moves, but by whom the Afghan people wind up supporting, even reluctantly. Vietnam—Lesson One.
Needless to say, I'll be picking up a copy of "Why Vietnam Matters" in the very near future. In the meantime, all of you should check out this past week's Frontline special entitled Obama's War. For those of you who lack a proper understanding of the facts on the ground, like me, it does a great job of explaining both the counterinsurgency argument (spoiler alert: apparently a proper counterinsurgency would take ~600,000 troops) and why that approach may not make any sense in Afghanistan.
Full video embedded below.
Remember when I made the comment that I didn't understand why politicians obsess over job creation? If not, it's all here (plus some great reader comments thrown in as an added bonus).
Well almost as if answering my question directly, Ezra Klein recently posted Bill Clinton's disapproval rating vs. unemployment:
Based on this chart I think you could make the conclusion that the old adage of "people vote with their pocketbook" should really be changed to "people vote with their W-2 forms". Or in other words, job creation matters.
Not surprisingly then comes the realization that most of the stimulus package will not be spent until 2010 or later*, which will surely have an impact on employment going into the mid-terms in 2010 and the Presidential election in 2012. Some may say that well that doesn't really sound like much of a stimulus plan then does it? And they'd be correct, but then we're back to square one about politicians and job creation.
For what it's worth, the view I'm hearing from M&A / Private Equity professionals is that with consumers continuing to unwind and the expectation of uncertain revenues into the foreseeable future, businesses will continue to focus on cost containment. The unfortunate side effect of this is that unemployment will likely remain high in the near term.
Image via WikipediaMedical malpractice reform is now synonymous with the conservative party. Unfortunately, Democrats now oppose tort reform almost entirely, claiming that it will have little to no effect on "bending the curve." The traditional line of thinking on why liberals oppose this type of reform is that they are in bed with trial lawyers who would stand to lose the most money. (One of the many derivations of this belief can be found in the urban legend that John Edwards is to blame for the yearly influenza vaccine shortage, thanks to a successful lawsuit against a vaccine manufacturer. A story which is patently false.)
However, med-mal reform in Texas has resulted in capping economic damages at $250,000, yet multiple cities are still > 2 x's the national average on a medicare spending / patient basis (click here for a helpful refresher).
So What Are We Really Talking About Here?
The few doctors that I personally know indicate that defensive medicine is the real culprit and is also perhaps the hardest to quantify. Thankfully, Philip Howard over at The Atlantic explains that this is also consistent with what the President has heard from medical practitioners, and then offers up a solution:
Creating special health courts is the proposal advanced by most serious observers to eliminate the incentives for defensive medicine--including by consumer groups such as AARP, patient safety groups, medical societies such as the AMA and the American College of Obstetricians and Gynecologists, and by such thought leaders as Bill Bradley, Mark McClellan, Newt Gingrich, and David Brooks.
Anyone care to venture a guess who opposes this idea? You guessed it:
But special health courts are vigorously opposed by trial lawyers.
So in other words, this unfortunately will not be a part of any bill coming out of Congress. If you would like to know the full list of tort reform proposals actually are, I've gone ahead and found
So in other words, this unfortunately will not be a part of any bill coming out of Congress. If you would like to know the full list of tort reform proposals actually are, I've gone ahead and foundthose for you as well. You can thank me later (click here for the full article):
- Special health courts - Supporters believe that the system will compensate more patients at a dramatically lower overhead cost (in the current system, almost 60 cents on the dollar go to legal fees and administrative costs, with an average of 5 years to resolution). Most importantly, by providing a system of justice that aspires to make rulings based on accepted medical standards, special health courts should substantially eliminate the need for "defensive medicine."
- Caps on damages - Over half the states have enacted "tort reform" limiting non-economic damages, generally capping "pain and suffering" at $250,000. But doctors can still be liable, when they did nothing wrong, for millions of dollars of economic damages... and doctors in states with tort reform still say they practice defensive medicine. By way of comparison, other countries in the western world typically limit non-economic damages...
- Medical screening panels - About 20 states have a requirement that malpractice cases be submitted first to expert panels. The panels have decidedly mixed reviews. The AMA recently released an article surveying their effectiveness.
- Safe harbors for following practice guidelines - The idea here is to insulate doctors from liability if they conform to accepted guidelines. There are two significant issues here: Dr. Jerome Groopman recently wrote about this issue in a piece for the Wall Street Journal.
- Early offer programs - This idea, originated by Professor Jeffrey O'Connell, encourages defendants to make an early offer of compensation--and encourages plaintiffs to take it because it limits attorney fees to 10 percent.
- Apology statutes - Several states have enacted laws that encourage doctors who have made mistakes to be open with patients, with the inducement that the apology cannot be used as evidence. It does nothing to help the doctor who is wrongly accused of making a mistake, however, which is the fear that drives defensive medicine.
The article even provides a handy chart which breaks out of the merits of each proposal, and analysis indicates that the special courts seem to be the most effective. Anyone care to guess whether or not Congress will include any of these proposals?
On the eve of tomorrow’s Senate Finance committee vote, I thought I’d resume my former self-appointed role of unofficial health care linker/commenter. So if that sort of thing doesn’t tickle your fancy, you might want to avoid this site for the immediate future.
Now that we’ve got that out of the way, a few weeks ago a friend sent along a NY Times review of T.R. Reid’s new book The Healing of America. In it, the author describes his adventures into 10 different country's health care systems all in an attempt to treat a stiff shoulder. A storyline that the NY Times refers to as a "gimmick", but admits that "what saves the book from slumping into a sack of anecdotes like Michael Moore’s 2007 documentary “Sicko” is a steel backbone of health policy analysis..." For example:
In Japan, and many European countries, private health insurers — all of them nonprofit — finance visits to private doctors and private hospitals through a system of payroll deductions.
In Canada, South Korea and Taiwan, the insurer is government-run and financed by universal premiums, but doctors and hospitals are private.
In Britain, Italy, Spain and most of Scandinavia, most hospitals are government-owned, and a tax-financed government agency pays doctors’ bills.
In poor countries around the world, private commerce rules: residents pay cash for all health care, which generally means no health care at all.
The book goes into much greater detail about the history of how each system was developed, and reveals that unsurprisingly, the differences in the underlying systems can produce vastly different treatments:
In France, a general practitioner sends him to an orthopedist (out-of-pocket consultation fee: $10) who recommends physical therapy, suggests an easily available second opinion if Mr. Reid really wants that surgery, and notes that the cost of the operation will be entirely covered by insurance (waiting time about a month).
In Germany, the operation is his for the asking the following week, for an out-of-pocket cost of about $30.
In London, a cheerful general practitioner tells Mr. Reid to learn to live with his shoulder. No joint replacement is done in Britain without disability far more serious than his to justify the expense and the risks, and if his golf game is that important, he can go private and foot the bill himself.
In Japan, the foremost orthopedist in the country (waiting time for an appointment, less than a day) offers a range of possible treatments, from steroid injections to surgery, all covered by insurance. (“Think about it, and call me.”)
In an Ayurvedic hospital in India, a regimen of meditation, rice, lentils and massage paid for entirely out of pocket, $42.85 per night, led to “obvious improvement in my frozen joint,” Mr. Reid writes, adding, “To this day, I don’t know why it happened.”
Interesting stuff! And if you are the type of person, like me, who prefers informed opinions over knee-jerk populism, then this might just be the book for you.
Click here for the full review.
When I read that Barack Obama was this year's recipient of the Nobel Peace Price, I actually started laughing. Since I'm sure most of you either had a similar reaction or just rolled your eyes at the 's news, I thought I'd pass along the following roundup of what people who get paid for their opinions had to say (Peace Prize Reax I, II , and III).
Here's How I Score It:
- Most accurate, George Packer:
President Obama should thank the Nobel committee and ask them to hold on to the Peace Prize for a couple more years...This seems like a prize for Europeans, not Americans, and I worry that at home it will damage him politically by reinforcing the notion that he is—and will be—a world icon rather than a successful President. I don’t mind him being the former, but I most want him to be the latter. Not even a Rookie of the Year is ready to be elected to the Hall of Fame. I’m afraid this prize will be bad for Obama. For political reasons and on the merits, he should quote Shakespeare to the Nobel committee: “As you shall prove me, praise me.”
- Most dismissive of the Nobel Prize in general, The Corner:
Here is a list of Nobel Peace Prize winners since 1980. There are some worthy recipients — Lech Walesa, Shirin Ebadi, Mohammed Yunus. But most Nobel Peace Peace prizes go to conventional left-wing types popular with European elites — Kofi Annan, Jimmy Carter, Al Gore, Mikhail Gorbachev. Before they break out the champagne at the White House, they may want to pause over the fact that Obama now shares this honor with Mohammed el-Baradei, Yasser Arafat, and flagrant liar Rigoberta Menchu Tum.
- Most partisan, the DNC
The Republican Party has thrown in its lot with the terrorists - the Taliban and Hamas this morning - in criticizing the President for receiving the Nobel Peace prize.
- My personal favorite, TigerHawk:
“YO OBAMA, I’M GONNA LET YOU FINISH, BUT I JUST WANNA SAY THAT MARTIN LUTHER KING JR WAS THE BEST NOBEL PRIZE WINNER OF ALL TIME.”
And just in case you want my official reaction, here it is: "Earn it."
UPDATE #1: In the comments, Clayton pointed out that my quote from the Corner wasn't "fair", and after going back and reading their post I actually agreed. So to keep things fair, I removed the original reference and quoted them in full.
UPDATE #2: Here's Obama's take:
"Let me be clear: I do not view it as a recognition of my own accomplishments, but rather as an affirmation of American leadership on behalf of aspirations held by people in all nations," he said at the White House. "To be honest, I do not feel that I deserve to be in the company of so many of the transformative figures who've been honored by this prize."
As of 2009, there is no fully conservative translation of the Bible which satisfies the following ten guidelines:
1. Framework against Liberal Bias: providing a strong framework that enables a thought-for-thought translation without corruption by liberal bias
2. Not Emasculated: avoiding unisex, "gender inclusive" language, and other modern emasculation of Christianity
3. Not Dumbed Down: not dumbing down the reading level, or diluting the intellectual force and logic of Christianity; the NIV is written at only the 7th grade level...
Now at this point you might be thinking to yourself, as I did, that they are referring to "liberal" in the religious sense of the word rather than the political ideology. Then we read the following:
6. Express Free Market Parables; explaining the numerous economic parables with their full free-market meaning...
And on and on they go. Now I am as fervent a believer as the next guy that we as Christians should actively seek to obtain as thorough an understanding of the text as humanly possible, but reading the Bible as innately supportive of any modern political ideology is idolatry. But maybe that's just me.
More Conservapedia Colbert-bait here.
On a related note, could someone tell me what the emotion is called when an event simultaneously triggers both laughter and sadness?
Personally, I enjoyed the breakout of the pharmaceutical industry, but feel free to click on the picture below for the giant version and decide which is your favorite (h/t The Big Picture):
For the next three weeks we will be choosing songs done by each of the savant guitarists featured in It Might Get Loud, which includes Jimmy Page (Led Zeppelin), Jack White (White Stripes, The Raconteurs, The Dead Weather), and The Edge (U2). If you are a guitarphile or simply interested in people who take their craft to a whole other level, this movie is a must see.
This week is from, in my opinion, the greatest rock n roll band of all time, Led Zeppelin.
“Ramble On” by Led Zeppelin
I could go on and on and on and on about the history of this band (a super group), the scandalous stories that surrounded their career (the “shark” incident), and the recording intricacies (headphone bleed throughs and squeaky drum pedals that you can hear on certain songs), but I will leave that for your own study because it requires a much much much longer post than what this is for. You’ll just have to buy me a beer sometime and listen to me wax poetic about them. Right now we will focus on the song alone.
“Ramble On” is from Led Zeppelin’s 1969 album Led Zeppelin II and is listed in the 500 Greatest Songs of All Time. But this song is famously known not only for its catchy acoustic intro and “bongos” throughout (it is actually Bonzo hitting a plastic trashcan), but for its heavy use of The Lord of The Rings references. Speaking of either Frodo Baggins as he travels to Mordor, or that of Aragorn as he has to choose between staying with his love Arwen or going to destroy the Ring in Mordor:
“Mine’s a tale that can’t be told,
My freedom I hold dear,
How years ago in the days of old,
When magic filled the air.
Twas in the darkest depths of Mordor
I met a girl so fair.
But Gollum, and the evil one crept up
And slipped away with her.”
Also the opening line - "Leaves are falling all around" - is guessed to be a paraphrase of the opening line of Tolkien's poem "Namárië". The poem may also be the inspiration for the entire first verse.
And now ladies and gents,
“Ramble On” by Led Zeppelin
Today is the first full day of fall, so I thought I'd take you all on a stroll back through the simpler time that was the Summer of 2009. It truly was the best of times and the worst of times wasn't it? And although Top 40 radio would have you believe it was the summer of Miley Cyrus, the Black Eyed Peas, and Beyonce, Music Is Art casually reminds us that there were actually some pretty solid albums released in the last few months.
For example, have you checked out Jack White's new band The Dead Weather?
Anyways, click here for MIA's list of the Best Albums of the Summer of 2009, and let me know if there are any glaring omissions (Chris, Matt, Blake, Hal I'm looking at you guys)?
Labels: Adventures in Niche Blogging
Awkward family photos (something I think we can all relate to):
"This just makes me uncomfortable"
Labels: Adventures in Niche Blogging
Every Gen Y'er I know of prefers artistic engagement photos. However since there is no clear definition of art, unfortunately (or fortunately for you and I) this can sometimes result in Awesomely Bad Engagement Photos:
Hal Denbar is never wrong. Whenever I get a message from him telling me to check out a band, it is guaranteed to be a winner. He first introduced me to FAS's own Black Joe Lewis, and recently a group called The Felice Brothers. I cannot stop listening to their album, and it was too hard to pick a single song to represent this week's Friday Afternoon Song so I chose two.
THE FELICE BROTHERS
"Theirs is a world of moons and moonshine, mountains and cabins, a place where men get drunk on Jack Daniels and stalk off, guns in hand, to confront their cuckolding wives. The Tennessee-bred Kings of Leon sang about a familiar world... but while those siblings were blessed with a fashion sense and rugged good looks, the Felices are ragged, scruffy, and dirty-faced. They're a pack of earth-stained country boys from the wilds of the Catskill Mountains..."
The Felice Brothers - which originally consisted of 3 real life brothers, which one eventually left to start his own group - got their start playing a their father's afternoon barbecues for his fellow carpenter colleagues, and eventually moved their show to the New York subway system. They began doing small tours and putting out a couple records on their own dime. Playing at arts festivals and folk festivals the brothers slowly got momentum and notoriety from their lively, upbeat live shows, and word quickly spread. They began touring with some larger acts (most notably Conor Oberst & the Mystic Valley Band last fall) and landed their first record deal in 2007 from a European label.
The band now consists of two of the brothers, Ian and James, and their friend Christmas (bass player who was previously a traveling dice player... really), and Greg Farley (who plays the washboard and fiddle).
The vocals are uncannily reminiscent of Bob Dylan - that is if Bob Dylan was in tune.
I hope you enjoy it as much as I do.
"Frankie's Gun!" by The Felice Brothers
"Take This Bread" by The Felice Brothers
Labels: Barack Obama, Department of Education, Direct-loan, John Cornyn, Pell Grant
(Gravina Island Bridge aka the bridge to nowhere)
I do not understand why politicians focus on job creation. Ok that’s not entirely true, I don’t understand why we let them get away with it. I mean, aren't business cycles more important after all?
Take, for example, Bill Clinton’s record in the 90’s. Dems tout this as though the dot-com boom wouldn’t have happened without him, yet I fail to see how Washington influenced a bunch of computer nerds out in Silicon Valley to create jobs. Conversely, George W has one of the worst records of job creation since the dawn of time (at least according to MSNBC), yet he presided over the dot-com bust, the fallout from Enron, 9-11, and the mortgage crisis. Sure he's partly culpable for that last point, but I strongly doubt any other politician would've applied the brakes on the housing bubble before it was too late.
And now we have continuing jobless claims remaining fairly constant at > 500k, with an administration claiming to have saved millions of jobs. It all seems like a bunch of nonsense doesn't it?
I say all of this to lead into today's news that the government is planning to
[Obama's] plan is to do away with a system in which the Federal Government subsidizes banks and other private finance companies like Sallie Mae to lend money to students. The Administration essentially wants to cut such companies out of the game and run the system itself. Democrats claim the move will save $87 billion over 10 years, which can be used for a laundry list of education priorities, including increasing the maximum amount of Pell Grants, expanding Perkins Loans and investing in community colleges and other programs.
Educational institutions currently have two ways to offer federal loans to students. In the Federal Family Education Loan (FFEL, pronounced "fell") program, the government pays subsidies to banks and lenders to dole out money to borrowers and reimburses companies up to 97% of the cost of any loan that is not paid back. The second way is the direct-loan program, created in 1993 as an alternate option, in which the government cuts out the middle man, lends money directly and gets all the profits.
"Ultimately, what they are trying to create here is the Post Office of student lending — you've got no choice," says Jack Remondi, vice chairman and CFO of Sallie Mae, the nation's largest lender, referring to Obama's Aug. 11 comments that questioned the efficiency of American letter carriers. "And this is the President's initiative on health care: if you create competition, that should drive down costs and save people money."
The loan industry estimates that up to 35,000 jobs might be lost by the transfer from FFEL to direct-loan. Members of Congress who represent states that employ a large portion of the industry workforce, like moderate Democratic Senator Ben Nelson of Nebraska, have opposed the measure for that reason. But the Department of Education (which would run the new and expanded program) maintains that... the total amount of jobs lost will actually be much less.
Approximately three-quarters of the FFEL loans in the 2008-09 academic year were already in the hands of the government.
Personally, I'd like to see both the costs associated with these two programs as well as their respective default rates before I make a final decision, but keeping wasteful programs afloat simply to appease angry Senators seems, how do I say this nicely, just a tad fiscally irresponsible.
Similarly, I was surprised to hear a few months ago that Senator John Cornyn voted for the F-22 boondoggle that even the Defense Department deemed wasteful. That was until I received my monthly newsletter from Senator Cornyn explaining that cutting the program would lead to the loss of valuable jobs in Texas. I guess I should've known.
So I ask you, the humble blog reader, where do we draw the line between government spending that is wasteful and government spending that is essential for job growth? Because I'm confused.
UPDATE: Matt Yglesias lays out the benefits of this move by the White House.
The Pan-American Highway is recognized as longest continuous road, spanning 29,800 miles from Prudhoe Bay in North Alaska right across Canada, the U.S., Central and South America – all the way to Ushuaia on the southern tip of Argentina. Driving it will take you through just about every climate the world has to offer and some of the prettiest spots on Earth.
Image via WikipediaSad news for Aggieland in yesterday's NY Times:
Norman E. Borlaug, the plant scientist who did more than anyone else in the 20th century to teach the world to feed itself and whose work was credited with saving hundreds of millions of lives, died Saturday night. He was 95 and lived in Dallas...
He was widely described as the father of the broad agricultural movement called the Green Revolution, though decidedly reluctant to accept the title. “A miserable term,” he said, characteristically shrugging off any air of self-importance.
Yet his work had a far-reaching impact on the lives of millions of people in developing countries. His breeding of high-yielding crop varieties helped to avert mass famines that were widely predicted in the 1960s, altering the course of history.
Largely because of his work, countries that had been food deficient, like Mexico and India, became self-sufficient in producing cereal grains.“More than any other single person of this age, he has helped provide bread for a hungry world,” the Nobel committee said in presenting him with the Peace Prize. “We have made this choice in the hope that providing bread will also give the world peace.”
Dr. Borlaug is the only Nobel Laureate from Texas A&M, and is perhaps one of the most important men of the 20th Century. His story might also be one of the best real-life examples of the power of teaching a man to fish.
His life's work is truly an inspiration.
The stories are almost too perfect. Tales of ragged beginnings, blues and soul music that congers up images of hot and dry lounges filled with fedora-adorned patrons (before they became trendy) wearing suspenders and smoking their Lucky Strikes, and a lightening-fast acclaim and rise to stardom... but don't be fooled into thinking this happened during the Dust Bowl. This is happening now.
While working in a pawn shop in down in Austin, Joe Lewis walked over one day and picked up a guitar. He took it home that night and started teaching himself how to play. Sharpening up his chops inside and outside of work hours he decided to hit up some local open mic nights as a solo musician, a period he now laughingly recalls as “horrible…I was usually too drunk or too scared to put on a good show, but people kept asking me to come back.”.
While he eventually put together a band with a solid lineup, Lewis couldn’t capture the mojo he was looking for and was seriously considering retiring from music in his mid-twenties -- until future bandmate, guitarist Zach Ernst entered the picture. Ernst was a student and UT and a part of a student organization that put on concerts and asked Joe Lewis - who was down on music and working at a restaurant shucking oysters - to open up for Little Richard in 2007. Enrst then put together a new group - consisting of Black Joe Lewis, Sugarfoot Watkins, Rooster Andrews, Big Show Varley, Wild Bill Slyder, McKnight the Night Train, and Sleepy Ramirez - and four weeks later Black Joe Lewis & The Honeybears played their first gig.
The labels quickly began knocking down their door and after signing with Lost Highway in 2008, they released their first full length album, Tell 'Em What You Think, on March 17, 2009. Filter Magazine named their song "Bitch, I Love You" this year's anthem for Valentines Day. (I also asked Kristi if it could be our first dance at our wedding. Turns out Van Morrison is more appropriate. Probably a good call.)
Ladies and gentlemen, in the vein of James Brown, Lightenin' Hopkins, Joe Tex, here comes the sugarfoot...
"Sugarfoot" by Black Joe Lewis & The Honeybears
(Via The Daily What)
It's almost as if the auto-tuner was created for this:
(hat tip: The Daily Dish)
What would you do if you found out during the 20th week of pregnancy that your child would not survive outside the womb for more than a couple of days, if it even survived the remainder of the pregnancy?
Over the weekend the Dallas Morning News published the story of Deidrea and T.K. Laux who were forced to answer this question when they learned that their baby boy (Thomas) had Trisomy 13, an incurable genetic disorder. Their story is as inspiring as it is heartbreaking (h/t Beliefnet):
Deidrea and T.K. stared out at the cavernous, packed sanctuary of Bent Tree Bible Fellowship.
Pastor Pete Briscoe told the congregation that the Lauxes were newlyweds, married 10 months earlier.
On this first Sunday in May, they wanted to dedicate their unborn son to God.
In a shaky voice, Deidrea described the bleak February day that she and T.K. learned of Thomas' condition. Feeling her son's movements in the long night that followed, she knew that God was with them and they wouldn't be alone.
When she explained Thomas' diagnosis to her fifth-grade Bible study group, the girls asked if it was OK to pray for a miracle.
"The miracles have been happening every day," Deidrea told the congregation, "when we feel our son moving and he's growing."
The Lauxes understood that their sadness and joy were inseparable, and they could choose to celebrate every moment they had with their son.
Every morning, T.K. brought his wife breakfast in bed and nestled near her belly for father-son talks. He imagined aloud that Thomas was scuba diving, four-wheeling, playing soccer. Thomas kicked and spun at the sound of T.K.'s voice, clearly alive - here and now.
"We're so grateful that God chose us to be his parents, because he is such a special little boy," Deidrea told the congregation as T.K. nodded beside her. "We're telling God, 'Thank you - thank you for this gift.' "
DMN also released a video documenting the Laux's journey from planning the funeral, to delivery, to the final heartrenching moments, and it is without a doubt one of the most powerful videos I've ever seen. I will warn you that the emotional response is pretty intense (i.e. you might cry), so you might consider waiting until you get home to watch it.
Words really can't do the video justice, so I'll simply close with these words from Deidrea Laux:
"We didn't terminate because ... there was going to be some sort of a medical miracle. We didn't terminate because he's our son."Click here for the video.
Also, back in June Andrew Sullivan compiled similar stories from women who decided to take the alternate route and terminate, collectively title It's So Personal. From reading these stories and having personally known a small number of women who've struggled with the aftermath of that decision, I can only say that this issue is more complicated than many are willing to admit.