By John Ballard
This post has a string of items. For me weekend reading is more reflective and discursive than the daily grind.
==?Christine Smallwood interviews Tony Judt in The Nation.
[His book] Ill Fares the Land traces the history of the postwar state in the United States and Europe, showing how rampant privatization, an excess of individualism and the worship of the market have produced unacceptable levels of inequality. Disparaging both extreme left- and right-wing solutions, Judt makes a case for social democracy, advocating a new conversation about our collective responsibilities as citizens, humanists and human beings.
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We've emerged from a twentieth century which we've learned to think of as a kind of seventy-year running battle between the over-mighty state and the wonders of individual freedom. Extreme forms of individualism versus extreme forms of collective enforced authority. Roughly speaking, Stalin versus the tea party. That's a caricature of the twentieth century. But it's one that we have to a large degree internalized, so when people think of the political choices facing them, they think of them in terms of maximized individual freedom versus maximized collective repression, or power or authority or whatever. And then they think of any changes with one or the other, regrettable compromises with freedom or so on. We need to change that conversation so we can think of the state not as some external creature that history has imposed upon us but simply as a way of collective organization that we chose to place onto ourselves. In that sense the liberal state either has a future or it doesn't, but it really is up to us.�
In my second marriage I was married to someone who was a very active American feminist and very anti the antiabortionists. I would find myself listening to her angrily say that abortion is a good thing and these people are crazed fascists and so on, and I'd think, This conversation is taking the wrong turn. What you have here are two powerfully held moral positions, incompatible socially, backed by different perspectives. But it's not a question of one of them being immoral and the other being moral. What we need to learn to do is conduct substantive moral conversations as though they were part of public policy, so that abortion is a terrible thing and a necessary thing, and both statements are true. You see what I mean? With decent medical services and proper prophylactic facilities and real contraceptive education and proper support for young people, particularly in poor areas, abortion would not be nearly as big an issue as it is. Then you could learn to think of difficult moral issues as part of social policy rather than just screaming at each other from either side of a moral barrier. Then we could reintroduce what look like religious kinds of conversations into national social policy debates.
More at the link. Quick, easy read, worth your time. I like how this guy thinks. H/T Abbas
As I read the interview, two comments left by our overnight visitor played in the background. Poor guy, he seems to be victim to the very mindset to which Judt points. Although disturbed by climate change he has no confidence in pro-active efforts to deal with it. He correctly points out the downside of ethanol production (but is apparently unfamiliar with Brazil) and has no confidence that a federal approach to any problem can prove to be any better than the messy, uncoordinated attempts of fifty states, e pluribus disunum. I want to hug him and reassure him everything will be okay, but it's hard to penetrate a negative attitude.
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==?Canadians healthier, outliving Americans
Canadians tend to lead longer, healthier lives than Americans on average, say researchers who point to lack of universal health care in the U.S. as one reason.�
The study's authors found a 19-year-old in Canada could expect to enjoy 2.7 more years of perfect health than a 19-year-old in the U.S. In this case, someone in perfect health would have a top score of 1.00 on the Health Utilities Index Mark 3.
The index lowers an individual's score depending on their level of disability in eight areas: vision, hearing, speech, ambulation dexterity or ability to move, emotion, cognition, pain and discomfort. The lowest score is 0.00 for death.
About two-thirds of the gap was because mortality rates in Canada are lower and the remaining one-third was thanks to lower rates of morbidity or disease in Canada �differences Feeny called "quite substantial" with policy implications on both sides of the border.
"I think that Canadians can look at these results and get some affirmation that the investments that they have made in reducing inequality and in having a health-care system with universality have paid off," said Feeny, who worked for more than 30 years in Canada at McMaster University in Hamilton, Ont., and the University of Alberta in Edmonton.
"I think it underscores the need for additional vigilance on emerging issues such as child poverty in Canada that will eventually affect population health," he added.
The survey itself did not say why Canadians are healthier, but the study's authors pointed to two major potential explanations:
Differences in access to care between the "prenatal to grave" health service offered by provinces and territories compared with the non-universal American access that is typically through employee coverage or Medicaid or Medicare for those with low incomes and seniors.- The higher degree of social inequity that is more pronounced in the U.S., particularly among seniors.
Just saying...
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==?"Bundled payments" for medical procedures.
What a concept! Pay for what you get.
The food business figured out years ago that a la carte pricing produces really expensive meals. The problem is that value-seeking customers don't like being charged for every pat of butter for bread or every cracker served with soup. They expect, quite reasonably, that the price on the menu includes whatever it costs for the dining experience. Moreover, the smart restaurateur who wants to stay in business picks up the cost of the entire meal if the customer has a bad dining experience.
It's too much to ask that medical professionals become as accommodating as your favorite place to dine, but a lot of slick advertising on TV indicates that's what they want patients to believe.
Four insurers, Aetna, Blue Shield of California, CIGNA and HealthNet, have agreed to pay bundled facility and physician fees at the pilot hospitals. The precise fees have yet to be determined, but advocates, including the insurers, believe that greater cooperation among healthcare providers will ultimately slow the rise of spending and drive down insurance premiums, The Los Angeles Times reports.
"The bundled payment is a step in the right direction ... but it's no panacea. We're taking baby steps in rethinking how these payment methodologies can provide the right kinds of incentives," Dr. Thomas Rosenthal, chief medical officer of the UCLA Hospital System, told the newspaper. LINK
Medicare makes a single reimbursement for all the hospital and doctor care for heart and joint procedures, rather than making separate payments to the facility and physicians.
Such combined payments are getting close attention during the health care debate as a way to encourage hospitals and doctors to work together to hold down costs and improve care.
Bundling payments moves medical charges away from the traditional fee-for-service system that pays providers separately for individual services � an arrangement critics of the current system say leads to doctors and hospitals delivering more care, but not better care."The current payment system is not designed to drive efficiency," says Harold Miller, chief executive of the Network for Regional Healthcare Improvement in Pittsburgh. For example, he says, it rewards providers for making mistakes that require additional procedures or result in ho$pital readmi$$ion$. [JB: Dollar signs not in the original. I did that to be cute.]
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Medicare tried the bundling concept with coronary bypass surgery in the mid-1990s. The program saved $42.3 million over three years, with costs decreasing from 10% to 37% at the four hospitals participating in the test. But the hospitals saw no increase in business. That experiment didn't include an incentive payment for Medicare beneficiaries to use the test hospitals....LINK
I've always said that doctors are better at healing than they are at business.
But doctors don't hold a candle to politicians when it comes to mismanaging money. Here's a political ticking bomb brought to you by politicians sucking up to America's love of all things military or defense-related.
Military health costs soar, raising possibility of higher out-of-pocket expenses
...Currently, active-duty troops and their families receive free healthcare except for out-of-pocket co-payments of $3 or $9 per prescription at civilian pharmacies. Retirees receive the same benefits by paying $230 a person or $460 a family each year, along with small co-payments for various types of care. Unlike continually rising private-insurance copays, TRICARE fees haven't changed since 1995.
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==?Deepwater Horizon is now as much a part of our vocabulary as Exxon-Valdez and Bhopal.
Families of workers who died in the accident have already filed lawsuits accusing BP of negligence. Congress, as well as the Minerals Management Service, the federal agency that regulates drilling in the Gulf, were already separately investigating allegations that BP has failed to keep proper documents about how to perform an emergency shutdown of the Atlantis, another Gulf oil platform and one of the largest in the world.
There are also indications that BP and Transocean, the owner of the Deepwater Horizon rig that burned and sank, could have used backup safety gear -- a remote acoustic switch that would stanch the flow of oil from a leaking well 5,000 feet underwater -- to prevent the massive spill now floating like a slow-motion train wreck towards the Mississippi and Louisiana coastline. The switch isn't required under U.S. law, but is well-known in the industry and mandated in other parts of the world where BP operates.
The writers at Facing South do superior investigative journalism.
Lot's more at the link.
Their work is air tight.
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==?Did anyone ever expect to see a White House Blog, much less a headline like this?
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==?And from Israel we have this...
This is What Direct Nonviolent Action looks like
More video from Al Walaja and the direct nonviolent action that the village is creating in order to stop the construction of the wall through their farmlands. This is what direct nonviolent action looks like in Palestine. This video was taken on 27 April 2010 by Activestills photographers.
Palestinian, Israeli and international demonstrators managed to stop the construction of the Wall in the village of alWalaja, south of Jerusalem for the second time this week. If completed, the path of the Wall in the area will surround the village completely, isolating it from all its lands, the cities of Bethlehem and Jerusalem and essentially the rest of the world.
Demonstrators managed to block the bulldozers in the early morning, and even climb and take over one of the machines. A Border Police force at the scene arrested on of the demonstrators � 15 year old Nabil Hajajla � who was beaten and pepper-sprayed. Following Hajajla�s arrest, Border Police officers managed to drag the demonstrators away from the bulldosers and construction was resumed.
Al-Walaja is an agrarian village of about 2,000 people, located south of Jerusalem and West of Bethlehem. Following the 1967 Occupation of the West Bank and the redrawing of the Jerusalem municipal boundaries, roughly half the village was annexed by Israel and included in the Jerusalem municipal area. The village�s residents, however did not receive Israeli residency or citizenship, and are considered illegal in their own homes.
Once completed, the path of the Wall is designed to encircle the village�s built-up area entirely, separating the residents from both Bethlehem, Jerusalem, and almost all their lands � roughly 5,000 dunams. Previously, Israeli authorities have already confiscated approximately half of the village�s lands for the building of the Har Gilo and Gilo settlements, and closed off areas to the south and west of it. The town�s inhabitants have also experienced the cutting down of fruit orchards and house demolition due to the absence of building permits in Area C.
According to a military confiscation order handed to the villagers, the path of the Wall will stretch over 4890 meters between Beit Jala and alWallaja, affecting 35 families, whose homes may be slated for demolition.
Beit Jala is a predominantly Christian town located 10 km south of Jerusalem, on the western side of the Hebron road, opposite Bethlehem. Once completed, he Wall will Isolate 3,200 Dunams of the town�s lands, including almost 3,000 Dunams of olive groves and the only recreational forest in the area, the Cremisan monastery and the Cremisan Cellars winery.
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