By John and Kat
Since the world didn't come to an end, we still need to keep up with all the stuff that continues.
Sometimes after scanning some of the stuff Kat finds I'm ready for it all to end, but after sifting through the mire a few encouraging stories come to the surface.
If this collection has any common denominator, it is that events often look different when seen through an international lens.
As the D.S.K. story illustrates countries and cultures are separated by more than politics and geography.
?World Fails to End By Ujala Sehgal
The Atlantic Wire. Read all about it. This is where I found the picture.
?German army confirms firing on violent protesters in Afghanistan
This is pretty nasty stuff. Seems NATO isn't winning many hearts & minds.
The German military on Friday, May 20, said its soldiers deliberately shot several people during a violent protest on Wednesday outside their base in the Northern Afghanistan city of Talokan.
The protesters had attacked the German soldiers' camp in Talokan with stones, hand grenades and Molotov cocktails.
According to the German military, its soldiers initially fired warning shots into the air and then began to fire targeted shots primarily in the leg area of demonstrators who continued to be violent.
Three German soldiers and five Afghan watchmen were wounded during the clash. Twelve demonstrators died.
?German armed forces cut by one-fifth in new shake-up
Like the rest of the world, Germany isn't swimming in wealth. Unlike the US they know how to cut expenses.
?German troops admit fears over 'partnering' with Afghan soldiers
Hello, Washington... anybody paying attention?
The incident has shocked German troops in Afghanistan. Several German soldiers have been quoted anonymously on the Spiegel Online website as saying they were wary of their Afghan colleagues and no longer wanted to work with them. "We are expected to train them, but they regard us as infidels who shouldn't be in their country in the first place," said one soldier.
? Spanish protesters defy pre-election rally ban
Has the Arab Spring started to spread like the avian flu? This looks something like Wisconsin.
Just thinking out loud...
Many protesters are also calling for reforms to Spain�s two-party system and a shake-up of the country�s political culture. Thousands have camped out in tents or under the stars at Madrid's central Puerta del Sol square, saying they would not budge until election day.
"When police approached, we told them our claims concerned them too, because they too had low salaries and mortgages they were struggling to pay," said Carlos Paredes, a spokesman for the movement.
Dubbed "the indignant" by some, the protesters also say they are planning a "silent cry," during which demonstrators will tape their mouths shut in a sign of protest once the proposed ban comes into force at midnight. The group is also becoming more commonly associated with the name M-15, a reference to May 15, when tens of thousands hit the streets in over 50 Spanish towns and cities.
The movement appeared on the Internet a few months ago in response to Spain's deepening economic woes. The group sides with no political party, though it is not calling for voters to abstain or spoil their ballots either. The government is asking them to express their discontent at the ballot box, not on the streets.
?The rage in Spain falls mainly on the pain
The rage in Spain continues as tens of thousands pack Madrid�s city centre for a sixth day in protest over austerity measures and crippling unemployment.
?The Atlantic Wire has this link...
? People of the world, Spain is in a revolution! But the media is trying to cover everything, so hear me :
Reddit chatter for anyone with the time to comb through it.
? Spain government rethinks ban as youth protests grow
This is the Reuters link.
Like Joe Biden, I'm thinking this may be a BIG F**KING DEAL.
?Spain protests: "This has never happened before"
BBC link, with video following a 30-second commercial.
It's looking like Tahrir Square redux, with young people camping out, peacefully protesting, organizing themselves as they sweep the place clean and take away trash.
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Kat has tons more links but I haven't time to cover it all.
But I want to share a few links from the last 24 hours, three regarding health care and one relating to jobs.
?Jobs first....
As Indian companies grow in the U.S., outsourcing comes home
India�s outsourcing giants � faced with rising wages at home � have looked for growth opportunities in the United States. But with Washington crimping visas for visiting Indian workers, some companies such as Aegis are slowly hiring workers in North America, where their largest corporate customers are based. In this evolution, outsourcing has come home.
Capuana, a manager for Aegis in New York, motivates this U.S. office with dress-down days and the prospect that workers could, one day, earn a stint training call center workers in Goa, India. One of his tasks is to staff 176 cubicles, where workers make or take calls for customers of prescription drug plans or Medicare contracts and enter and verify information. The pay runs $12 to $14 an hour, with bonus checks of up to $730 a month.
Yep. You read that right. India is outsourcing to America, setting up call centers here.
Many Aegis employees at the site are not very aware that they work for an Indian company. The Dallas headquarters, though, celebrates India�s independence on Aug. 15. And the call center workers have made music videos for each other: The Indian office performed a Bollywood song, and workers at the U.S. office danced to the Black Eyed Peas.
But with all its globalism, Aegis also has its culture clashes. Some managers from India have a hard time understanding what motivates U.S. workers and why they are less-educated than their Indian peers. One Indian-born manager said he thinks that the U.S. standard of living has spoiled Americans and that they take less pride in their work. In other words, he says, they are lazy.
The India executives are also puzzled by the appeal of dress-down practices. �We don�t do that� in India, says Ramya Devi Ramachandran, 27, a former administrative assistant at the lower Manhattan office who worked for Aegis in India before moving to New York.
Essar and Aegis, however, want to step up the cross-sharing this year, shuffling dozens of U.S. Aegis employees to Goa and Bangalore in India to help handle large U.S. government contracts. Aegis executives say the cross-continent exchange will help India�s call centers keep up during peak Medicare enrollment season and aid the company�s cross-cultural efforts.
Lazy? Is anyone surprised? I'm certainly not. As a cafeteria manager when I hired my first Mexican workers in the Eighties I thought I had gone to heaven. No more absenteeism, fights, broken dishes or bitching about too much hard work. If you want to make an immigrant look really puzzled ask about the unemployment benefits where he or she came from. Experienced employers know well that waves of immigrants are the best source of good employees. Topo bad more unemployed Americans are unaware. But don't get me started...
?One man's personal story of ALS.
Al Lewis, an occasional contributor at The Health Care Blog, shares the story of his wife's passing as a victim of ALS, Lou Gehrig's Disease, and his efforts to get major league baseball to help raise money and awareness of the disease.
For those of you whose loved ones are still alive, here are two practical pieces of advice � that no one gave us � for those final two days, the only ones I feel we mismanaged. First and most importantly, your loved one will lose his/her ability to blink, and won�t be able to communicate that. Your patient�s eyes will dry out, which has got to be very uncomfortable (try going 2 minutes without blinking!). I don�t know the solution, only the problem that needs to be solved that the hospice nurse (the only weak link in our caregiving chain) didn�t mention. Second, we were told by that hospice nurse to leave her alone on the bed and not offer physical contact. (�That way Janet will know that it is OK to die.�) We followed those instructions but they didn�t seem right. I mean, how would anyone know? There aren�t any controlled trials. You can�t interview the patient afterwards. So my advice would be to follow your instincts. Janet�s family and I have replayed those two days altogether too many times, faulting ourselves until recently, when the passage of time has permitted more objectivity.
?Medicare Breaks the Inflation Curve
Good news reports are few and far between, but this post at Health Beat is great news. Even if the analysis proves to have been flawed, there is no way it can be that far off. I have to conclude that Medicare under new management is being run better than before.
Today, S&P released data tracking the growth of health care costs which showed that over the year ending March 2011, Medicare spending rose at an annual rate of 2.78%�the lowest rate posted for the Medicare Index in its six-year history. [Do take a look at this four-page report. This is Standard & Poor's, not known to be careless.]
[...] Why is health care inflation decelerating? In the commercial sector, the recession no doubt plays a major role. Insured patients often have high deductibles that must be paid before they receive care. As a result, hospitals report that patients are putting off elective surgery. Thus, commercial insurers are paying out a lower share of premiums. (See for example, Cigna�s most recent financial report which shows patients� �relatively moderate use of medical services�.)
[...] Why is Medicare cost growth slowing? It appears that �costs for Medicare patients are being better contained than those covered under commercial insurance plans,� observes David M. Blitzer, chairman of the S&P Index Committee. And the provisions in the Affordable Care Act that will put Medicare on the road to financial solvency haven�t even begun to kick in. Meanwhile, conservatives argue that we must privatize Medicare, because taxpayers cannot affords �runaway� government entitlement programs. I wonder how they explain the S&P report.
?Also at The Health Care Blog Roger Collier posted Much More Reform Needed for Medicare? in the wake of some grim actuarial projections from the trustees of the Medicare Trust Fund (who apparently haven't seen the S&P report).
In response to a blindingly ignorant comment left at the site by one of the regular trolls, I allowed myself to cut loose with the following which at this time is still awaiting moderation.
John Ballard says: Your comment is awaiting moderation. May 20, 2011 at 4:40 pm
I agree that as long as the costs of medical care continue to rise faster than the rates of inflation and/or GDP Medicare is �unsustainable� as we know it today.
I do not agree, however, that it is now �insolvent� (with an �e�) because it IS currently paying out what it is supposed to. It is true that if nothing is done to control either benefits or charges being submitted for payment the trust fund will be depleted in a short time, but even then the word insolvent is not accurate. Worst case scenarios project the program will pay out 75% of costs about 2036 and that percentage will steadily rise to about 90% as the baby boom dies off. Poor expectations to be sure, but hardly in the category of �insolvent.� which means completely unable to pay anything. at all.
Clearly there is a problem, but scrapping the system without first making a few tough adjustments is both risky and .short-sighted. Besides, the challenge is not how the bills are paid (Medicare, single-payer, MSA�s, vouchers, private insurance or some hybrid thereof). The real problem is the continuing surge of costs being submitted for procedures, referrals, tests, drugs, durable medical equipment, home health care, therapies of endless types and the list goes on and on.
Here is a link to a great overview of what has happened to medical care during the last fifty years. Read it and weep.
http://www.healthbeatblog.com/2011/05/how-medicine-became-a-growth-business-.html
My personal remedy (politically unrealistic) is derived from a couple of ideas advanced by Andrew Sullivan and Ezra Klein. Sullivan mused that �If everyone aged 40 or over simply made sure we appointed someone to be our power-of-attorney and instructed that person not to prolong our lives by extraordinary measures if we lost consciousness in a long, fatal illness or simply old age, then we�d immediately make a dent in some way on future healthcare costs.� http://andrewsullivan.thedailybeast.com/2011/04/a-modest-proposal-on-healthcare-costs.html
Ezra Klein noticed what Sullivan said and added �What if, to be eligible for Medicare, you had to give someone power of attorney and sign a living will?� http://www.washingtonpost.com/blogs/ezra-klein/post/what-if-medicare-required-a-living-will/2011/04/13/AFk8qZsE_blog.html
I go them both one better. I say find a way to reward any beneficiary who voluntarily executes advance directives for health care and appoints at least three agents with POA to make medical decisions in the event of incapacity. This isn�t a complicated problem It is, however, very much like substance abuse with a vast number of people in denial.
Here is a link to an excellent example of advance directives for Georgia but I�m sure other states have equally good arrangements.
http://aging.dhr.georgia.gov/DHR-DAS/GEORGIA%20ADVANCE%20DIRECTIVE%20FOR%20HEALTH%20CARE-07.pdf
It�s time to quit all this carping about how we pay bills and find a way to stop having so many. And the biggest financial hemorrhage is at the last months of life. I came across a grim joke that the reason coffins have nails is to keep out the oncologists. Anyone who has done their homework knows, the biggest expense we face is the delusional idea that dying is optional. It ain�t. And that, my friend, is an incontrovertible fact.
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