June 22, 2020

Posted by orrinj at 7:40 PM

HEALTH CARE REFORM IS ABOUT REDUCING CONSUMPTION:

People Have Stopped Going to the Doctor. Most Seem Just Fine. (Sandeep Jauhar, June 22, 2020, NY Times)

Most patients, on the other hand, at least those with stable chronic conditions, seem to have done OK. In a recent survey, only one in 10 respondents said their health or a family member's health had worsened as a result of delayed care. Eighty-six percent said their health had stayed about the same.

[A]  vast majority of patients seem to have fared better than what most doctors expected. It will probably take years to understand why. Perhaps patients mitigated the harm of delayed care by adopting healthful behaviors, such as smoking less and exercising more. Perhaps the huge increases in stress were balanced out by other things, such as spending more time with loved ones.

However, there is a more troubling explanation to consider: Perhaps Americans don't require the volume of care that their doctors are used to providing.

It is well recognized that a substantial amount of health care in America is wasteful, accounting for hundreds of billions of dollars of the total health care budget. Wasteful care is driven by many forces: "defensive" medicine by doctors trying to avoid lawsuits; a reluctance on the part of doctors and patients to accept diagnostic uncertainty (which leads to more tests); the exorbitant prices that American doctors and hospitals charge, at least compared to what is charged in other countries; a lack of consensus about which treatments are effective; and the pervasive belief that newer, more expensive technology is always better.

One of the most significant factors in wasteful health care is having too much supply of health care per capita in certain areas. In specialist-heavy Miami-Dade County, for example, Medicare spends more than twice per person what it spends in Santa Fe, N.M., largely because there is more per capita utilization of doctors' services. Sadly, more care doesn't always result in better outcomes.

If beneficial routine care dropped during the past few months of the pandemic lockdown, so perhaps did its malignant counterpart, unnecessary care. If so, this has implications for how we should reopen our health care system. Doctors and hospitals will want to ramp up care to make up for lost revenue. But this will not serve our patients' needs.

People need to have "coverage" to allay their financial concerns, but denied procedures (by those notorious death panels) that don't improve outcomes.

Posted by orrinj at 7:04 PM

LAFAYETTE ARE HERE:

Vermont's royal welcome for the Marquis de Lafayette (Mark Bushnell, 6/21/20, VT Digger)

Early in the morning of June 28, 1825, between 3,000 and 4,000 Vermonters gathered in Windsor to greet a returning hero. They probably didn't mind the hour. Many of them were farmers from the surrounding area and were used to rising before dawn. Besides, since this visitor had come from so far to see them, getting up early was the least they could do. 

At about 7 a.m., they first caught sight of the elegant fringed carriage bearing their guest, Marie-Joseph Paul Roch Yves Gilbert du Motier, better known as the Marquis de Lafayette. 

In the 1820s, Lafayette was one of the Revolution's few surviving heroes. Washington, Franklin, Hamilton and others were dead. Jefferson and Adams were in their 80s and in frail health; indeed, they would die within the year.

In contrast, Lafayette was a comparatively young 67. Born into a wealthy French family and orphaned at 13, he had followed his father's path into the military. Despite his privileged background, Lafayette had ardently embraced the colonies' fight for liberty. At the age of 19, he sailed to North America and persuaded Congress to commission him a general in the Continental Army. Though he proved himself a competent, if not entirely gifted, officer, Lafayette was vital to the colonies' efforts.  His loyalty to the cause and his connections in the French government proved instrumental in winning crucial French support that helped turn the tide of the war. Americans loved him.

Lafayette had returned to France, where he led troops in the fight for liberty during his own country's revolution. But he always vowed he would return and do a tour of the country he had helped create.

Now, nearly a half century after leaving, Lafayette was back. While in Massachusetts, he had been complimented on his impeccable English, which he only started to learn as a teenager sailing to North America. Explaining his fluency, he said, "I am an American citizen who has been absent for a time."

If possible, Lafayette's absence had only made American hearts grow fonder. As his carriage rolled into Windsor escorted by Revolutionary War veterans and troops from New Hampshire, people crowded the streets to see him. 

Lafayette addressed the crowd from the balcony of John Pettes' Coffee House, then sat down to breakfast. He was either ravenous from the trip or too polite to mention that he had already eaten breakfast before departing New Hampshire a little more than an hour earlier.

He had no time to linger in Windsor. Over the next day and a half he had appointments to keep across Vermont. He and his entourage, which now included Vermont veterans and troops, had to move at breakneck speed. 

Posted by orrinj at 6:59 PM

SOMEONE EXPLAINED TO DONALD...:

Trump's Maduro comments create political mess in must-win Florida (MATT DIXON and GARY FINEOUT, 06/22/2020, Politico)

That contradicts comments he made in an interview with Axios in which he second-guessed his own administration's decision to recognize opposition leader Juan Guaidó as the South American country's legitimate president. On the potential Maduro meeting, he said "you lose very little with meetings."

The interview, published Sunday night, immediately sent shockwaves through Florida's political ecosystem, especially in South Florida, which is home to more than 400,000 Hispanics of Venezuelan origin. Many of those are expats who fled Maduro's socialist regime. During a briefing Monday, White House spokesperson Kayleigh McEnany clarified that, despite his comments, Trump continues to view Guaidó as Venezuela's legitimate leader.

The mere flirtation with diplomatic talks with Maduro could hurt Trump's standing in the nation's largest swing state, which he needs to win in November in order to return to the White House for a second term. It also has big down-ticket implications as Republicans try to flip a vulnerable Miami congressional seat and fend off Democrats' attempt to win seats in the region that could inch them close to taking control of the Florida Senate for the first time in nearly two decades.

Republicans up and down the ballot have also galvanized around a central 2020 messaging strategy focused on branding Democrats as far-left lovers of socialism. Months of that groundwork is now, at least in part, set back by the president's own comments.

"Trump talks tough on Venezuela, but admires thugs and dictators like Nicolas Maduro," Joe Biden tweeted Sunday night. "As President, I will stand with the Venezuelan people and for democracy."


...that Maduro is a Socialist Nationalist, so the embrace was on brand.

Posted by orrinj at 6:55 PM

BUT, ANTIFA...:

Army Soldier Plotted 'Jihadi Attack' on His Own Unit With Neo-Nazi Satanists: Feds (Spencer Ackerman & Adam Rawnsley,  Jun. 22, 2020, Daily Beast)


Federal prosecutors in New York accused a U.S. soldier of giving sensitive information on U.S. troop movements to a satanic white-supremacist group as part of a criminal conspiracy to murder U.S. military service members and provide material support to a foreign terrorist organization.  

According to an indictment released Monday, Private Ethan Phelan Melzer provided "confidential U.S. Army information" to an infamous organization known as the Order of the Nine Angles (O9A), a British occult Nazi group whose works have been promoted by white-supremacist militia Atomwaffen and which has expressed support for al Qaeda. Melzer's contacts within O9A described their plans as "literally organizing a jihadi attack."

Prosecutors say that Melzer shared information about his Army unit's "location, movements, and security" with the satanic neo-Nazi group because he was allegedly planning an ambush attack on his fellow soldiers alongside O9A. 

Posted by orrinj at 6:36 PM

SADLY, THE GREATEST EPISODE WAS NEVER SHOT:

This Early Cheers Episode Explains Why Everybody Still Knows the Sitcom's Name (NITISH PAHWA, JUNE 22, 2020, Slate)

[A]ccolades aside, what's truly remarkable about Cheers is that, almost 40 years after its premiere, it mostly remains a warm, friendly, accessible show, despite some attitudes of its time. It began as a collaboration between brothers Glen and Les Charles, writers for M*A*S*H, The Mary Tyler Moore Show, Taxi, and others, and James Burrows, a longtime TV director. As Burrows told the New York Times in 1983, the trio "wanted to create a show around a Katharine Hepburn-Spencer Tracy-type relationship" between a sophisticate and an average Joe.

They came up with a former Boston Red Sox relief pitcher and Casanova named Sam Malone (Danson), whose problems with alcoholism derailed his career and who now stays sober while owning and tending his own bar, Cheers. His former coach, Ernie Pantusso (Nicholas Colasanto), helps run things, while the sharp Carla Tortelli (Rhea Perlman) works as a waitress, and the three regularly serve proud postal worker Cliff Clavin (John Ratzenberger) and accountant Norm Peterson (George Wendt), the latter such a staple at the bar that he's cheered by name whenever he walks through the door. The Hepburn to Sam's Tracy is intellectual, snobbish Diane Chambers (Shelley Long), an academic who, after being dumped by her fiancé and former professor, takes a job serving at Cheers.

The famous Sam-and-Diane dynamic is an essential part of the show and affects just about every plot point in some way, but the show is not just about the two of them--it explores all the characters' lives in detail. And as Cheers goes along, characters filter in and out, including new bartender Woody (Harrelson), psychiatrists Frasier Crane (Grammer) and Lilith Sternin (Bebe Neuwirth), and businesswoman Rebecca Howe (Kirstie Alley). The show is also very proud of its firm Boston and Massachusetts roots, featuring cameos from local celebrities and politicians like Wade Boggs, Tip O'Neill, John Kerry, and Michael Dukakis. As any actual Bostonian will be quick to tell you, Cheers as the characters know it never really existed, although there is a bar at the exterior location seen on the show, formerly known as the Bull & Finch Pub and now a tourist landmark named Cheers Beacon Hill.

Obviously, the greatest episode would have been the one where Vera came to fish Norm out of the bar and is played by Michelle Pfeiffer.

Posted by orrinj at 6:29 PM

POWER BROKEN:


Posted by orrinj at 6:19 PM

GONNA NEED MORE BRONZE:

The statues of Samuel Johnson can stay (Matthew Walther, June 22, 2020, The Week)

His life (1709-1784) was more or less bookended by the beginning and end of the British transatlantic slave trade, of which he was an inveterate and uncompromising opponent. He dismissed Jamaica, the most profitable of the British colonies at the time, as "a place of great wealth and dreadful wickedness, a den of tyrants, and a dungeon of slaves." He once offered a toast at a dinner in Oxford to "the next insurrection of the negroes in the West Indies." His verdict on the American Founding ("How is it that we hear the loudest yelps for liberty among the drivers of negroes?") is in some ways the first and last word on the subject.

Nor was his belief in the wickedness of slavery a mere abstract commitment of the kind so familiar to scribblers then as now. Johnson's valet Francis Barber was a freed black Jamaican who eventually became his heir, an astonishing bequest that was widely reported in the English press at the time. With the help of his friend Tobias Smollett, Johnson secured Barber's release from naval service (for which he thought he should have been disqualified on grounds of health) and paid for him to receive an education. Johnson's relationship with Barber was one of genuine friendship and the latter was an invaluable source for James Boswell and other early biographers of the great man, including those like Sir John Hawkins who were disgusted by their subject's "ostentatious bounty [and] favour to negroes."

Johnson's loathing of racial injustice was not limited to chattel slavery. He heaped scorn on both colonial participants in the French and Indian War, which he called "only a quarrel of two robbers." Nor was this his only apparently forward-looking view. He hated the civil penalties under which British Catholics would live until 1829 and thought it absurd that in Rome of all places men were allowed to visit legally sanctioned brothels ("I would punish it much more than is done"). [...]

What made Johnson's views possible? In addition to his penchant for contrarianism, one might suggest his wide and generous reading, which attuned him to the experience of people far away and utterly unlike himself. (Among his favorite books was Richard Knolles's Generall Historie of the Turkes, the first serious English treatment of the history of the Ottoman Empire, which Johnson lamented was full of "enterprizes and revolutions, of which none desire to be informed.") More important than either of these, however, was his deep religious faith. Johnson could not stand to see "black men... repining under English cruelty" for the simple reason that he believed human beings are made lovingly in the image of God and possessed of an innate metaphysical dignity.

Posted by orrinj at 6:16 PM

THE rIGHT IS THE lEFT:


Posted by orrinj at 1:02 PM

ALWAYS THIRD WAY:


Posted by orrinj at 12:00 AM

PURITAN NATION:

What Liberty Meant to the Pilgrims (NATHANAEL BLAKE, June 18, 2020, National Review)

Turner's book, They Knew They Were Pilgrims, alternately affirms and challenges both the popular mythos and its critics. Beginning with the separatist movement in England and continuing until Plymouth was incorporated into Massachusetts in 1691, Turner provides an engaging account of the Pilgrims, from Calvinist theology to colonial politics. While validating some criticisms, he asserts that the Pilgrims matter for more than their legend, and he deftly uses the history of Plymouth to explore ideas of liberty in the American colonies.

This should be of particular interest to conservatives as we debate rival claims about the founding principles of our nation, which the study of colonial life places in context. Though the Declaration of Independence asserts a right to liberty, we do not all mean the same thing by it. Turner demonstrates that colonial ideas of liberty were not uniform, even in Plymouth, though there was a dominant theme. The Pilgrims and their descendants understood liberty not as individual freedom to live as one pleased; when they encountered that kind of freedom at Thomas Morton's Merry Mount settlement, they saw it as "licentiousness and recklessness." Rather, the Pilgrims sought freedom for Christians, redeemed from bondage to sin and Satan, to live in accord with Scripture, covenanting as a congregation free from the dominion of the corrupt Church of England.

In Turner's telling, this understanding was essential to the development of New England Congregationalism. The establishment of Massachusetts did not efface Plymouth but fulfilled it, for "England's transplanted puritans were remaking themselves in Plymouth's image" as new towns formed their own covenant churches. An ocean away from England, the theoretical distinctions between the Plymouth colonists who wanted to separate from the Church of England and the Puritans of Massachusetts Bay, who had wanted to purify it, were negated as the churches of both colonies established themselves as self-governing congregations.

The development of New England Congregationalism alone would suffice to secure the Pilgrims' place in history, but Plymouth also had the distinction of initiating political self-government in New England. The colony held annual elections with a franchise much broader, albeit still limited, than that in England, and trial by jury was a fundamental right. Most adult men could aspire to participation in both the religious and political government of the colony. But this communal liberty did not imply broad personal liberty. The Pilgrims believed that government had a responsibility to constrain individuals to conform to the righteous mores of the community, and they had no qualms about regulating matters from speech to sex to attire.



Posted by orrinj at 12:00 AM

WHAHAPPEN?:

When the KKK Played Against an All-Black Baseball Team (John Florio & Ouisie Shapiro, 6/22/20, The Nation)

[T]he Klan had an image problem in Kansas. In 1922, Governor Henry Justin Allen had launched a crusade to oust the organization from the state. By early 1925, the State Supreme Court had banned the KKK on the grounds that it had been operating without a state charter. While the decision was on appeal before the U.S. Supreme Court, the Klan was free to continue to operate--and to roll out a full-court press to prove it wasn't the hate-mongering machine so many feared, but, rather, made up of solid citizens.

The Klan had already used its PR smoke-machine to embed itself into local communities, sponsoring parades, picnics, and beauty contests. It donated money to churches and hospitals. Its members showed up at Christmas parties for orphans, wearing Santa suits and handing out gifts to children. And it backed state and local politicians.
 
Now, with its case pending in the country's highest court, it was looking for still more favorable ink--and got wind that the Monrovians were looking for paydays. (In all likelihood, the Klan had been reading the Wichita Eagle, the city's other white paper. A few weeks before the game, the Eagle wrote that the Monrovians were "open for a game with any team in Kansas.")

For the white-robed, playing a black team was a gift-wrapped photo op, a chance to show that the Klan was part of the local community--and friendly toward Wichita's black citizens.

For baseball fans in Kansas, it was a chance to see the Monrovians play. The team had won the Colored Western League pennant in 1922, the one and only year the league existed. The following year, with no league left to champion, the Monrovians continued as an independent team, scratching together a living by playing any game that came with a paying audience.

The Klan's Chapter No. 6 took the challenge--and to show the game would be an above-board contest, it hired Catholic umpires. Bob Rives has his suspicions about the choice. "I think the Klan was fearful that it would lose, and if it lost, it would be considered inferior to the black team. And so they announced in advance that the two umpires would be Irish Catholics. The Klan in Kansas then was at least as anti-Catholic as it was anti-black. My opinion is that they were paving the way to be able to say, well, we really didn't lose. Look at who the umpires were."

It turned out it didn't matter. The Eagle described the affair as the "best attended and most interesting game in Wichita" that day, a seesaw battle that began as a pitcher's duel and ended in a flurry of runs. Bigotry lost the game, 10-8, and it also lost the bigger prize: the Klan was evicted from Kansas two years later, when the Supreme Court refused to hear the case.