In Rolling Stone, his latest hit on Wall Stteet malfeasance:
http://www.rollingstone.com/politics/news/the-people-vs-goldman-sachs-20110511?print=true
Next Tuesday I go to the hospital for a coronary catheterization. Below is a report from the Times on a protocol developed by Peter Pronovost, MD:
The intensive care units at nearly every hospital in Michigan participated — 103 I.C.U.’s. What they had to do was use a five-point checklist to prevent infection when inserting the catheters. The steps were: Wash hands. Cover the patient with sterile drapes. Clean the skin with chlorhexidine antiseptic. Do not insert catheters into the groin area. Remove catheters as soon as they are no longer needed*….“Within 3 months after implementation, the median rate of infection was 0, a rate sustained throughout the remaining 15 months of follow-up. All types of participating hospitals realized a similar improvement.”
*I’ll wear this on my chest.
From James Fallows, writing in The Atlantic:
For decades any “serious” approach to medical spending has had to cope with various tangled economic/technological/moral realities. This is a different kind of “market” from almost any other, as David Goldhill so vividly described in our magazine. You can shop around for houses or used cars, but you don’t have the same kind of comparison-shopping opportunities when you go to the emergency room or when a doctor recommends one drug versus another. Technology has the opposite effect on medical costs from many other parts of the economy: more and more miracles become available, but at higher and higher cost. And the “insurance” aspect of our current system is skewed in many ways: You can pay fire insurance year after year and never have a fire, whereas all of us are going to die, and the great majority of us will require expensive treatment at some point before we do. “Insurance” therefore is a matter both of spreading risks across a general population, as with fire insurance; but also of spreading risks across the stages of each person’s life cycle, from the lower-cost early years to the higher-cost later ones. This creates markets forces and distortions unique to the health-care world.
And here’s an intelligent, frightening analysis, with a radical yet hopeful solution:
How American Health Care Killed My Father
Here’s a view of health care that shows why the patient is NOT a ‘customer’.”
Daily Kos today
Fuck you, Senator Kyl.
From Ezra Klein’s blog today:
A while ago, a woman asked me, as my local HOA Board President, what she should do to get a railing going up her steps. Her husband had troulble walking up the steps from their car after coming back from the VA hospital; they have a disabled tag on their car. I told her about getting an architectural approval form, even got the form for her, and walked her through getting the form approved. When it had finally been approved, I gave her the names of some handymen who could install the railing for her. She was surprised, at that point, that the HOA was not going to contract out and pay for the work. “Oh, I thought, because it was ‘disabled,’….”
So, she thought the HOA should be paying for it. I had to tell her that no, the HOA was not, unfortunately, going to pay for it, and she would be responsible for getting it installed, like all the rest of the people in the community who have had railings installed.
I wish we could pay for it. I wish we could put a railing up for old Mr. Cooper, who could really use one. And several other infirm members of the community.
I wish we, the HOA, could be responsible for the water main branches going from the street into each house. I wish we could take care of the gardens in people’s back yards. I wish we could stain all the privacy fences (the Covenant says the homeowner is required to weatherproof their privacy fences).
But, we don’t. We can’t. If you have a tree in your back yard (within your fence), it is your responsibility, as are the shrubberies and flowers there. We just don’t have the money to pay for everything that would be nice.
We could have the money, if we raised the maintenance fee high enough. But everyone would scream. Or, we could have a special assessment. Even louder screams.
People forget that the HOA is a kind of local government. Its mandate is spelled out in the Covenant and By-laws, and the Rules as determined by the Board. The Board is a unicameral legislature (the camera for the nonce is my livingroom), which elects its own officers, just as was done by early, colonial legislatures on the States. It has no independent source of income; all monies flow from the Residents, through the Regime Fee, which, if you think about it, is a kind of tax. This is taxation with representation. Whatever the HOA spends, it is spending your money. It is your friends and neighbors, with you, who pay the landscapers, the garbage collectors, the paving resealer, the fence mender, the gate maintenance, lighting, water, termite control, gutter cleaning and repair, water damage repair, and everything else spelled out in the yearly budget (which you saw at the recent Annual Meeting). So when someone says, ‘Why can’t the HOA pay for this?’ they need to consider, do I want to ask my friends and neighbors to pay for my needs?
Which is one reason why the Tea Party deficit hawks, and even the so-called conservatives here in SC, drive me crazy: they (like the lady above with the railing) want all the services–schools, fire and police protection, street and highway mainenance, national defence, trips to Mars, Iraq invasions, and so on–but don’t think they should have to pay for these things.
Then who?
I’m all for fiscal conservatism. At our last Board meeting, I saw that, even with a bare-bones budget, we would run a deficit without raising the regime fee. It had to be raised; we have no madate to run a deficit. So the regime fee went up 2%. Hadn’t raised it in three years. Ever so sorry. But we, all of us, as good citizens of whatever polis, state, nation, city, town we’re talking about, have to be responsible. We must.
New Yorker, Jan. 17, 2011:
“This is my copy of the Constitution,” John Boehner, the Speaker of the House, said at a Tea Party rally in Ohio last year, holding up a pocket-size pamphlet. “And I’m going to stand here with the Founding Fathers, who wrote in the preamble, ‘We hold these truths to be self-evident, that all men are created equal, that they are endowed by their creator with certain unalienable rights including life, liberty and the pursuit of happiness.’ ” Not to nitpick, but this is not the preamble to the Constitution. It is the second sentence of the Declaration of Independence.
