August 9th, 2012
arvindsuguness
Super-sizing Medicine
Writing for The New Yorker, Atul Gawande argues that emulating the standardization of chain restaurants like The Cheesecake Factory can help fix our health care system:

“It is unbelievable to me that they would not manage this better,” Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. “I don’t know anything about medicine,” he said. But when I pressed he thought for a moment, and said, “This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.”

This is not at all the normal way of doing things in medicine. (“You’re scaring me,” he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the “best practices” are?

Read the full article here.
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Super-sizing Medicine

Writing for The New Yorker, Atul Gawande argues that emulating the standardization of chain restaurants like The Cheesecake Factory can help fix our health care system:

“It is unbelievable to me that they would not manage this better,” Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. “I don’t know anything about medicine,” he said. But when I pressed he thought for a moment, and said, “This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.”

This is not at all the normal way of doing things in medicine. (“You’re scaring me,” he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the “best practices” are?

Read the full article here.

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July 23rd, 2012
atomvincent

Adding Up to the End of the World

Bill McKibben writes for Rolling Stone on the staggering - and horrifying - realities of climate change as spelled out through three simple numbers.

But what all these climate numbers make painfully, usefully clear is that the planet does indeed have an enemy – one far more committed to action than governments or individuals. Given this hard math, we need to view the fossil-fuel industry in a new light. It has become a rogue industry, reckless like no other force on Earth. It is Public Enemy Number One to the survival of our planetary civilization. “Lots of companies do rotten things in the course of their business – pay terrible wages, make people work in sweatshops – and we pressure them to change those practices,” says veteran anti-corporate leader Naomi Klein, who is at work on a book about the climate crisis. “But these numbers make clear that with the fossil-fuel industry, wrecking the planet is their business model. It’s what they do.”

Read the full article here.

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July 18th, 2012
atomvincent

Rich People Are Assholes

Lisa Miller writes for New York Magazine on new research that suggests the more money you have, the likelier you are to be a jerk.

Earlier this year, Piff, who is 30, published a paper in the Proceedings of the National Academy of Sciences that made him semi-famous. Titled “Higher Social Class Predicts Increased Unethical Behavior,” it showed through quizzes, online games, questionnaires, in-lab manipulations, and field studies that living high on the socioeconomic ladder can, colloquially speaking, dehumanize people. It can make them less ethical, more selfish, more insular, and less compassionate than other people. It can make them more likely, as Piff demonstrated in one of his experiments, to take candy from a bowl of sweets designated for children. “While having money doesn’t necessarily make anybody anything,” Piff says, “the rich are way more likely to prioritize their own self-interests above the interests of other people. It makes them more likely to exhibit characteristics that we would stereotypically associate with, say, assholes.”

Read the full article here.

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June 21st, 2012
atomvincent

Money & Music

We live in complicated times. Technology has put the whole history of recorded media at our fingertips. For more than a decade, fewer and fewer people have been paying for music and those that do use services, such as Spotify and iTunes, that have been shown to do very little in the way of providing substantial revenue to artists. The problem this creates - that artists are making increasingly less and in some cases effectively nothing from their work - is one that I (and I believe many others) struggle with morally and philosophically.

In a recent post for NPR’s All Songs Considered Blog, Emily White vocalized this struggle, admitting that while she longs to support the artists she loves, she has only ever paid for a handful of records in her life. Shortly after, David Lowery (front-man of Camper Van Beethoven and Cracker, as well as professor on the business of music at the University of Georgia), wrote an open response to White for the blog Trichordist, illuminating the dire straits many artists now find themselves in and boiling down the reality of getting music “for free.”

As you might expect, quite the debate has begun to rage across the web in the days since the exchange. Writing on the issue for Salon, Scott Timberg looks at both sides of the argument and illustrates just how important this conversation is to keeping the arts alive.

So who’s right? In the broad sense, they both are: White is describing the way music sharing works among her generation, one that came of age after the fetishism of cover art, liner notes and the physical qualities of records and CDs. (It would be interesting here to look at the generational makeup of the vinyl revival, which is driven in part by a longing for sound vastly warmer and more expansive than that on MP3s but also by the old-school ritual of a brick-and-mortar shop, an informed and/or forbidding clerk, and the tangibility of the physical object.) She comes across as wanting to do what’s right.

But Lowery’s argument – despite a few misspellings and the jumble of well-considered and rushed thoughts that the Web all but requires – is one of the most important meditations on the state of music in our time. He drops some crucial statistics here, among them that “Recorded music revenue is down 64 percent since 1999,” and that “The number of professional musicians has fallen 25 percent since 2000.” He refers indirectly to something equally important: The money being spent on music is not ending up in the hands of musicians, or even labels, or members of the creative class, from the record store clerk to a label president. It’s going to Apple – which could, thanks to iTunes, buy every surviving label with pocket change – and other technology companies.

Perhaps the most effective argument of Lowery’s is an extended metaphor about a lawless urban neighborhood – shades of the strange days during the L.A. riots — that never raised a police force.

So in this neighborhood people simply loot all the products from the shelves of the record store. People know it’s wrong, but they do it because they know they will rarely be punished for doing so. What the commercial Free Culture movement (see the “hybrid economy”) is saying is that instead of putting a police force in this neighborhood we should simply change our values and morality to accept this behavior. We should change our morality and ethics to accept looting because it is simply possible to get away with it.  And nothing says freedom like getting away with it, right?

But it’s worse than that. It turns out that Verizon, AT&T, Charter etc etc are charging a toll to get into this neighborhood to get the free stuff. Further, companies like Google are selling maps (search results) that tell you where the stuff is that you want to loot … Further, in order to loot you need to have a $1,000 dollar laptop, a $500 dollar iPhone or $400 Samsumg (sic) tablet. It turns out the supposedly “free” stuff really isn’t free. In fact it’s an expensive way to get ‘free’ music… And none of that money goes to the artists!

Read the full article here.
Read Emily White’s piece for NPR here.
Read David Lowery’s response here. 

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April 11th, 2012
arvindsuguness
Is America In Decline?
Writing for Financial Times Magazine, Edward Luce argues that America’s economic and political dysfunction have left us under-invested in our own future:

American politics tracks the growing divide between the elites and everyone else. The two reinforce each other – America’s bifurcating economy polarises the politics and vice versa. America’s parties now behave in a Westminster parliamentary fashion in a system consciously designed to grind to a halt unless there is cross-party co-operation. To give one example, the use of the filibuster to block legislation in the Senate has risen to 70 per cent of bills in 2008 from just 8 per cent in the mid-1960s. Since then it has risen further. The result is often paralysis.
It would be wrong to put equal blame on both parties – Republicans are far more parliamentary than the Democrats. As the veteran political observers Norm Ornstein and Thomas Mann point out in their forthcoming book, It’s Even Worse Than It Looks, America is suffering from asymmetric polarisation. “The Republican Party has become an insurgent outlier – ideologically extreme; scornful of compromise; unpersuaded by conventional understanding of facts, evidence, and science,” they write. “When one party moves this far from the center, it is extremely difficult to respond to the country’s most pressing challenges.”
…
Beneath the fiscal high jinks, however, lies even more troubling evidence that America’s sense of pragmatism is missing. In daggers-drawn Washington, Democrats and Republicans have been able to agree only on a certain type of spending cut. The bulk are targeted at the one slice of the federal budget that qualifies as investment – “domestic non-defence discretionary spending”, which accounts for only 12 per cent of the pie. This includes research and development, infrastructure and education programmes – areas that matter greatly to America’s future competitiveness. They could be described as the “tomorrow” part of the US budget. The remainder, which is mostly healthcare for retirees, pensions, defence and interest payments on past debt, might be seen as the “yesterday” portion. Yet Washington’s first instinct in the new era of austerity was to shortchange the future. There will be more to come even if Obama is re-elected.

Read the full article here.
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Is America In Decline?

Writing for Financial Times Magazine, Edward Luce argues that America’s economic and political dysfunction have left us under-invested in our own future:

American politics tracks the growing divide between the elites and everyone else. The two reinforce each other – America’s bifurcating economy polarises the politics and vice versa. America’s parties now behave in a Westminster parliamentary fashion in a system consciously designed to grind to a halt unless there is cross-party co-operation. To give one example, the use of the filibuster to block legislation in the Senate has risen to 70 per cent of bills in 2008 from just 8 per cent in the mid-1960s. Since then it has risen further. The result is often paralysis.

It would be wrong to put equal blame on both parties – Republicans are far more parliamentary than the Democrats. As the veteran political observers Norm Ornstein and Thomas Mann point out in their forthcoming book, It’s Even Worse Than It Looks, America is suffering from asymmetric polarisation. “The Republican Party has become an insurgent outlier – ideologically extreme; scornful of compromise; unpersuaded by conventional understanding of facts, evidence, and science,” they write. “When one party moves this far from the center, it is extremely difficult to respond to the country’s most pressing challenges.”

Beneath the fiscal high jinks, however, lies even more troubling evidence that America’s sense of pragmatism is missing. In daggers-drawn Washington, Democrats and Republicans have been able to agree only on a certain type of spending cut. The bulk are targeted at the one slice of the federal budget that qualifies as investment – “domestic non-defence discretionary spending”, which accounts for only 12 per cent of the pie. This includes research and development, infrastructure and education programmes – areas that matter greatly to America’s future competitiveness. They could be described as the “tomorrow” part of the US budget. The remainder, which is mostly healthcare for retirees, pensions, defence and interest payments on past debt, might be seen as the “yesterday” portion. Yet Washington’s first instinct in the new era of austerity was to shortchange the future. There will be more to come even if Obama is re-elected.

Read the full article here.

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April 2nd, 2012
atomvincent

Marx in 2012

As we approach the 193rd anniversary of Karl Marx’s birth, John Lanchester examines the predictions Marx made about the development of the capitalist system and how they compare with the socio-economic realities of our contemporary world. For the London Review of Books:

He was right: no alternative has developed. Economics as a discipline has in effect become the study of capitalism. The two are taken as the same subject. If there were ever going to be a serious and sustained theoretical challenge to the hegemony of capitalism inside economics – a serious and sustained challenge subsequent to the one provided by what used to be called ‘actually existing socialisms’ – you’d have thought one would have come along since the near terminal meltdown of the global economic system in 2008. But all we’ve seen are suggestions for ameliorative tweaking of the existing system to make it a little less risky. We have at the moment this monstrous hybrid, state capitalism – a term which used to be a favourite of the Socialist Workers Party in describing the Soviet Union, and which only a few weeks ago was on the cover of the Economist to describe the current economic condition of most of the world. This is a parody of economic order, in which the general public bears all the risks and the financial sector takes all the rewards – an extraordinarily pure form of what used to be called ‘socialism for the rich’. But ‘socialism for the rich’ was supposed to be a joke. The truth is that it is now genuinely the way the global economy is working.

The financial system in its current condition poses an existential threat to Western democracy far exceeding any terrorist threat. No democracy has ever been destabilised by terrorism, but if the cashpoints stopped giving out money, it would be an event on a scale that would put the currently constituted democratic states at risk of collapse. And yet governments act as if there is very little they can do about it. They have the legal power to conscript us and send us to war, but they can’t address any fundamentals of the economic order.

Read the full article here.

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