Information for tough decisions

The New York Times reports that seniors are seeking information for tough decisions that they’ll make.  Doctors are getting paid to offer end of life planning support.

Three non-profits — the California Health Care Foundation, Cambia Health Foundation and John A. Hartford Foundation — fielded a poll of 736 doctors who see patients 65 and older. Only 14 percent said they had already billed Medicare for the new counseling, though the survey was conducted February 18 through March 7, meaning the earliest participants only had about six weeks from the start of the benefit. Altogether, 95 percent of doctors in the poll expressed support for the Medicare benefit and a big majority considered such conversations important….

All told, it was only about 20 minutes before Diamond’s white sneakers shuffled out of the room and the appointment was over. He was to review the paperwork with his two daughters before signing it, but he said he had looked forward to the session simply because it was a new experience. Diamond said he saw it as both necessary and comforting.

Medicare reimbursements for the appointments vary by region and the type of facility, but on average, an initial 30-minute session in a doctor’s office costs $86. As those experiences proliferate, the topic of discussing end-of-life care may return to the relatively uncontentious mantle it once enjoyed.

Death is scary, but lots of things are scary.  Having a plan to address uncertainty helps a lot of people become less scared as well as maintain control over themselves and their environment.  In a medical finance context, having a plan allows people to get the care that they want with some modicum of dignity.  It is not a death panel.  People can choose to have the hospital go all out with a strong possibility of a long stay in an ICU while others may choose to have hospice as their preferred option.  It is a matter of choice instead of a mandated non-choice that all people will get every type of care even when the individual would prefer not to have that care.

It is not a death panel.  It is information and advice from a trusted expert to make good choices.








Tuesday Morning Open Thread

emily s 1972 1 Lenny

From commentor Emily S:

Here are two shots of Lenny. My French teacher in the 9th grade, Miss Ellard, had kittens to be adopted and that’s how I got Lenny. She was a wonderful cat who purred any time you picked her up and loved to be petted and combed with a metal comb.

emily s 1970 1 Lenny
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My biggest laugh of the day was this David Letterman tale, as reported by NYMag:

[A] few weeks ago, I got very excited because the Obamas invited myself and my wife to a state dinner, and I said, “Oh my god, Regina, we’ve been invited to a state dinner!” And she says, “Oh, I love steak.” I said, “No.”… So we go to the steak, state dinner, and it’s for the heads of the Nordic states, and President Obama was giving remarks before he introduced the heads of state. And he was talking about how cooperative their union was, the Nordic states. Yes, they have differences, but by and large, they all felt and had the same beliefs, and they were good for mankind, and believed in the right thing, and they were strong allies for the United States. He said, “Don’t misunderstand me, they do argue. They do have … as a matter of fact, there is still an ongoing fight in the Nordic States about which country is happiest.” And then the prime minister of Iceland got up, and he said, “We are working on a defensive weapons system right now.” And this gets everybody’s attention! Like, Iceland, really? Working on a defensive weapons system? And he said, “Yes, volcanoes. We just haven’t figured out how to aim them yet.” So I’m seated at dinner next to a man who is the assistant chief of staff to the prime minister of Norway. And I’m feeling like a big shot. And we’re chatting, and we’re chatting, and we’re chatting. And when it comes about dessert time, and the guy says to me, “Excuse me. Why are you here?” And I said, You know what? I think I picked up somebody else’s mail. And he said, “So you’re here by mistake?” And I said, Yeah. And he said, “Oh.” So there you go — you get invited to the state dinner, nobody knows why. That’s the sum total of being retired…

From my admittedly parochial viewpoint (among other factors, my mother-in-law is Norwegian), one should keep firmly in mind that Scandinavians have a sense of humor so dry it could be used as a dessicant in designer sneaker boxes…



Open Thread: Welfare Ranchers Get No Respect

There’s never a FREEDUMB-loving billionaire around when you really need one…

Any of our BundyBund-addicted lawyers (or others) want to weigh in on the chance that Koch beneficiary and “snake oil salesman” Ken Ivory might finally have skirted one government regulation too many here? Who’s got standing to address this?



When They Said “Come Down” I Threw Up

HRClinton 2016. Because somebody needs to be the grown-up.  [Emphasis in the original.]

The notion that Hillary is the “grown up” in this campaign is perhaps true, considering the competition. But what does it mean to be a “grown up”? I think we can all agree that Barack Obama is probably the best example of a “grown up” politician that we’ve seen in the past few years. And if we look at Obama’s actions around the time when Hillary’s campaign was flopping around like a gutted fish in 2008, after her moron advisors helped her lose the race, we can see what a “grown up” did.

He quietly let Hillary’s campaign burn out, and when she quit, he was gracious about it.  We should expect the same from Hillary, and we should also expect Bernie to quit when he feels that it is bloody obvious to his supporters that he’s lost.  We should also expect him to endorse Hillary wholeheartedly and without reservation.

At this point in 2008, I was concerned about Hillary’s campaign, but I assumed she would come around.  In 2016, I feel the same about Bernie. Both of them, as well as their advisors and supporters, said some dumb things in the death throes of their campaigns.  (And a lot of people were freaking out.)  Those dumb things were forgotten by early Fall, 2008, and I’m sure the same will be true by Fall, 2016.

Speaking of “grown ups”, at this point in 2008, there were fewer “grown ups” in the Hillary camp than in the Sanders camp today:

One of the revealing nuggets of information from the recent NYT/CBS poll was that 72% of Bernie supporters say they plan to vote for Clinton against Trump. That compares to 60% of Hillary supporters who said the same thing about Obama in the same poll eight years ago. As we know, virtually all of Hillary’s supporters went on to vote for Obama. […]

I expect both Bernie and Hillary to be grown-ups and end this thing soon, and I expect Bernie’s supporters to back Hillary in the general. Apparently I’m in the minority here, but I don’t see more evidence of impending disaster than there was in 2008.








Monday Evening Open Thread: Don’t Mourn, Organize!

Presumably related, from The Nation:

The gig economy has not been an enormous issue on the campaign trail, and legislators in Congress haven’t attempted to address it in any comprehensive way. But Thursday in Washington, Senator Elizabeth Warren waded into the debate with a lengthy policy speech at the annual New America conference in which she said it’s time to “rethink the basic bargain for workers who produce much of the value in this economy.”

Warren’s essential point is that for all the talk about Uber, ride-sharing apps and their brethren are only part of a larger, destructive trend toward classifying workers as part-time. “Long before anyone ever wrote an article about the ‘gig economy,’ corporations had discovered the higher profits they could wring out of an on-demand workforce made up of independent contractors,” Warren said. Indeed, 53 million Americans—one in three workers—is a freelancer

Warren sees the gig economy as more of a symptom than a cause. “The gig economy has become a stopgap for some workers who can’t make ends meet in a weak labor market,” she said. “For many, the gig economy is simply the next step in a losing effort to build some economic security in a world where all the benefits are floating to the top 10 percent.” …

Her proposals: Improve the safety net (expanded Social Security, a new system of catastrophic insurance coverage), make employee benefits portable, and increase regulation & clarify laws around part-time work. As described at the link, all of these proposals are nicely calculated to make Kochsuckers and other Republicans fall down in foaming fits. Which is a good short-term goal on its own, but they’re also important steps towards stopping the relentless erosion of the middle class for the benefit of the Zero-Point-One Percent.

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Apart from agitating, what’s on the agenda for the evening?



Learning Curves are For Pussies

This gives me a sad:

The Obama administration announced Monday that the United States would fully lift a longstanding U.S. embargo on lethal arms sales to Vietnam, a decision that reflects growing concerns about China’s military clout and illustrates the warming bilateral ties between the former enemy nations.

President Obama unveiled the new arrangement at a news conference with Vietnamese President Tran Dai Quang during the opening day of his first visit to the country. Obama emphasized that his decision reflected a maturing relationship and deepening cooperation on security and economic investment four decades after the end of the Vietnam War.

Two years ago, the administration eased portions of the arms embargo that had been in place since 1975 to help bolster Vietnam’s maritime security in the South China Sea, where China’s move to exert more naval control of crucial shipping corridors has angered Vietnam, the Philippines and other nations that have claimed sovereignty.

Obama said the latest step “was not based on China or any other considerations. It was based on our desire to complete what has been a lengthy process of moving towards normalization with Vietnam.”

Maybe we should focus on the idea that normal relationships means something other then arming them to the teeth with weapons that will inevitably be used in a bad way somehow, somewhere, some time. It’s like Jon Stewart is on to something.

It’s just depressing. Basically, the the federal government’s foreign policy prescriptions for my entire life are fundamentally no different than the NRA’s domestic position, which is that more guns are always better all the time.








For the Birds: Monday Afternoon Open Thread

Here’s a good-looking pelican:

pelican mad beach

I’m having an extremely shitty day, so I’d rather look at pelicans than talk about politics or other awful topics. But you feel free to discuss whatever you’d like — open thread!








Smarter to be Lucky Than Lucky to Be Smart*

Years ago, a NYC cabbie gave me this sage piece of advice: “The only way to get crosstown during rush hour is to be born there.”

Apparently this is truer than it seemed at the time. Economist Robert Frank has a piece in The Times detailing the strong link between luck and success:

One’s date of birth can matter enormously, for example. According to a 2008 study, most children born in the summer tend to be among the youngest members of their class at school, which appears to explain why they are significantly less likely to hold leadership positions during high school and thus, another study indicates, less likely to land premium jobs later in life. Similarly, according to research published in the journal Economics Letters in 2012, the number of American chief executives who were born in June and July is almost one-third lower than would be expected on the basis of chance alone.

Even the first letter of a person’s last name can explain significant achievement gaps. Assistant professors in the 10 top-ranked American economics departments, for instance, were more likely to be promoted to tenure the earlier the first letter of their last names fell in the alphabet, a 2006 study found. Researchers attributed this to the custom in economics of listing co-authors’ names alphabetically on papers, noting that no similar effect existed for professors in psychology, whose names are not listed alphabetically.

Particularly interesting that bit about econ departments, given that many economists no doubt consider themselves exemplary Rational Actors.

Much of this will be familiar to those who have read Malcom Gladwell’s Outliers. But it can never be said enough–especially as the people who most need to hear it are the ones most resistant to hearing it. Sadly, the problem isn’t just whiny billionaires; the article’s comments section is filled with a lot of, “Yes, but I work harder than all those other guys.”

*The bloody-but-wise Charlemagne, from the original cast album of Pippin.



Monday Morning Open Thread: Pets Get to Come into the House!

shit the goat

Or so the goat would tell you. From “occasional commenter” Isobel:

This is Shit the Goat. He is named Shit because we are constantly saying “Oh shit, the goat’s in the house!”. The puns truly write themselves with that name.

He is a six-month-old male goat who is very friendly and likes to lay on the porch and eat with our dogs. Over the last two months, he has become a part of the pack. He loves to eat beans and corn from my hands. He also loves table scraps, specifically ramen noodles.

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The late great Molly Ivins once had a dog named Shit (for reasons, but not the same reason).

And if you need another pick-me-up for a Monday morning, the “Chewbacca Lady” [warning: autoplay] really does have the most infectious laugh…

What’s on the agenda as we start another week?
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Late Night Open Thread: Our Opposition, in Their Own Words



Lazy Sunday

I got nothing accomplished but did take two naps and played some Fallout 4. Made a big pot of black bean chili and fed Carlo and Christion (the two fraternity boys living here this summer until they can find jobs) and several of their friends. Now watching the Pens and getting ready for GOT.

The furkids are relaxing:

kids

I like having the frat kids staying here over the summer. Keeps me young.








The Battle for Fallujah (Has Once Again) Begun!

3143CB00-9A6B-4E85-A41A-680FC57092E3_w640_s*

Earlier today, which is already tomorrow in Iraq, Iraqi Prime Minister Haider al Abadi announced that Iraqi Forces (regular Iraqi Army and [most likely the National] Police, as well as irregular forces from the sectarian and tribal militias) had begun their operations to retake Fallujah. From the Iraqi perspective, specifically the Iraqi leadership’s perspective, this is necessary to take the remaining Islamic State pressure off of Baghdad. This is because Baghdad as the seat of government is the core of Iraq for the Iraqi leadership, whether it makes strategic, operational, or tactical sense.

What should be of great concern to everyone is whether the fate of Fallujah is similar to that of Ramadi. The Iraqis retook it, but it was reduced to rubble. And as Major Mohammed Hussein, a member of the counter-terrorism battalion that was first into Ramadi at the start of the offensive remarked: “All they (Islamic State) leave is rubble. You can’t do anything with rubble.” Islamic State has, apparently, mined and wired explosives throughout Fallujah as they did in Ramadi and there is a large civilian population trapped within the city and behind the enemy lines. The Iraqi’s have conducted an Information Operation informing these civilians to fly white flags from their buildings so they won’t be targeted by the Iraqi Forces. Unfortunately if they do so they will be targeted by the Islamic State Forces for collaboration.

Here’s what Ramadi looks like now:

isisramadidestructionap16116413304064 **ramadiisiscratersap16116413160960**

* Image from Voice of America.

** Images found here.



Open Thread: Yes, I’m #TeamHillary

Despite Chuck Toad’s best efforts (‘Polls. Polls? Polls! Soundbites! But — polls!’), in my opinion today’s Meet the Press was actually a good show for Hillary Clinton (‘Votes. Work. Votes, votes, work, VOTE.’).

Transcript of the interview here. First question:

CHUCK TODD: Is Bernie Sanders now helping Donald Trump?

SEC. HILLARY CLINTON: Oh, I don’t think so. I think that Senator Sanders has every right to finish off his campaign however he chooses. I do think there will then be the obvious need for us to unify the party. I faced the same challenge in 2008. I will certainly do my part, reaching out to Senator Sanders, reaching out to his supporters. And I expect him to do his. And he said about a week ago, he was going to spend seven days a week trying to defeat Donald Trump. And I believe that’s the case… (after Todd rephrases the same question) I’m not going to negotiate with [the Sanders campaign] today on your show. I’m going to say when it’s time, I am reaching out to do my part to try to unify the party. I expect him to do the same. I did that when I lost a much closer race to Senator Obama. Because I knew that whatever our differences were, just as whatever our differences are between me and Senator Sanders, they pale in comparison to Donald Trump and the Republicans. And I think most of Senator Sanders’ supporters understand that as well.

Later, in response to Todd asking if she’d accept Mark Cuban as her VP…

SEC. HILLARY CLINTON: I am absolutely intending to look far and wide. And I think that is the best way to find somebody who can really capture what’s needed in the country, and businesspeople have, especially successful businesspeople who are really successful as opposed to pretend successful, I think have a lot to offer.

CHUCK TODD: Pretend successful? You don’t think–

SEC. HILLARY CLINTON: Yeah.

CHUCK TODD: –is there anything Donald Trump’s done that you think should be praised?

SEC. HILLARY CLINTON: I think he needs to release his tax returns. The only two we have show that he hasn’t paid a penny in taxes. And yet he goes around talking about “Make America great.” You know? That means paying for our military. That means paying for our roads. That means paying for the V.A. That means a lot of things. And if you’ve got someone running for president who’s afraid to release his tax returns, because it will expose the fact that he pays no federal income tax, I think that’s a big problem.

CHUCK TODD: No, my question was there’s nothing about his background that is praiseworthy?

SEC. HILLARY CLINTON: We’ll find out. Because we have to get below the hype. We have to find what the reality is…

HRClinton 2016. Because somebody needs to be the grown-up.



Simply Amazing

Black and White Teletubbies set to Joy Division.








NYC Meet-Up: Proof of Lively

nyc meetup 5

Via commentor RedDirtGirl, instigator & organizer…

nyc meetup 1
Standing at left, “Celia Dexter”, “RedDirtGirl”, can’t remember first seated woman on left :(, Helen, LAO, Robin Gittelman, ads, DaveNYC, Jerry, Sam, IvanX

nyc meetup 2
PurpleGirl and Helen
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