An almost fail

When I came home last night from refereeing a good soccer game, my son was still up.  It was way past his bed time. He was busy being a happy but tired toddler when he saw me.

“Daddy home, JayJay bunny, bunny jumping on Mommy and Daddy bed,  Daddy home!”

He does know how to be adorable as he attempted to avoid brushing his teeth.  The offer to join him in being a bunny was his best alternative to brushing teeth.  Unfortunately, I’m usually  a responsible parent, so the tempting offer was declined. We brushed teeth, sang a song, and he went to sleep fairly quickly.

On a typical night, this would be unexpected only for the time of night. Last night, it was unexpected because he had been sent home from daycare for throwing up, a fever, and odd breathing sounds.  I thought he just had daycare crud.  Daycare crud’s typical treatment is rest, hydration and lots of lap time.   I picked him up after I left work, and we spent the afternoon watching Team Umizoomi, napping, and drinking apple juice. 

And then my wife had several points of near failure in the medical system last night.

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Ready for kindergarten

My daughter’s first day of kindergarten is today.  She is excited.  Last night she laid out her new dress from her Mimi, her new backpack from Grandma and her favorite hair bow on the guest bed.  She is determined to be ready today.  When we read The Night before Kindergarten last night, she insisted she could not read as she told us all about the words on each page, and then she proclaimed that she was really big and really ready to go to big girl school.

I am so proud of her, and I know that she is ready to go to school.  I am not sure if I am ready for her to go.  I am still trying to figure out how she has gotten so big, so independent, so confident and so much herself in these five years.  I remember taking her to library playdates where my leg was crushed in tiny toddler deathgrip, I remember going to birthday parties where the parachute play was too much.  At the same time, I remember the continuous stream of questions, “What that, how come, Daddy why?” and insatiable curiousity.  I have several thousand pages of pictures saved in a laundry bag downstairs, her family drawn as bunnies, people, puppies, and ducks (I look very good as a duck).  So she is ready, although I have a hard time believing she is.

Friday was orientation, there are thirty three kids in her cohort split into two rooms.  The teacher seemed very nice and very together, and the school was decked out in Seuss.   Saturday was the information fair day, and as my kids ate cupcakes, I talked to the principal.  She said that this year was an odd year, as there are only two classrooms while the last five years had three classes of kindergarteners.  Some of the shift could be explained by a redrawing of the feeder pattern, but she did not know where the other three quarters of a class had gone.

My daughter and her classmates were born between the summer of 2008 and the summer of 2009, so these kids were conceived  between late 2007 to fall 2008.  These kids are the first cohort of recession babies.  They were conceived at the drop. 

Kids are expensive, and for the most part, timing can be manipulated for better times or better opportunities.  Birthrates dropped dramatically among the cohorts of women who make up the moms of my daughter’s classmates. 

I am not a demographer, but I wonder what the impact on the lives of my daughter’s cohort as it is significantly smaller than the cohorts that surround it in age.  My son’s cohort is a bit larger than my daughter, and the cohorts of current third and fourth graders are a bit larger.  I wonder how the smaller cohort will matter for public finance as they will be a short window of lower educational spending, a short window of fewer knuckleheads entering prime knucklehead zone, and a short window of a tight entry level job market. 

Oh well, she is ready for kindergarten, and I’ll worry about all this other stuff after she shows me a picture she drew during her first day in big girl school. 

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Open Thread: Words That Need Repeating

Click on the tiny text to embiggen.

Via Dave Weigel, “Calling All Sad Clowns“:

… If you’ve never suffered from depression, or had a public career, the suicide of a successful person makes no damn sense. It’s the same reason why an artist quitting or breaking his band up makes no sense—you wanted something, and you’ve finally grabbed it, so why would you ever give that up? What’s wrong with you?

Depression is what’s wrong with you…

It’s contradictory, and pointless, and bears very little relationship to the reality of what you’re going through. It’s unpredictable in a way that makes you feel callow; I’ve been sad but functional after the deaths of family members, then horribly depressed while walking home on a random Wednesday. The problem with a public career, like Williams had (and most journalists have), is that you’re “only as good as your last one.” Most of the time, you create something that goes off well, and you can bask in it. And sometimes you pull it off and are sure that you peaked—down you go, down the spiral.

Does this sound pathetic? Good eye. That’s one of the realizations that hits you on the way down. How many millions of people are in legitimately less fair, less pleasant situations than you? They cope, and you can’t? Like Tabin says, the mind is able to lie to itself. The moments when you need help, anything from tricks you’ve learned to help from friends to real therapy, are the moments when your synapses are crackling with ways to make you hopeless.

It’s a very good thing to see people reacting to the Williams suicide by talking honestly and asking if any of their friends need help. Depression is the weak disease that convinces you it’s invincible. And voices of reason can stop that.








How Is This Not Manslaughter?

How?

William DeHayes was showing Hoover his gun collection. While he was showing her his .22 caliber revolver, it accidentally fired and shot Hoover in the head, according to the Hernando County Sheriff’s Office. [More at the Tampa Bay Times.]

Hoover died in the ER yesterday; the child she was carrying died with her.

This is, of course, merely the ordinary awful that necessarily flows from Second Amendment fundamentalism.  I’ll say one thing:  anyone who chalks an incident like this to the necessary cost of preserving freedom cannot be said to be pro-life.  If abortion by gun is OK by you…

In any event, the blunt fact of unfettered gun ownership and the celebration of a culture of the gun is that those most at risk of gun violence remain those who own them and their friends and family.  Put together the gun-suicides, “accidents” like these,* and shootings of intimate partners and or others known to the shooter, and you have well over half of all gun deaths in the US — a number which in total is essentially the same as those we lose to road accidents.

The fantasy of the gun? It’s all fun and games until the reaper lays hold of its victim’s cloak:

Hans_Baldung_-_The_Knight,_the_Young_Girl,_and_Death_-_WGA01179

There’s more.  Here’s the bit that I just can’t stand:

Police are still investigating the incident, but believe it was an accidental shooting, according to the Tampa Bay Times.

An accident? Not a charge of involuntary manslaughter?

Maybe that’ll come, but sweet FSM! You pick up a gun and shoot someone dead — even if you didn’t mean to — and that’s not a crime?

The NRA, ammosexuals, and all their enablers in politics and the media tell us that the term “responsible gun owners” has actual meaning.  It doesn’t, as this case demonstrates .  I’ll update this post if it turns out that Mr. DeHayes faces actual consequences for taking another person’s life, but until then, I’m going to vent:

Responsible means that whatever happens with your gun is your fault.  Period.  You accidentally discharge it and no-one gets hurt? How’s this:  big fine, confiscate the weapon involved, lose the right to bear arms for a year for the first incident, forever if you repeat.  Someone gets hurt or dies?  Jail. Civil liability.  Loss of gun rights for life.  That’s responsibility.

But of course, I dream.  That’s not how we roll.  Instead, we’ll just  water the tree of liberty with a newlywed, and celebrate life by burying her fetus — and wait (not long) for the next red harvest.

a disregard for human life while engaging in wanton or reckless behavior.  The state may be able to prove involuntary manslaughter by showing the defendant’s recklessness or lack of care when handling a dangerous instrument or weapon, – See more at: http://statelaws.findlaw.com/florida-law/florida-involuntary-manslaughter-laws.html#sthash.4lq9WNmn.dpuf
an unintentional killing that results from recklessness or criminal negligence, or from an unlawful act that is a misdemeanor or low-level felony (such as DUI). – See more at: http://criminal.findlaw.com/criminal-charges/involuntary-manslaughter-overview.html#sthash.wd8fjq3H.dpuf
an unintentional killing that results from recklessness or criminal negligence, or from an unlawful act that is a misdemeanor or low-level felony (such as DUI). – See more at: http://criminal.findlaw.com/criminal-charges/involuntary-manslaughter-overview.html#sthash.wd8fjq3H.dpuf
an unintentional killing that results from recklessness or criminal negligence, or from an unlawful act that is a misdemeanor or low-level felony (such as DUI). – See more at: http://criminal.findlaw.com/criminal-charges/involuntary-manslaughter-overview.html#sthash.wd8fjq3H.dpuf

*Scare quotes because such shootings are not acts of god — the deer that darts across the road just at the moment when you have to swerve into a tree or take a 400 pound antlered rodent through the windshield.  They are the statistically predictable outcomes of handing guns out freely to a population in which only half of the folks are above average.  That is, even though there is no way to predict that Ms. Hoover would fall victim to this awfulness, we knwo we can expect some number per year or month of folks felled by stupidity, carelessness, and general fuck ups with a gun.

Image: Hans Baldung, The Knight, the Young Girl, and Death, c. 1505.

 








Why is John getting fucked this time?

JC wrote last night as he got kicked in the balls by the world:

Do you have any idea how hard it is to deal with addiction and get treatment in America? I have gold plated insurance, am comfortably middle class, and I have been going through sheer hell trying to get into a facility. It’s almost like you have to show up with a syringe full of heroin dangling from your arm and a crack pipe in your mouth to get anyone to take you seriously…

Why is this so fucking hard? Am I just incompetent or is it this fucking bad everywhere?…Why is it that getting into rehab requires a fucking PhD in bullshit and the equivalent of a tax attorney’s knowledge of procedure? Isn’t getting clean tough enough? Jeebus

There are a couple of things in play.  The first and biggest reason why JC is getting fucked over hard right now is that there are nowhere near enough rehab beds in this country.  Most of this is historical in two aspects.

The first is that addictive diseases are now seen as medical issues with significant mental health components.  Any other physical health problem would see it treated and paid for as a physical health problem.  However diseases of addiction were long seen to be either mental health problems with minimally related physical health problems, or solely a matter of someone needing to sack up.  That was the attitude when health insurance started to propogate.  Early health insurance had minimal to no mental health coverage, and over the course of the past sixty years, mental health coverage was both slowly added to coverage and poorly paid.

The big policy change on this matter was the 2008 Mental Health Parity and Addiction Equity Act.  This act required policies that cover groups of more than fifty (50) people to pay for mental health and recovery services at the same benefit level and same accessibility standards as any other physical health act.  A side effect of the act is that providers in this field are slowly starting to see their commercial rates rise.  Over the long term, this should mean more beds will be available.  PPACA has a couple of policy changes that will decrease the degree of fucking over as well.

The other major policy driving that contributed to John being fucked over this year is the Medicaid Institutions for Mental Diseases exclusion policy:

The IMD exclusion is found in section 1905(a)(B) of the Social Security Act, which prohibits “payments with respect to care or services for any individual who has not attained 65 years of age and who is a patient in an institution for mental diseases” except for “inpatient psychiatric hospital services for individuals under age 21.” The law goes on to define “institutions for mental diseases” as any “hospital, nursing facility, or other institution of more than 16 beds [my emphasis], that is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services.” The IMD exclusion was intended to ensure that states, rather than the federal government, would have principal responsibility for funding inpatient psychiatric services.

Medicaid is one of the major payers for mental health services in this country.  They don’t get to set policy for facilities that don’t bill Medicaid, but there are very few facilities (excluding celebrity rehab spas) that can’t afford to not bill Medicaid.  This policy was designed to keep states from closing their state hospitals and long term mental health care facilities and dumping those people onto the Federally paid for portion of Medicaid.  The side effect is the facilities that are out there are artificially limited to sixteen beds or less.  There are a couple of work-arounds (mainly defining how multiple 16 bed pods are seperate facilities) but there are significant limitations on facilities.

So to recap; in patient rehabilitation and detox services have historically been seen as mental health services which means sporadic coverage at low rates.  That is slowly changing.  And those providers which do rehab and detox are limited to small facilities.  More people have access to these services without supply increasing.  And since John is usually a a functional individual on most measures (excluding mopping), he does not need emergency admittance, so he is getting fucked because there are nowhere near enough beds to help the people who need help but can get by at a lower quality of health and living without the service.