Felix Gephart
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U.S. Health Insurance Costs Rise Sharply

[ed.  Good thing we got rid of that nasty old public option and can now turn our attention to deregulating every industry under the sun -  for, you know, jobs or something. Why are the most rapacious elements of our society the only ones deemed too big to fail?] 

by Reed Abelson and Nina Bernstein

Major health insurance companies have been charging sharply higher premiums this year, outstripping any growth in workers’ wages and creating more uncertainty for the Obama administration and employers who are struggling to drive down an unrelenting rise in medical costs.

A study released on Tuesday by the Kaiser Family Foundation, a research group, showed that the average annual premium for family coverage through an employer reached $15,073 in 2011 — 9 percent higher than in the previous year. And even higher premiums could be on the way, particularly in New York, where some companies are asking for double-digit increases for about 1.3 million New Yorkers in individual or small-group plans, setting up a battle with state regulators.

The higher premiums are particularly unwelcome at a time when the economy is sputtering and unemployment is hovering at about 9 percent. Many businesses cite the cost of coverage as a factor in their decision not to hire, and health insurance has become increasingly unaffordable for more Americans. The cost of family coverage has about doubled since 2001, compared with a 34 percent gain in wages.

How much the new federal health care legislation pushed by President Obama is affecting rates remains a point of debate, with some consumer advocates and others suggesting that insurers have raised prices in anticipation of new rules that would, in 2012, require them to justify any increase of more than 10 percent. Kaiser pointed out that the increase this year could be an anomaly, after several years of 3 percent to 5 percent increases during the recession.
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Since last year, the Insurance Department has posted more than 4,000 policyholder objections online. In one typical letter, a small businessman, citing six years of annual increases of more than 15 percent, raged, “There are no words to express how utterly greedy and unconscionable another double-digit increase in health care costs are to the world of small companies and those employed by them.”

Such messages are not lost on Benjamin M. Lawsky, the state’s superintendent of financial services, who oversees the department. “We get it,” he said. “These increases are often hitting people who just can’t afford it.”

“At the same time,” he added, “we have to make sure these companies stay healthy. What keeps us up at night is the need to strike a responsible balance.”

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hearts (by hildaDS)
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Eat, Smoke, Meditate: Why Your Brain Cares How You Cope

by Alice G. Walton

Most people do what they have to do to get through the day. Though this may sound dire, let’s face it, it’s the human condition. Given the number of people who are depressed or anxious, it’s not surprising that big pharma is doing as well as it is. But for millennia before we turned to government-approved drugs, humans devised clever ways of coping: Taking a walk, eating psychedelic mushrooms, breathing deeply, snorting things, praying, running, smoking, and meditating are just some of the inventive ways humans have found to deal with the unhappy rovings of their minds.

But which methods actually work?

Most people would agree that a lot of our unhappiness comes from the mind’s annoying chatter, which includes obsessions, worries, drifts from this stress to that stress, and our compulsive and exhausting need to anticipate the future. Not surprisingly, the goal of most adults is to get the mind to shut up, calm down, and chill out. For this reason, we turn to our diverse array of feel-good tools (cigarettes, deep breathing, and what have you). Some are healthier and more effective than others, and researchers are finally understanding why certain methods break the cycle and others exacerbate it.

Last year, a Harvard study confirmed that there’s a clear connection between mind wandering and unhappiness. Not only did  the study find that if you’re awake, your mind is wandering almost half the time, it also found that this wandering is linked to a less happy state. (You can actually use the iPhone app used in the study to track your own happiness.) This is not surprising, since when your mind is wandering, it’s not generally to the sweet things in your life: More likely, it’s to thoughts like why your electric bill was so high, why your boss was rude to you today, or why your ex-husband is being so difficult.

Another study found that mind wandering is linked to activation of network of brain cells called the default mode network (DMN), which is active not when we’re doing high-level processing, but when we’re drifting about in “self-referential” thoughts (read: when our brain is flitting from one life-worry to the next).

Meditation is an interesting method for increasing one’s sense of happiness because not only has it stood the test of time, but it’s also been tested quite extensively in the lab. Part of the effect of mindfulness meditation is to quiet the mind by acknowledging non-judgmentally and then relinquishing (rather than obsessing about) unhappy or stress-inducing thoughts.

New research by Judson Brewer, MD, PhD and his group at Yale University has found that experienced meditators not only report less mind wandering during meditation, but actually have markedly decreased activity in their DMN. Earlier research had shown that meditators have less activity in regions governing thoughts about the self, like the medial prefrontal cortex: Brewer says that what’s likely going on in experienced meditators is that these “‘me’ centers of the brain are being deactivated.

They also found that when the brain’s “me” centers were being activated, meditators also co-activated areas important in self-monitoring and cognitive control, which may indicate that they are on the constant lookout for “me” thoughts or mind-wandering – and when their minds do wander, they bring them back to the present moment. Even better, meditators not only did this during meditation, but when not being told to do anything in particular. This suggests that they may have formed a new default mode: one that is more present-centered (and less “me”-centered), no matter what they are doing.

“This is really cool,” Brewer says.” As far as we know, nobody has seen this type of connectivity pattern before. These networks have previously been shown to be anti-correlated.”

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Lemongrass

by Anthony Kuhn

Imagine you're trekking through the concrete jungle of just about any Southeast Asian city. The first thing you notice is the smorgasbord of smells, some enticing, others downright rank. Amid the urban odor-rama, one sweet herbal fragrance stands out. It's lemongrass. And it's just about everywhere.

This herb is essential to Thai, Vietnamese, Cambodian, Indonesian and other Asian cuisines that have become popular in the West in recent years. And lemongrass takes much of the credit for the light and aromatic character of Southeast Asian cooking. It's prized for lightening meat-laden, oily dishes and strong seafood smells. Thai people also swear by its legendary medicinal properties.

To really understand the role of lemongrass in Thai cuisine, visit Naj, a family-run restaurant and cooking school located beside Bangkok's bustling Convent Road. The founder's son, Tanaporn Markawat shows us where he gets some of his ingredients.

"So now we are in our herbs garden. We have more than 50 herbs," he says, pointing out over the yard. "We have lemongrass, basil, cumin, pandanus...the main ingredients that we use in Thai food."

Tanaporn removes the tough, fibrous outer layers of a stalk of lemongrass, revealing its pink insides, and unleashes an incredible smell.

Inhale deeply, and you will absorb a fragrance that is intense and ornate, like a filigreed eave curlicuing from the roof of a Thai Buddhist temple.

Asian restaurants rely heavily on stir-frying and deep frying, and too much oil can be a problem. But lemongrass, Tanaporn says, can lift the weight of the meat and oil, and replace that weight with an herbal pungency and an exquisite lightness.

"In most of the Thai dishes, we use the lemongrass, it's very important," he explains. "Sometimes when you have the curry, the curry is oily, and the lemongrass can help you digest, it can help your blood circulation. It's very healthy," he says.

To really understand the power of lemongrass, eat a pile of the stuff raw...in the form of a Thai lemongrass salad. It's a dish you seldom find in restaurants outside Thailand, but it's not hard to make yourself. Lemongrass is increasingly available at Asian markets and grocers in the U.S.

Tanaporn cuts several lemongrass stalks into little discs. Bits of dried shrimp, squid and peanuts add crunch. Tiny chili peppers provide punch – far above their weight. Finally, Tanaporn pours on a dressing of lime juice, fish sauce and sugar. He tosses the salad and serves it wrapped in jade green-colored betel leaves. The resulting dish is typically Thai in its combination of citrus, seafood, hot, sour, salty and spicy flavors.

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Michael Carson, The lost ring somewhere in this area (21st century)
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Your Next Partner

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I believe that we, that this planet, hasn’t seen its Golden Age. Everybody says its finished … art’s finished, rock and roll is dead, God is dead. Fuck that! This is my chance in the world. I didn’t live back there in Mesopotamia, I wasn’t there in the Garden of Eden, I wasn’t there with Emperor Han, I’m right here right now and I want now to be the Golden Age …if only each generation would realise that the time for greatness is right now when they’re alive … the time to flower is now.

Patti Smith
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Elton John

Contemporary Batik and Tie Dye, Crown Publishers  1973
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Protesters Bare All Over a Proposed San Francisco Law

[ed.  Ahhh...I love San Francisco.]

by Malia Wollan

Perhaps it should not be a surprise that San Francisco does not have a law against being naked in public, nor that a small, unselfconscious segment of the city’s residents regularly exercise that right.

That tiny minority was joined this weekend in the autumn fog and cold by unclothed sympathizers at a “Nude-In.” One of their objectives was to draw attention to a proposed law — introduced by Scott Wiener, a city supervisor — that would prohibit nudity in restaurants and require unclad people to put a towel or other material down before sitting bare-bottomed on benches or other public seats.

Mr. Wiener said the law was introduced in response to an increase in nakedness in parks, streets and restaurants.

“It used to be that there would be one nude guy wandering around the neighborhood and no one thought twice about it,” said Mr. Wiener, who represents the city’s Castro district. “Now it’s a regular thing and much more obnoxious. We have guys sitting down naked in public without the common decency to put something down underneath them.”

Mr. Wiener’s effort was destined to grab headlines, but he probably did not anticipate that his legislation would inspire even more people to disrobe.

“Wiener might as well have shot lasers and fireworks into the sky announcing that public nudity is legal,” said George Davis, 65.

A self-described “urban nudist” who once ran for mayor and often campaigned in the buff, Mr. Davis now spends most afternoons lounging in his birthday suit in a public plaza in the Castro.

Putting a towel between your backside and a seat is “basic nudist etiquette,” said Mr. Davis, adding that the legislation requiring it was “totally unnecessary.”

Still, Mr. Davis said, the publicity about the proposed law could be credited for the new faces at the Nude-In, which was held Saturday at the Jane Warner Plaza in the Castro.

Other nearby cities like Berkeley and San Jose have passed laws prohibiting public nudity, but in San Francisco it remains legal. In accordance with state law, public nudity is only illegal when accompanied by “lewd thoughts or acts” or “where there are present other persons to be offended or annoyed.” But since state law prohibits police officers from being the offended party, it takes a citizen’s arrest— a rare occurrence in a city that prides itself on its open-mindedness and tolerance — to take a naked person into custody.

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How Life Arose on Earth, and How a Singularity Might Bring It Down

by George Musser

It didn’t take long for the recent Foundational Questions Institute conference on the nature of time to delve into the purpose of life. “The purpose of life,” meeting co-organizer and Caltech cosmologist Sean Carroll said in his opening remarks, “is to hydrogenate carbon dioxide.” Well, there you have it. Carroll is one of the most reflective scientists I know and would never claim to reduce all of human existence to molecular disequilibrium. Still, it’s nice to know your place in the grand scheme of things. The FQXi meeting had much to say about where we came from—and where we’re headed.

Last year, Carroll blogged the backstory of where his purpose-of-life line came from. He had bumped into Mike Russell of JPL, an expert on the origin of life, on an airplane and got to chatting about the role that living things play in the geochemical cycles of our planet. Russell was on hand at the FQXi conference, too, and elaborated on his engrossing thesis tracing our descent to inorganic chemical reactions.

In Russell’s picture, the primeval Earth looked uncannily like a giant bacterium. At the seafloor, in spots like the Lost City hydrothermal vents, the chemically reduced interior met the oxidized exterior, creating a state of chemical disequilibrium. Hydrogen bubbling up from the interior sought to combine with carbon dioxide dissolved from the atmosphere to form methane, but this reaction has a bottleneck because intermediate stages such as formaldehyde require an input of energy (see this helpful graph). A geochemical reaction known as serpentinization can push through the bottleneck, using metals such as iron as catalysts, but biological reactions are more efficient, and Russell mapped out a series of steps whereby serpentinization would evolve into membrane-encased cells.

Evolution at this stage was not by natural selection, but by the spontaneous generation of complexity; the Darwinian version came later as information-bearing molecules arose. The scenario is commonly referred to as “metabolism-first” as opposed to “genetics-first.” It is the protobiological version of the principle that the way to a man’s heart is through his stomach.

The process would have given birth to two of the three kingdoms of life, bacteria and archaea. Russell suggested that life might have arisen multiple times on Earth and, indeed, on any planet with similar chemical imbalances. Phylogeny replicates geology.

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Photo of Lost City​ hydrothermal field, courtesy of NOAA

Inappropriate Force

[ed.  The officer in question has now been identified as Deputy Inspector Anthony V. Bologna of the NYPD Patrol Borough Manhattan South.]

by James Fallows

Unless there is something faked about this video, which is on the New York Times' City Room site and is based on annotation and slow-mo apparently from USLaw.com, a uniformed New York City police officer abused power in a way that was cruel and cowardly during yesterday's Wall Street protests. It's worth the time to watch.
 

He walks up; unprovoked he shoots Mace or pepper spray straight into the eyes of women held inside a police enclosure; he turns and walks away quickly (as they scream, wail, and fall to the ground clawing at their eyes) in a way familiar from hitmen in crime movies; and he discreetly reholsters his spray can.

You may have already seen this. If you haven't, it is worth knowing about. If this is what it looks like, it is outrageous. The mayor and others should say something. And this man can certainly be identified.
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Update: according to the NYT, the chief police spokesman, Paul Browne, said that the policeman used pepper spray "appropriately." Great. On the video we can't hear what either side is saying. But at face value, the casualness of the officer who saunters over, sprays right in the women's eyes, and then slinks away without a backward glance, as if he'd just put down an animal, does not match my sense of "appropriate" behavior by officers of the law in a free society.

Think about it: If this were part of some concerted, "appropriate" crowd-control plan, then presumably the pepper-spray officer would have talked with the other policemen trying to control the women. He would have stayed on the scene; he had done something dramatic to affect a situation, so -- again, if this were "appropriate" -- presumably he would have talked with the other officers about what to do next. But look at that video and see what seems "appropriate" to you.

Police officers make countless hard decisions every day, often at the risk of their own safety or lives. It's a harder job than I have. But everything about this scene suggests an officer who has forgotten about some of these hard choices. He just zaps 'em and walks away as they scream.

Update I  Video taping makes a difference.

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Personal Best

by Atul Gawande

I've been a surgeon for eight years. For the past couple of them, my performance in the operating room has reached a plateau. I’d like to think it’s a good thing—I’ve arrived at my professional peak. But mainly it seems as if I’ve just stopped getting better.

During the first two or three years in practice, your skills seem to improve almost daily. It’s not about hand-eye coördination—you have that down halfway through your residency. As one of my professors once explained, doing surgery is no more physically difficult than writing in cursive. Surgical mastery is about familiarity and judgment. You learn the problems that can occur during a particular procedure or with a particular condition, and you learn how to either prevent or respond to those problems.
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It wouldn’t have been the first time I’d hit a plateau. I grew up in Ohio, and when I was in high school I hoped to become a serious tennis player. But I peaked at seventeen. That was the year that Danny Trevas and I climbed to the top tier for doubles in the Ohio Valley. I qualified to play singles in a couple of national tournaments, only to be smothered in the first round both times. The kids at that level were playing a different game than I was. At Stanford, where I went to college, the tennis team ranked No. 1 in the nation, and I had no chance of being picked. That meant spending the past twenty-five years trying to slow the steady decline of my game.

I still love getting out on the court on a warm summer day, swinging a racquet strung to fifty-six pounds of tension at a two-ounce felt-covered sphere, and trying for those increasingly elusive moments when my racquet feels like an extension of my arm, and my legs are putting me exactly where the ball is going to be. But I came to accept that I’d never be remotely as good as I was when I was seventeen. In the hope of not losing my game altogether, I play when I can. I often bring my racquet on trips, for instance, and look for time to squeeze in a match.

One July day a couple of years ago, when I was at a medical meeting in Nantucket, I had an afternoon free and went looking for someone to hit with. I found a local tennis club and asked if there was anyone who wanted to play. There wasn’t. I saw that there was a ball machine, and I asked the club pro if I could use it to practice ground strokes. He told me that it was for members only. But I could pay for a lesson and hit with him.

He was in his early twenties, a recent graduate who’d played on his college team. We hit back and forth for a while. He went easy on me at first, and then started running me around. I served a few points, and the tennis coach in him came out. You know, he said, you could get more power from your serve.

I was dubious. My serve had always been the best part of my game. But I listened. He had me pay attention to my feet as I served, and I gradually recognized that my legs weren’t really underneath me when I swung my racquet up into the air. My right leg dragged a few inches behind my body, reducing my power. With a few minutes of tinkering, he’d added at least ten miles an hour to my serve. I was serving harder than I ever had in my life.

Not long afterward, I watched Rafael Nadal play a tournament match on the Tennis Channel. The camera flashed to his coach, and the obvious struck me as interesting: even Rafael Nadal has a coach. Nearly every élite tennis player in the world does. Professional athletes use coaches to make sure they are as good as they can be.

But doctors don’t. I’d paid to have a kid just out of college look at my serve. So why did I find it inconceivable to pay someone to come into my operating room and coach me on my surgical technique?

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Illustration: Barry Blitt