Bitter Pill: Why Medical Bills Are Killing Us

When Sean Recchi, a 42-year-old from Lancaster, Ohio, was told last March that he had non-Hodgkin’s lymphoma, his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier, and she and her family credited the doctors and nurses at MD Anderson with extending his life by at least eight years.

Because Stephanie and her husband had recently started their own small technology business, they were unable to buy comprehensive health insurance. For $469 a month, or about 20% of their income, they had been able to get only a policy that covered just $2,000 per day of any hospital costs. “We don’t take that kind of discount insurance,” said the woman at MD Anderson when Stephanie called to make an appointment for Sean.

Stephanie was then told by a billing clerk that the estimated cost of Sean’s visit — just to be examined for six days so a treatment plan could be devised — would be $48,900, due in advance. Stephanie got her mother to write her a check. “You do anything you can in a situation like that,” she says. The Recchis flew to Houston, leaving Stephanie’s mother to care for their two teenage children.

About a week later, Stephanie had to ask her mother for $35,000 more so Sean could begin the treatment the doctors had decided was urgent. His condition had worsened rapidly since he had arrived in Houston. He was “sweating and shaking with chills and pains,” Stephanie recalls. “He had a large mass in his chest that was … growing. He was panicked.”

Nonetheless, Sean was held for about 90 minutes in a reception area, she says, because the hospital could not confirm that the check had cleared. Sean was allowed to see the doctor only after he advanced MD Anderson $7,500 from his credit card. The hospital says there was nothing unusual about how Sean was kept waiting. According to MD Anderson communications manager Julie Penne, “Asking for advance payment for services is a common, if unfortunate, situation that confronts hospitals all over the United States.”

Diagnosed with non-Hodgkin’s lymphoma at age 42. Total cost, in advance, for Sean’s treatment plan and initial doses of chemotherapy: $83,900. Charges for blood and lab tests amounted to more than $15,000; with Medicare, they would have cost a few hundred dollars

The total cost, in advance, for Sean to get his treatment plan and initial doses of chemotherapy was $83,900.

Why? (...)

When I asked MD Anderson to comment on the charges on Recchi’s bill, the cancer center released a written statement that said in part, “The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”

The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.

The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companies.”

DePinho’s salary is nearly triple the $674,350 paid to William Powers Jr., the president of the entire University of Texas system, of which MD Anderson is a part. This pay structure is emblematic of American medical economics and is reflected on campuses across the U.S., where the president of a hospital or hospital system associated with a university — whether it’s Texas, Stanford, Duke or Yale — is invariably paid much more than the person in charge of the university.  (...)

Recchi’s bill and six others examined line by line for this article offer a closeup window into what happens when powerless buyers — whether they are people like Recchi or big health-insurance companies — meet sellers in what is the ultimate seller’s market.

The result is a uniquely American gold rush for those who provide everything from wonder drugs to canes to high-tech implants to CT scans to hospital bill-coding and collection services. In hundreds of small and midsize cities across the country — from Stamford, Conn., to Marlton, N.J., to Oklahoma City — the American health care market has transformed tax-exempt “nonprofit” hospitals into the towns’ most profitable businesses and largest employers, often presided over by the regions’ most richly compensated executives. And in our largest cities, the system offers lavish paychecks even to midlevel hospital managers, like the 14 administrators at New York City’s Memorial Sloan-Kettering Cancer Center who are paid over $500,000 a year, including six who make over $1 million.

Taken as a whole, these powerful institutions and the bills they churn out dominate the nation’s economy and put demands on taxpayers to a degree unequaled anywhere else on earth. In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.

by Steven Brill, Time |  Read more:

Photo: uncredited

That’s Not A Droid, That’s My Girlfriend

Osamu Kozaki’s life in Tokyo is, by his own admission, often a lonely one. The 35-year-old, an engineer who designs industrial robots, has had few relationships with women in his life. Those few have almost always gone badly.

So when Kozaki’s girlfriend, Rinko Kobayakawa, sends him a message, his day brightens up. The relationship started more than three years ago, when Kobayakawa was a prickly 16-year-old working in her school library, a quiet girl who shut out the world with a pair of earphones that blasted punk music.

Kozaki sums up Kobayakawa’s personality with one word: tsundere – a popular term in Japan’s otaku geek culture, which describes a certain feminine ideal. It refers to the kind of girl who starts out hostile but whose heart gradually grows warmer. And that’s what has happened; over time, Kobayakawa has changed. These days, she spends much of her day sending affectionate missives to her boyfriend, inviting him on dates, or seeking his opinion when she wants to buy a new dress or try a new hairstyle.

But while Kozaki has aged, Kobayakawa has not. After three years, she’s still 16. She always will be. That’s because she is a simulation; Kobayakawa only exists inside a computer.

Kozaki’s girlfriend has never been born. She will never die. Technically, she has never lived. She may be deleted, but Kozaki would never let that happen.

Because he’s in love.

Kozaki is one of hundreds of thousands of Japanese who have bought Love Plus, a game released on the Nintendo DS in 2009, which is intended to simulate the experience of high-school romance with one of three pre-programmed teen girl characters. For a sizable number of loyal male gamers, it has become something more: a relationship that, if not entirely like dating a real woman, comes close as a source of affection.

“I really do love her,” Kozaki explains, when he and two of his friends meet with me in a coffee shop in Akihabara, the Tokyo neighbourhood at the centre of Japan’s otakuculture. Kozaki fully expects the game to be a lifelong commitment. “If someone were to ask me to stop, I don’t think I could do it,” he says.

Kozaki recounts what happened when an updated version of the game came out; which meant he had to move his saved data onto a new program. Kozaki couldn’t come at the idea of having two simultaneous versions of his virtual girlfriend in existence, so he asked a friend to delete the old saved data for him. It was — almost — as if he had arranged for someone to be murdered, he says. “I cried when he pushed that delete button,” he says, acknowledging that it sounds strange. “It was as if I crossed a border line from reality.”

by Aubrey Belford, The Global Mail |  Read more:
Photo: Aubrey Belford

Banksy (see also: Banksy Mural Mystery Deepens)

Social Work in the Tenderloin Will Kill Something Inside of You

The Tenderloin is widely acknowledged as the most hellish neighborhood in San Francisco. Out of the city's ten most violent crime plots, the Tenderloin is home to seven. Recent stats estimate the neighborhood has an average of three major crimes per hour, including one-third of the city’s drug offenses, with a yearly mean of two crimes per resident. The population is made up of more than 6,000 homeless people and contains one-fourth of the city’s HIV-positive drug users. Filthy sidewalks and vacant buildings peppered with single-occupancy hotel rooms provide a home to all levels of drugs and prostitution.

My friend Lorian has been employed as a social worker in the Tenderloin for several years now. Her tweets about it (things like: “today: 4 dead clients, 1 murdered provider, 1 client defecated in the lobby, 1 dead dog, & 1 facebook friend posted pictures of nachos.”) got me curious as to what her job is like. She was kind enough to answer some of my questions.

VICE: I imagine it varies greatly, but can you describe your average workday?

Lorian: The first thing is getting through the door at 9 AM. We usually have to step over clients or random strangers passed out on the benches from drinking and/or using since God knows when. The smell is the first thing that hits you—a stench of urine, feces, poor hygiene—it's really at its strongest in the morning, but you get used to it throughout the day. Then we check our voicemail. Twenty messages from the same two or three clients who either scream their financial requests over and over, simply sit there and breathe, or tell you that witches are under their beds waiting for the next blood sacrifice. Paranoid clients like to fixate on witches, Satan, etc. Anyway, we get ready to open and hand out checks to the clients who are either on daily budgets, or who make random check requests. The budgeted clients are the most low-functioning, as they can be restricted to as little as $7 per day in order to curb their harm reduction. They'll go and spend that $7 on whatever piece of crack they can find, and then two hours later they're back, begging for more money. Clients will find some really brilliant ways to beg. When we're not dealing with clients out in the lobby, which can involve anything from handing out checks to cleaning up blood to clearing the floor for folks having seizures, we're usually dealing with the government agency assholes over at Social Security. I personally work with around 200 clients, so the paperwork and filing can be extraordinary. My “average day” starts at 9 AM and lasts until 7 or 8 PM.

by Blake Butler, Vice |  Read more:

Images: uncredited

Sehriyar Cem - Untitled 92, 2011 acrylic on canvas 39.4 x 35.4 in
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P.G. Wodehouse
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The Extraordinary Science of Addictive Junk Food

On the evening of April 8, 1999, a long line of Town Cars and taxis pulled up to the Minneapolis headquarters of Pillsbury and discharged 11 men who controlled America’s largest food companies. Nestlé was in attendance, as were Kraft and Nabisco, General Mills and Procter & Gamble, Coca-Cola and Mars. Rivals any other day, the C.E.O.’s and company presidents had come together for a rare, private meeting. On the agenda was one item: the emerging obesity epidemic and how to deal with it. While the atmosphere was cordial, the men assembled were hardly friends. Their stature was defined by their skill in fighting one another for what they called “stomach share” — the amount of digestive space that any one company’s brand can grab from the competition.

James Behnke, a 55-year-old executive at Pillsbury, greeted the men as they arrived. He was anxious but also hopeful about the plan that he and a few other food-company executives had devised to engage the C.E.O.’s on America’s growing weight problem. “We were very concerned, and rightfully so, that obesity was becoming a major issue,” Behnke recalled. “People were starting to talk about sugar taxes, and there was a lot of pressure on food companies.” Getting the company chiefs in the same room to talk about anything, much less a sensitive issue like this, was a tricky business, so Behnke and his fellow organizers had scripted the meeting carefully, honing the message to its barest essentials. “C.E.O.’s in the food industry are typically not technical guys, and they’re uncomfortable going to meetings where technical people talk in technical terms about technical things,” Behnke said. “They don’t want to be embarrassed. They don’t want to make commitments. They want to maintain their aloofness and autonomy.”

A chemist by training with a doctoral degree in food science, Behnke became Pillsbury’s chief technical officer in 1979 and was instrumental in creating a long line of hit products, including microwaveable popcorn. He deeply admired Pillsbury but in recent years had grown troubled by pictures of obese children suffering from diabetes and the earliest signs of hypertension and heart disease. In the months leading up to the C.E.O. meeting, he was engaged in conversation with a group of food-science experts who were painting an increasingly grim picture of the public’s ability to cope with the industry’s formulations — from the body’s fragile controls on overeating to the hidden power of some processed foods to make people feel hungrier still. It was time, he and a handful of others felt, to warn the C.E.O.’s that their companies may have gone too far in creating and marketing products that posed the greatest health concerns.

The discussion took place in Pillsbury’s auditorium. The first speaker was a vice president of Kraft named Michael Mudd. “I very much appreciate this opportunity to talk to you about childhood obesity and the growing challenge it presents for us all,” Mudd began. “Let me say right at the start, this is not an easy subject. There are no easy answers — for what the public health community must do to bring this problem under control or for what the industry should do as others seek to hold it accountable for what has happened. But this much is clear: For those of us who’ve looked hard at this issue, whether they’re public health professionals or staff specialists in your own companies, we feel sure that the one thing we shouldn’t do is nothing.”

As he spoke, Mudd clicked through a deck of slides — 114 in all — projected on a large screen behind him. The figures were staggering. More than half of American adults were now considered overweight, with nearly one-quarter of the adult population — 40 million people — clinically defined as obese. Among children, the rates had more than doubled since 1980, and the number of kids considered obese had shot past 12 million. (This was still only 1999; the nation’s obesity rates would climb much higher.) Food manufacturers were now being blamed for the problem from all sides — academia, the Centers for Disease Control and Prevention, the American Heart Association and the American Cancer Society. The secretary of agriculture, over whom the industry had long held sway, had recently called obesity a “national epidemic.”

Mudd then did the unthinkable. He drew a connection to the last thing in the world the C.E.O.’s wanted linked to their products: cigarettes. First came a quote from a Yale University professor of psychology and public health, Kelly Brownell, who was an especially vocal proponent of the view that the processed-food industry should be seen as a public health menace: “As a culture, we’ve become upset by the tobacco companies advertising to children, but we sit idly by while the food companies do the very same thing. And we could make a claim that the toll taken on the public health by a poor diet rivals that taken by tobacco.”

“If anyone in the food industry ever doubted there was a slippery slope out there,” Mudd said, “I imagine they are beginning to experience a distinct sliding sensation right about now.” (...)

What happened next was not written down. But according to three participants, when Mudd stopped talking, the one C.E.O. whose recent exploits in the grocery store had awed the rest of the industry stood up to speak. His name was Stephen Sanger, and he was also the person — as head of General Mills — who had the most to lose when it came to dealing with obesity. Under his leadership, General Mills had overtaken not just the cereal aisle but other sections of the grocery store. The company’s Yoplait brand had transformed traditional unsweetened breakfast yogurt into a veritable dessert. It now had twice as much sugar per serving as General Mills’ marshmallow cereal Lucky Charms. And yet, because of yogurt’s well-tended image as a wholesome snack, sales of Yoplait were soaring, with annual revenue topping $500 million. Emboldened by the success, the company’s development wing pushed even harder, inventing a Yoplait variation that came in a squeezable tube — perfect for kids. They called it Go-Gurt and rolled it out nationally in the weeks before the C.E.O. meeting. (By year’s end, it would hit $100 million in sales.)

According to the sources I spoke with, Sanger began by reminding the group that consumers were “fickle.” (Sanger declined to be interviewed.) Sometimes they worried about sugar, other times fat. General Mills, he said, acted responsibly to both the public and shareholders by offering products to satisfy dieters and other concerned shoppers, from low sugar to added whole grains. But most often, he said, people bought what they liked, and they liked what tasted good. “Don’t talk to me about nutrition,” he reportedly said, taking on the voice of the typical consumer. “Talk to me about taste, and if this stuff tastes better, don’t run around trying to sell stuff that doesn’t taste good.”

To react to the critics, Sanger said, would jeopardize the sanctity of the recipes that had made his products so successful. General Mills would not pull back. He would push his people onward, and he urged his peers to do the same. Sanger’s response effectively ended the meeting.

“What can I say?” James Behnke told me years later. “It didn’t work. These guys weren’t as receptive as we thought they would be.” Behnke chose his words deliberately. He wanted to be fair. “Sanger was trying to say, ‘Look, we’re not going to screw around with the company jewels here and change the formulations because a bunch of guys in white coats are worried about obesity.’ ”

The meeting was remarkable, first, for the insider admissions of guilt. But I was also struck by how prescient the organizers of the sit-down had been. Today, one in three adults is considered clinically obese, along with one in five kids, and 24 million Americans are afflicted by type 2 diabetes, often caused by poor diet, with another 79 million people having pre-diabetes. Even gout, a painful form of arthritis once known as “the rich man’s disease” for its associations with gluttony, now afflicts eight million Americans.

The public and the food companies have known for decades now — or at the very least since this meeting — that sugary, salty, fatty foods are not good for us in the quantities that we consume them. So why are the diabetes and obesity and hypertension numbers still spiraling out of control? It’s not just a matter of poor willpower on the part of the consumer and a give-the-people-what-they-want attitude on the part of the food manufacturers. What I found, over four years of research and reporting, was a conscious effort — taking place in labs and marketing meetings and grocery-store aisles — to get people hooked on foods that are convenient and inexpensive. I talked to more than 300 people in or formerly employed by the processed-food industry, from scientists to marketers to C.E.O.’s. Some were willing whistle-blowers, while others spoke reluctantly when presented with some of the thousands of pages of secret memos that I obtained from inside the food industry’s operations. What follows is a series of small case studies of a handful of characters whose work then, and perspective now, sheds light on how the foods are created and sold to people who, while not powerless, are extremely vulnerable to the intensity of these companies’ industrial formulations and selling campaigns.

by Michael Moss, NY Times |  Read more:

Image: Grant Cornett

Zero-Days

Welcome to the Malware-Industrial Complex

Every summer, computer security experts get together in Las Vegas for Black Hat and DEFCON, conferences that have earned notoriety for presentations demonstrating critical security holes discovered in widely used software. But while the conferences continue to draw big crowds, regular attendees say the bugs unveiled haven’t been quite so dramatic in recent years.

One reason is that a freshly discovered weakness in a popular piece of software, known in the trade as a “zero-day” vulnerability because the software makers have had no time to develop a fix, can be cashed in for much more than a reputation boost and some free drinks at the bar. Information about such flaws can command prices in the hundreds of thousands of dollars from defense contractors, security agencies and governments.

This trade in zero-day exploits is poorly documented, but it is perhaps the most visible part of a new industry that in the years to come is likely to swallow growing portions of the U.S. national defense budget, reshape international relations, and perhaps make the Web less safe for everyone.

Zero-day exploits are valuable because they can be used to sneak software onto a computer system without detection by conventional computer security measures, such as antivirus packages or firewalls. Criminals might do that to intercept credit card numbers. An intelligence agency or military force might steal diplomatic communications or even shut down a power plant.

It became clear that this type of assault would define a new era in warfare in 2010, when security researchers discovered a piece of malicious software, or malware, known as Stuxnet. Now widely believed to have been a project of U.S. and Israeli intelligence (U.S. officials have yet to publicly acknowledge a role but have done so anonymously to the New York Times and NPR), Stuxnet was carefully designed to infect multiple systems needed to access and control industrial equipment used in Iran’s nuclear program. The payload was clearly the work of a group with access to government-scale resources and intelligence, but it was made possible by four zero-day exploits for Windows that allowed it to silently infect target computers. That so many precious zero-days were used at once was just one of Stuxnet’s many striking features.

Since then, more Stuxnet-like malware has been uncovered, and it’s involved even more complex techniques (see “The Antivirus Era Is Over”). It is likely that even more have been deployed but escaped public notice. Meanwhile, governments and companies in the United States and around the world have begun paying more and more for the exploits needed to make such weapons work, says Christopher Soghoian, a principal technologist at the American Civil Liberties Union.

“On the one hand the government is freaking out about cyber-security, and on the other the U.S. is participating in a global market in vulnerabilities and pushing up the prices,” says Soghoian, who says he has spoken with people involved in the trade and that prices range from the thousands to the hundreds of thousands. Even civilian law-enforcement agencies pay for zero-days, Soghoian says, in order to sneak spy software onto suspects’ computers or mobile phones.

by Tom Simonite, MIT Technology Review |  Read more:

Image: Dan Page

Steve Javiel, Inspiration
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No Comments

[ed. Excerpted from a recent post on The Big Picture (one of the best financial blogs on the internet) titled "Why I Am Considering Getting Rid of Comments". Duck Soup gets hardly a fraction of the traffic TBP does, but Mr Ritholtz' post goes a long way in explaining why I've been reluctant to implement a comments section here. If you're interested in this type of issue he provides a couple of links that are well worth reading, including: How to Spot - and Defeat - Disruption on the Internet and COINTELPRO Techniques for Dilution, Misdirection and Control of an Internet Forum.]

Since I began this humble blog almost 11 years, 25,000 posts and 110 million page views ago, it has managed (despite my best efforts) to accumulate half a million comments.

This was never my intention.

I created this blog, in the words of Daniel Boorstin, to figure out what I think. It is where I gather my favorite charts, quotes, links and assorted ideas. The blog is simply a diary of random thoughts of a person working in finance. Think of it as the musings of an intelligent investor who, despite studying his subject for decades, still puzzles over many aspects of it.

Overall, the goal with this blog has been an attempt to discern the objective “Truth” (whatever that means) in an industry that does its best to hide that truth from public view. When I do uncover a small measure of truth, I enjoy sharing the discovery here. (...)

Managing blog comments has become an increasingly time consuming job. Policing the spammers, trolls, haters, and other purveyors of falsehoods has become a larger time suck than I am willing to accept. Dealing with such cretins hardens your outlook and shortens your temper more than I care for. Perhaps this is the reason so many high profile blogs have closed down their comments altogether.

Were I to shut down my comments, it would be for a reason I have not seen enumerated elsewhere: The intellectually disingenuous rhetorical sleight of hand that has become a substitute for legitimate debate. (See this and this). I simply do not have the time nor the interest in correcting every half-truth and lie. But I have even less interest in polluting the blog with this sort of nonsense.

Therein lay my quandry. A harsh solution beckons.

by Barry Ritholtz, The Big Picture |  Read more:

Karen Tusinski
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Michelle Blade, Day 359. 366 Days of the Apocalypse. 2012.
Acrylic ink on paper, 8 x 10”
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The Drones Come Home

A dozen years ago only two communities cared much about drones. One was hobbyists who flew radio-controlled planes and choppers for fun. The other was the military, which carried out surveillance missions with unmanned aircraft like the General Atomics Predator.

Then came 9/11, followed by the U.S. invasions of Afghanistan and Iraq, and drones rapidly became an essential tool of the U.S. armed forces. The Pentagon armed the Predator and a larger unmanned surveillance plane, the Reaper, with missiles, so that their operators—sitting in offices in places like Nevada or New York—could destroy as well as spy on targets thousands of miles away. Aerospace firms churned out a host of smaller drones with increasingly clever computer chips and keen sensors—cameras but also instruments that measure airborne chemicals, pathogens, radioactive materials.

The U.S. has deployed more than 11,000 military drones, up from fewer than 200 in 2002. They carry out a wide variety of missions while saving money and American lives. Within a generation they could replace most manned military aircraft, says John Pike, a defense expert at the think tank GlobalSecurity.org. Pike suspects that the F-35 Lightning II, now under development by Lockheed Martin, might be “the last fighter with an ejector seat, and might get converted into a drone itself.”

At least 50 other countries have drones, and some, notably China, Israel, and Iran, have their own manufacturers. Aviation firms—as well as university and government researchers—are designing a flock of next-generation aircraft, ranging in size from robotic moths and hummingbirds to Boeing’s Phantom Eye, a hydrogen-fueled behemoth with a 150-foot wingspan that can cruise at 65,000 feet for up to four days.

More than a thousand companies, from tiny start-ups like Miser’s to major defense contractors, are now in the drone business—and some are trying to steer drones into the civilian world. Predators already help Customs and Border Protection agents spot smugglers and illegal immigrants sneaking into the U.S. NASA-operated Global Hawks record atmospheric data and peer into hurricanes. Drones have helped scientists gather data on volcanoes in Costa Rica, archaeological sites in Russia and Peru, and flooding in North Dakota.

So far only a dozen police departments, including ones in Miami and Seattle, have applied to the FAA for permits to fly drones. But drone advocates—who generally prefer the term UAV, for unmanned aerial vehicle—say all 18,000 law enforcement agencies in the U.S. are potential customers. They hope UAVs will soon become essential too for agriculture (checking and spraying crops, finding lost cattle), journalism (scoping out public events or celebrity backyards), weather forecasting, traffic control. “The sky’s the limit, pun intended,” says Bill Borgia, an engineer at Lockheed Martin. “Once we get UAVs in the hands of potential users, they’ll think of lots of cool applications.”

The biggest obstacle, advocates say, is current FAA rules, which tightly restrict drone flights by private companies and government agencies (though not by individual hobbyists). Even with an FAA permit, operators can’t fly UAVs above 400 feet or near airports or other zones with heavy air traffic, and they must maintain visual contact with the drones. All that may change, though, under the new law, which requires the FAA to allow the “safe integration” of UAVs into U.S. airspace.

If the FAA relaxes its rules, says Mark Brown, the civilian market for drones—and especially small, low-cost, tactical drones—could soon dwarf military sales, which in 2011 totaled more than three billion dollars. Brown, a former astronaut who is now an aerospace consultant in Dayton, Ohio, helps bring drone manufacturers and potential customers together. The success of military UAVs, he contends, has created “an appetite for more, more, more!” Brown’s PowerPoint presentation is called “On the Threshold of a Dream.”

by John Horgan, National Geographic |  Read more:

Photo: Joe McNally

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On Being Private in Public

We all know that we are under CCTV surveillance on many occasions each day, particularly when we are in public places. For the most part we accept that being – or potentially being – watched in public places is a reasonable price to pay for the security that 24-hour surveillance offers. However, we also have expectations about what is done with CCTV footage, when, and by whom. A recent discussion with a friend threw up some interesting questions about the nature of these expectations and their reasonableness.

My friend works in a bar where, unsurprisingly, there are several CCTV cameras. Everyone knows where these cameras are and that they are permanently in operation – there is not supposed to be any secrecy. Whilst the primary purpose of the cameras is to promote security, a member of the management team has begun to use them in a way that could be seen as ethically problematic: she logs on to view the footage in real-time, remotely, at her home. In addition to watching the footage, the manager has also addressed points of staff discipline based on what she sees. Perhaps particularly troubling is that she has commented on the way a member of staff behaved when no one was around – when the member of staff thought that she was ‘alone’.

To me there seems to be something wrong about this, but it is hard to pinpoint exactly what: the members of staff know that the cameras are there and they know that the real-time camera footage can be viewed from the office in the bar. Perhaps the first issue involves expectations about the likelihood and purpose of being watched. Given that the primary purpose of the cameras is to promote security, the staff might reasonably expect that no close attention will be paid to the footage unless there is a serious incident. Under such circumstances, the movements of the staff members will only be closely observed insomuch as they are part of, or relevant to, the incident in question. In addition, any incidental embarrassing or indiscreet behaviour that a member of staff might engage in whilst apparently ‘alone’ would pale in significance in light of the details of the serious incident. In contrast, when the manager watches from home she is interested in particular in the behavior of the members of staff – she pays close attention to them. Relatedly, when used for security purposes, footage is often viewed retrospectively and non-essential parts are fast-forwarded. The manager, on the other hand, is watching closely, in real-time, with no antecedent security concerns.

The second issue is what it is appropriate for the manager to do when she is off duty. It is true that the behaviour of staff and the security of the bar do not cease to be within her professional interest in general when she leaves to go home. If she were to hear that a member of staff conducted himself inappropriately whilst she was not there, the fact that she was not on duty at the time would not and should not prevent her from addressing it. However, there does seem to be something about her viewing live footage of the bar in her leisure time and acting on what she sees as not quite right. The intuition might be that the scope of her role – particularly her jurisdiction to discipline – does not extend to her home when off duty. However, this intuition can be challenged if we imagine that – instead of noticing something from home on the cameras – she were to ‘drop in’ on her day off and happen to view the same thing. If she were to act on what she views under these circumstances I doubt any eyebrows would be raised.

Probably, the core of the unease we might feel derives from the seeming ‘misuse’ of the CCTV: watching for whether members of staff take too long on their breaks or don’t answer the telephone as quickly as possible are not security matters. In addition, the invisibility of the watchful eye seems to make a difference: when she drops in on her day off her presence is known about. Finally, some of the unease might also relate to suspicions about the manager’s motivation for watching remotely from home: whether she acts or comments on what she sees or not, watching the movements of staff members like a fly on the wall shifts her interest from professional to personal.

But do these factors really make this practice ethically problematic? Is the off duty home-viewing really something we can object to? The cameras are there, the signs indicating their presence are clear and the bar is, after all, a public place and a place of work. But, when the customers are all gone and you’re left shutting up for the night, should you not be able to dance-as-you-mop in private?

by Hannah Maslen, Practical Ethics, University of Oxford |  Read more:

Image via: Wikipedia

I’m Waiting for my UPS Man

There are two websites where you can add a gram of heroin to your shopping cart as if you were buying asparagus on Fresh Direct. One belongs to Sigma-Aldrich, the St. Louis chemical company that synthesizes pure opioids for use in laboratory studies. For this you need to be a federally accredited laboratory. The other is Silk Road, the anonymous marketplace where drugs are priced in untraceable Bitcoin currency. For this you just need an internet connection.

Most of us do so much online shopping, and the interface has become so standardized, that the bland machinery of ecommerce is part of the texture of our waking lives: clicking “add to shopping cart” is like flicking a light switch. So although you might be perturbed if a salesperson offered you heroin from behind a department store counter, the aesthetic of the product page makes the transaction seem instantly mundane. Really, the only surprise is that Amazon hasn’t gotten into the game already. It’s strange to recall that rock music once made the act of buying drugs sound as mythically cool as the act of taking them. Today, Lou Reed would go to Silk Road instead of Lexington and 125th, and the man he’d be waiting for a week later would be totally unwitting, and from UPS.

Silk Road got a lot of publicity in 2011 for its heroin and LSD offerings; most of the websites that sell recreational drugs specialize in experimental compounds imported from China, still legal or quasi-legal because no legislative body can possibly keep up with an enterprising chemist. However, to dodge broader regulations about what you can encourage people to put in their bodies, most of these drugs are advertised under some other category: bath salts, plant food, pool cleaner. Like the ecommerce interface itself, the product pages are redolent of dull domestic life. So far, the most popular of these drugs is mephedrone (not to be confused with methadone), a substitute for MDMA that arrived in the UK in around 2009 and in the US last year. Mephedrone became famous in the British tabloids as “Meow Meow,” a “street name” that turned out to have been the invention of a lone Wikipedia user. It’s now been banned almost everywhere, after being implicated in a handful of deaths (and one notorious face-eating, which later turned out to have nothing to do with it). But dozens of its relatives still count as legal highs.

While Silk Road is like eBay, many of the websites offering “research chemicals” are more like Zappos: full-featured specialist retailers that operate openly and expect to be around for long enough that it’s worth investing in customer retention. These websites don’t just have shopping carts and checkouts: they also have user reviews, product alerts, seasonal sales and multiple worldwide delivery options. (“Really great product these pellets are. compared to the “o5” pellets, and the 6apb powder ive had from numerous sources, these absolutely blew me away. 2 pellets made for an amazing reaction, the 5apb adds SO much to the mix. Also, top notch customer support and service, as usual. Shipped same day. rc-lab is always a pleasure to do business with.”) We all know from The Wire that drug dealers have learned a lot from the marketing techniques of legitimate businesses. But the timing of their seasonal sales, for instance, doesn’t quite make sense: it’s not as if you need to clear out all your heavy winter junk to make way for the graceful new spring collections. One wonders if the retailers are so delighted with their off-the-shelf e-commerce platforms that they’ve decided to imitate more mainstream websites by any other means that occur to them.

There is, however, one area in which they really fall down, and that’s friendliness to the newbie. Methoxetamine, methiopropamine, ethylphenidate, etizolam, benzofuran, camfetamine, pentedrone—who can keep up? The merchants can give you the best customer service in the world, but the one thing they can’t do is explain the effect of these drugs and how much you might want to swallow, because, remember, they’re only selling plant food. Could it be that, just when it seemed like the internet was robbing the drug world of all its dangerous glamor, the problem’s actually just been flipped upside down? In the old days, you knew what you wanted but didn’t know where to get it. In 2013, you can get almost anything but have no idea what it is.

by Ned Beauman, N+1 |  Read more:

Image: Image copyright (c) 2010 by J. Peter Siriprakorn

What is Love?

It is a telling statistic that the ­most frequently ‘what is…?’ question typed into Google last year was: what is love? This fact probably reveals more about the society that asks an internet search engine such a thing, than any answer reveals about the nature of love. But if not Google, then where else can we look to understand love? The fantasy-making machines of Hollywood and Bollywood insist that there is only one answer worth indulging: the romantic kind. Most people, it would seem, agree, if only by default. They are dragged into seeking the person who will make them ‘whole’ via a dating website, or by a less tangible, though no less keenly felt urge cultivated by the same, dominant culture that insists we must find ‘the one’. Not that its origins are modern. Ever since the poet Sappho wrote, in the seventh century BCE, of love rippling under her skin like wind through trees, romantic love has been imagined as irresistible, a crucial experience that marks the peak of human existence.

Yet, the Google stats suggest that there is also a silent global search underway — many of us are clearly not satisfied with romance as an answer. The real problem, then, might be that contemporary culture leaves us unprepared for thinking about love in anything other than a one-dimensional mode. Just as marriage has seized the monopoly on public affirmations of love, so a notion of romance has restricted what we can imagine as a loving relationship.

The ancient Greeks, unlike us, did not have a single word for love but many. As is often noted, they had philia (friendship) and eros (desire), storge (affection) and agape (unconditional love). Perhaps that is another part of our problem. Our language invites us to think of love as a single, unified thing, when it is nothing of the sort. I suspect that words are not enough to address this modern deficiency. What we need is a new sense of the variety of love’s experiences. Fortunately there is another storehouse we can draw on from our ancient forebears: and it is not their words, but their myths that can enlighten us.

In a sense, we are lumbered with the dominance of romantic love; it can't simply be sidestepped in favour of friendship, for example. That would never work: the erotic is simply too powerful. But the ancient myths can help us realise why romance is such a successful sell, if short-lived. Perhaps the myth that best captures the allure of romance is Aristophanes’ idea about soulmates, from Plato’s Symposium The story goes that human beings originally had two heads, four arms and four legs. We were shaped like round balls and tumbled across the face of the Earth at great speed. The gods grew alarmed at this display of power. So Zeus hatched a plan. He would cut human beings in half, leaving each with just one head, two arms and two legs.

These mutilated halflings were a pathetic sight. In particular, they developed the habit of devoting considerable amounts of their now limited energy searching for their lost halves. The desire to find the missing other was irresistible. Individuals sustained the search in spite of repeated break-ups and romantic disasters in the indefatigable belief that the right person — ‘the one’ — was out there. The promise of love, they felt, was nothing less than wholeness.

The myth has had a long life, accurately describing to this day the inner experience of those who feel life is incomplete without such love. In fact, it wasn’t until the 18th century that Aristophanes’ way of thinking about love reached its logical conclusion, when Jean-Jacques Rousseau wrote of how he fell in love as a young man. Only after that experience, he mused, could he be sure that he had genuinely lived. The upshot was that romantic love had become the goal in its own right. It matters not who you fall in love with, so long as you have fallen in love. The experiential ideal usurps the complex personal reality. That is why romance has us so much in its grip and empties us out in the process. It is the same with the dogmatic pursuit of happiness.

Crucially, however, Plato’s original myth about soulmates ends not with an elusive, illusory happiness, but with a twist. And here it might have something to teach us, suggesting an escape hatch out of the romantic stronghold. Zeus takes pity on the halved humans. He moves their genitals round so that when they meet they can embrace and find a little release for their passion. Sex is a temporary taste of unity, and it helps, though only to a degree. So when Hephaestus, the god of craftsmen, passes by and promises the couples a wish, these tragic figures speak with one voice. Weld us together, they cry: melt us one into the other!

Hephaestus obliges. The two become one. And the new situation reveals another way in which love gets stuck. Glued together, gazing only into each other’s eyes, the lovers lose touch with the rest of life. Not caring for anything else, death takes on an attractive hue, and they dream of sharing a last single breath together — a fantasy that lives on in the French euphemism, la petite mort, and in the romantic climax to Romeo and Juliet. But as the psychologist Erich Fromm put it in The Art of Loving (1956), for love to have a future, couples need to be able to move from falling in love to standing in love. Lovers must learn to embrace what lies outside their cosy twosome in order to survive. As Freud made explicit, dyadic love can be nurturing, but can equally be claustrophobic and alienating, and Aristophanes’ tale suggest it must be transcended.

The question is, how? How can the energy that romantic desire releases be directed outwards so that it feeds a passion not just for life together, but for life itself, led together. An answer is given by another ancient myth, one that is almost forgotten today. It concerns the infant god of love, familiar to us as Eros, but it also introduces us to another, less familiar figure, his brother.

by Mark Vernon, Aeon |  Read more:

Video: Hedwig and the Angry Inch

A Note to Readers

[ed. Down for a couple days, back up Monday (hopefully). Have a good weekend.]
Photo: markk

[ed. All good vacations come to an end eventually.]
Photo: markk