Sunday, April 19, 2015
Almonds Get Roasted in Debate Over California Water Use
California almonds are becoming one of the world's favorite snacks and creating a multibillion-dollar bonanza for agricultural investors. But the crop extracts a staggering price from the land, consuming more water than all the showering, dish-washing and other indoor household water use of California's 39 million people.
As California enters its fourth year of drought and imposes the first mandatory statewide water cutbacks on cities and towns, the $6.5 billion almond crop is helping drive a sharp debate about water use, agricultural interests and how both affect the state's giant economy.
Almonds have claimed the spotlight as "the poster child of all things bad in water," almond grower Bob Weimer said.
People around the world are eating over 1,000 percent more California almonds than they did just a decade ago, and last year almonds became the top export crop in the nation's top agriculture state. China's booming middle class is driving much of the demand.
That strong Asia market is producing up to 30 percent returns for investors, prompting agri-businesses to expand almond planting in the state by two-thirds in the past decade. The crop has come to be dominated by global corporations and investment funds.
Rows of almond trees now cover nearly 1 million acres in California, many of them on previously virgin hillsides or in pastures or desert with little rain or local water. Since each tiny nut requires a gallon of water, almonds are consuming 1.07 trillion gallons annually in the state, one-fifth more than California families use indoors.
So when Gov. Jerry Brown ordered cities and towns this month to cut their water consumption by 25 percent but exempted farms, almonds got toasted in the public heat that followed.
"Drought villains?" the Los Angeles Times asked this month. A Sacramento TV station referred to "almond-shaming." National Public Radio called almond farms "a rogue's gallery" of water users.
Now almond farmers and investors are on the defensive. (...)
As big a global money-maker as California's agriculture is, though, it's little more than a blip in the state's economy. And that's driving the debate on water use.
In all, agriculture uses 80 percent of the water that Californians draw from groundwater and surface supplies but produces just 1.5 percent of the state's gross domestic product, noted Christopher Thornberg, an economist who has served as an economic adviser to state agencies.
As California enters its fourth year of drought and imposes the first mandatory statewide water cutbacks on cities and towns, the $6.5 billion almond crop is helping drive a sharp debate about water use, agricultural interests and how both affect the state's giant economy.Almonds have claimed the spotlight as "the poster child of all things bad in water," almond grower Bob Weimer said.
People around the world are eating over 1,000 percent more California almonds than they did just a decade ago, and last year almonds became the top export crop in the nation's top agriculture state. China's booming middle class is driving much of the demand.
That strong Asia market is producing up to 30 percent returns for investors, prompting agri-businesses to expand almond planting in the state by two-thirds in the past decade. The crop has come to be dominated by global corporations and investment funds.
Rows of almond trees now cover nearly 1 million acres in California, many of them on previously virgin hillsides or in pastures or desert with little rain or local water. Since each tiny nut requires a gallon of water, almonds are consuming 1.07 trillion gallons annually in the state, one-fifth more than California families use indoors.
So when Gov. Jerry Brown ordered cities and towns this month to cut their water consumption by 25 percent but exempted farms, almonds got toasted in the public heat that followed.
"Drought villains?" the Los Angeles Times asked this month. A Sacramento TV station referred to "almond-shaming." National Public Radio called almond farms "a rogue's gallery" of water users.
Now almond farmers and investors are on the defensive. (...)
As big a global money-maker as California's agriculture is, though, it's little more than a blip in the state's economy. And that's driving the debate on water use.
In all, agriculture uses 80 percent of the water that Californians draw from groundwater and surface supplies but produces just 1.5 percent of the state's gross domestic product, noted Christopher Thornberg, an economist who has served as an economic adviser to state agencies.
by Ellen Knickmeyer, AP | Read more:
Image: Rich Pedroncelli
How "One-Plus-Five" is Shaping American Cities
[ed. See also: Nice Downtowns, How Did They Get That Way?]
Nobody would for one minute mistake a car or an airplane from 1955 for one from today. Everything, from technology to style is just too different.
By contrast, enter a new house or an apartment and clues that give away the newness are harder to find: They may be obvious in kitchen and bath, but even that is not certain, since fashionable retro stoves and claw-foot tubs could be deceiving even in those places where technology would be most likely. The new house would probably be more open and bigger, but from light switches to receptacles, from door hardware to double hung windows, things look essentially the same. On second glance, though, things in the new house feel flimsier, thinner and less substantial. Maybe there is a white plastic porch railing masquerading as solid wood or vinyl siding doing the same, maybe the doors are light, hollow and molded instead of being made from actual wood panels. This general impression might deepen when one starts looking "under the hood": copper and cast iron pipes replaced by PVC, true dimension heavy wood joists and posts replaced by engineered trusses, strand board, and quick growth studs light as cigar boxes. Slate has yielded to asphalt shingles, wood floors have become laminate, and porcelain sinks replaced by cultured stone. Brick now comes as a thin cement imitation, cornices are made from Fypon, and flagstone water tables are only paper thin. (...)
The rather recent appearance of the "one-plus-five" formula has moved the debate from the suburbs to the city and from a discussion about components to one about whole buildings and even urban form. What is "one plus five"? It is the wood construction, "stick-built" urban mixed-use building, exactly five stories tall, erected on a concrete podium. The first level capped by the concrete deck is retail, parking, meeting rooms or amenities and the floors above it are apartments, condos, or dormitories erected under the 3A construction type classification of the building model code IBC. (...)
With the stroke of a pen (via IBC 2009) an entire building group, the urban elevator building, moved from being a substantial structure made of concrete, steel or brick to one that is put together with two-by-fours like a single family home. This change amounts to an often overlooked revolution in the construction industry and in urban development. (...)
For centuries the quality of their buildings and a certain permanence set cities apart and allowed decades and centuries of layers to create the textual richness we associate with them. City buildings could be reused in many ways because their structure were still good after 50 or a hundred years or more. Baltimore has a rich tradition in creative reuse of beautiful breweries, factories, mills and warehouses, each with substantial bones and each having been once each a trail blazer of sorts for innovation and skills. It is hard to imagine that fifty years onward folks would get excited about the one-plus-five buildings or contemplate an adaptive re-use. Too flimsy to last even that long, these buildings will probably have to be demolished once they become obsolete, unable to stand as the testimony of our times.
by Klaus Philipsen, Community Architect | Read more:
Image: ArchPlan, Inc.
Nobody would for one minute mistake a car or an airplane from 1955 for one from today. Everything, from technology to style is just too different.
By contrast, enter a new house or an apartment and clues that give away the newness are harder to find: They may be obvious in kitchen and bath, but even that is not certain, since fashionable retro stoves and claw-foot tubs could be deceiving even in those places where technology would be most likely. The new house would probably be more open and bigger, but from light switches to receptacles, from door hardware to double hung windows, things look essentially the same. On second glance, though, things in the new house feel flimsier, thinner and less substantial. Maybe there is a white plastic porch railing masquerading as solid wood or vinyl siding doing the same, maybe the doors are light, hollow and molded instead of being made from actual wood panels. This general impression might deepen when one starts looking "under the hood": copper and cast iron pipes replaced by PVC, true dimension heavy wood joists and posts replaced by engineered trusses, strand board, and quick growth studs light as cigar boxes. Slate has yielded to asphalt shingles, wood floors have become laminate, and porcelain sinks replaced by cultured stone. Brick now comes as a thin cement imitation, cornices are made from Fypon, and flagstone water tables are only paper thin. (...)The rather recent appearance of the "one-plus-five" formula has moved the debate from the suburbs to the city and from a discussion about components to one about whole buildings and even urban form. What is "one plus five"? It is the wood construction, "stick-built" urban mixed-use building, exactly five stories tall, erected on a concrete podium. The first level capped by the concrete deck is retail, parking, meeting rooms or amenities and the floors above it are apartments, condos, or dormitories erected under the 3A construction type classification of the building model code IBC. (...)
With the stroke of a pen (via IBC 2009) an entire building group, the urban elevator building, moved from being a substantial structure made of concrete, steel or brick to one that is put together with two-by-fours like a single family home. This change amounts to an often overlooked revolution in the construction industry and in urban development. (...)
For centuries the quality of their buildings and a certain permanence set cities apart and allowed decades and centuries of layers to create the textual richness we associate with them. City buildings could be reused in many ways because their structure were still good after 50 or a hundred years or more. Baltimore has a rich tradition in creative reuse of beautiful breweries, factories, mills and warehouses, each with substantial bones and each having been once each a trail blazer of sorts for innovation and skills. It is hard to imagine that fifty years onward folks would get excited about the one-plus-five buildings or contemplate an adaptive re-use. Too flimsy to last even that long, these buildings will probably have to be demolished once they become obsolete, unable to stand as the testimony of our times.
by Klaus Philipsen, Community Architect | Read more:
Image: ArchPlan, Inc.
Saturday, April 18, 2015
Leafly: The "Yelp of Weed"
[ed. More relevant than ever. An indispensable resource.]
But Leafly isn't just for recreational pot smokers. Leafly prides itself on building a website and mobile apps with medical marijuana patients in mind—the site's polished look deviates from other marijuana-themed sites where flashing ads often border on the epileptic. Such base aesthetics might have been fine for potheads of another generation, but today's medical marijuana patients are more sophisticated, seeking a safe place to learn about their medicine.The brainchild of three former Kelly Blue Book employees, Leafly began as a side project in 2010, shortly after cofounder Scott Vickers received a doctor's recommendation to use medical marijuana to help with his insomnia. As a white-collar professional, he wanted to build a site for people like him. That meant no overt pot symbolism, no girls clad in bikinis, no flashing ads. Originally based in Newport Beach, California, he and his cofounders, Cy Scott and Brian Wansolich, met on weekends to design and build the site, eventually quitting their jobs at the end of 2011 to work full-time on Leafly. (...)
Before Privateer's acquisition, Leafly had clocked about 15,000 marijuana strain reviews. Today, it boasts more than 50,000 from 80,000 registered users, bringing in $100,000 in revenue each month. With its new editorial site, the company hopes to see revenue light up, blooming to $1 million a month in the next year. Leafly's Android and iOS apps are also seeing success, with 200,000 new iOS downloads a month and 5,000 Android installs each week.
Much of its success on the web can be attributed to Leafly's SEO dominance for strain queries, making it a high destination for people to learn about their herbal refreshment. In addition to reviews that range from the eloquent to the typo-ridden ("F#$%ING KILLL-ERRRR!!!!" one user wrote), people also rate how effective strains are for treating certain ailments, such as pain, stress, depression, and insomnia—as well as the drugs' effects, including euphoria, creativity, dry mouth, and paranoia. Leafly landing pages highlight which dispensaries in a vicinity carry particular strains—and their going rates. Leafly also has a feature called Cannabis Strain Explorer to aid with reefer discovery, organizing more than 500 types in a periodic table of sorts that users can filter by effects and nearby availability.
by Alice Truong, Fast Company | Read more:
Image: Leafly
Design Experts Trash Hillary Clinton’s New Logo
To many graphic design experts of both political stripes, Hillary Clinton’s new logo would be better off in the trash bin.
The presumptive Democratic presidential frontrunner unveiled as her campaign logo a blue ‘H’ and a rightward-facing red arrow. It’s blanketed all over her website and sits at the top of her new Facebook page. On her revamped Twitter handle, the ‘H’ has even taken the place of the iconic picture of Clinton wearing dark shades and reading her Blackberry.
Some high-minded critics say it’s all wrong. The arrow’s direction and its Republican-minded red color, for starters, has raised alarm that she’s signalling an imminent political shift to the right.
Going with an abstract design has also opened the door to all manner of Internet fun: a new copycat font dubbed “Hillary Bold” and a do-it-yourself widget that lets anyone make their own Clinton-like logo, and plenty of odd interpretations, including a plane hitting New York’s Twin Towers and rip-offs of the Federal Express and Wikileaks logos.
“I think the Hillary logo is really saying nothing,” said Scott Thomas, the design director for Barack Obama’s 2008 presidential campaign and who later worked on the Whitehouse.gov website’s redesign. “It’s just a red arrow moving to the right.” (...)
Of course, campaigns are hardly won or lost on a logo. But political veterans say this remains a critical branding event – just think of the buzz surrounding Obama’s ‘O’ back in 2007 or even how donkeys and elephants during the 19th century came to be associated with Democrats and Republicans. A good logo can go a long way in the modern-day digital era where campaigns are desperately trying to reach attention-starved possible voters, volunteers and donors via their phones and Facebook feeds. Create an easy-on-the-eyes brand and it can pay big dividends as someone decides whether to open yet another email message from a politician, or just hit delete. (...)
The presidential candidates of 2016 are facing perhaps the toughest audience yet when it comes to their design elements. Obama’s 2008 and 2012 logos — an iconic ‘O’ that went through numerous iterations widely interpreted as a rising sun — loom as the best-in-class benchmarks. Twitter and other social media allow for instant criticism, and there’s the prospect that the reaction to a new logo can go even more viral than the logo itself.
Consider the response since Clinton unveiled her logo less than a week ago. On the online image hosting service Imgur, more than 1.1. million views have landed on a post featuring a “five-minute” redesign of Clinton’s logo that turns the image entirely to different shades of blue and adds in a more curved arrow which “gives the logo a feeling of energy and life.”
The presumptive Democratic presidential frontrunner unveiled as her campaign logo a blue ‘H’ and a rightward-facing red arrow. It’s blanketed all over her website and sits at the top of her new Facebook page. On her revamped Twitter handle, the ‘H’ has even taken the place of the iconic picture of Clinton wearing dark shades and reading her Blackberry.Some high-minded critics say it’s all wrong. The arrow’s direction and its Republican-minded red color, for starters, has raised alarm that she’s signalling an imminent political shift to the right.
Going with an abstract design has also opened the door to all manner of Internet fun: a new copycat font dubbed “Hillary Bold” and a do-it-yourself widget that lets anyone make their own Clinton-like logo, and plenty of odd interpretations, including a plane hitting New York’s Twin Towers and rip-offs of the Federal Express and Wikileaks logos.
“I think the Hillary logo is really saying nothing,” said Scott Thomas, the design director for Barack Obama’s 2008 presidential campaign and who later worked on the Whitehouse.gov website’s redesign. “It’s just a red arrow moving to the right.” (...)
Of course, campaigns are hardly won or lost on a logo. But political veterans say this remains a critical branding event – just think of the buzz surrounding Obama’s ‘O’ back in 2007 or even how donkeys and elephants during the 19th century came to be associated with Democrats and Republicans. A good logo can go a long way in the modern-day digital era where campaigns are desperately trying to reach attention-starved possible voters, volunteers and donors via their phones and Facebook feeds. Create an easy-on-the-eyes brand and it can pay big dividends as someone decides whether to open yet another email message from a politician, or just hit delete. (...)The presidential candidates of 2016 are facing perhaps the toughest audience yet when it comes to their design elements. Obama’s 2008 and 2012 logos — an iconic ‘O’ that went through numerous iterations widely interpreted as a rising sun — loom as the best-in-class benchmarks. Twitter and other social media allow for instant criticism, and there’s the prospect that the reaction to a new logo can go even more viral than the logo itself.
Consider the response since Clinton unveiled her logo less than a week ago. On the online image hosting service Imgur, more than 1.1. million views have landed on a post featuring a “five-minute” redesign of Clinton’s logo that turns the image entirely to different shades of blue and adds in a more curved arrow which “gives the logo a feeling of energy and life.”
by Darren Samuelsohn, Politico | Read more:
Images: Clinton and Obama Campaigns
Friday, April 17, 2015
Serving All Your Heroin Needs
Fatal heroin overdoses in America have almost tripled in three years. More than 8,250 people a year now die from heroin. At the same time, roughly double that number are dying from prescription opioid painkillers, which are molecularly similar. Heroin has become the fallback dope when an addict can’t afford, or find, pills. Total overdose deaths, most often from pills and heroin, now surpass traffic fatalities.
If these deaths are the measure, we are arguably in the middle of our worst drug plague ever, apart from cigarettes and alcohol.
And yet this is also our quietest drug plague. Strikingly little public violence accompanies it. This has muted public outrage. Meanwhile, the victims — mostly white, well-off and often young — are mourned in silence, because their parents are loath to talk publicly about how a cheerleader daughter hooked for dope, or their once-star athlete son overdosed in a fast-food restaurant bathroom.
The problem “is worse than it’s ever been, and young people are dying,” an addiction doctor in Columbus, Ohio — one of our many new heroin hot spots — wrote me last month. “This past Friday I saw 23 patients, all heroin addicts recently diagnosed.”
So we are at a strange new place. We enjoy blissfully low crime rates, yet every year the drug-overdose toll grows. People from the most privileged groups in one of the wealthiest countries in the world have been getting hooked and dying in almost epidemic numbers from substances meant to numb pain. Street crime is no longer the clearest barometer of our drug problem; corpses are.
Most of our heroin now comes not from Asia, but from Latin America, particularly Mexico, where poppies grow well in the mountains along the Pacific Coast. Mexican traffickers have focused on a rudimentary, less-processed form of heroin that can be smoked or injected. It is called black tar, which accurately describes its appearance. Cheaper to produce and ship than the stuff of decades past from Asia, heroin has fallen in price, and so more people have become addicted.
The most important traffickers in this story hail from Xalisco, a county of 49,000 people near the Pacific Coast. They have devised a system for selling heroin across the United States that resembles pizza delivery.
Dealers circulate a number around town. An addict calls, and an operator directs him to an intersection or a parking lot. The operator dispatches a driver, who tools around town, his mouth full of tiny balloons of heroin, with a bottle of water nearby to swig them down with if cops stop him. (“It’s amazing how many balloons you can learn to carry in your mouth,” said one dealer, who told me he could fit more than 30.)
The driver meets the addict, spits out the required balloons, takes the money and that’s that. It happens every day — from 7 a.m. to 7 p.m., because these guys keep business hours.
The Xalisco Boys, as one cop I know has nicknamed them, are far from our only heroin traffickers. But they may be our most prolific. As relentless as Amway salesmen, they embody our new drug-plague paradigm.
Xalisco dealers are low profile — the anti-Scarface. Back home they are bakers, butchers and farm workers, part of a vast labor pool in Xalisco and surrounding towns, who hire on as heroin drivers for $300 to $500 a week. The drug trade offers them a shot at their own business, or simply a chance to make some money to show off back home — kings until the cash goes. Meanwhile, in the United States, they drive old cars with their cheeks packed like chipmunks’, and dress like the day workers in front of your Home Depot.
The heroin delivery system appeals to them mainly because there is no cartel kingpin, no jefe máximo. It is meritocratic — so unlike Mexico. They are “people acting as individuals who are doing it on their own: micro-entrepreneurs,” said one phone operator for a crew who I interviewed while he was in prison. They are “looking for places where there’s no people, no competition,” he said. “Anyone can be boss of a network.” Thus the system distills what appeals to immigrants generally about America: It is a way to translate wits and hard work into real economic gain.
If these deaths are the measure, we are arguably in the middle of our worst drug plague ever, apart from cigarettes and alcohol.
And yet this is also our quietest drug plague. Strikingly little public violence accompanies it. This has muted public outrage. Meanwhile, the victims — mostly white, well-off and often young — are mourned in silence, because their parents are loath to talk publicly about how a cheerleader daughter hooked for dope, or their once-star athlete son overdosed in a fast-food restaurant bathroom.The problem “is worse than it’s ever been, and young people are dying,” an addiction doctor in Columbus, Ohio — one of our many new heroin hot spots — wrote me last month. “This past Friday I saw 23 patients, all heroin addicts recently diagnosed.”
So we are at a strange new place. We enjoy blissfully low crime rates, yet every year the drug-overdose toll grows. People from the most privileged groups in one of the wealthiest countries in the world have been getting hooked and dying in almost epidemic numbers from substances meant to numb pain. Street crime is no longer the clearest barometer of our drug problem; corpses are.
Most of our heroin now comes not from Asia, but from Latin America, particularly Mexico, where poppies grow well in the mountains along the Pacific Coast. Mexican traffickers have focused on a rudimentary, less-processed form of heroin that can be smoked or injected. It is called black tar, which accurately describes its appearance. Cheaper to produce and ship than the stuff of decades past from Asia, heroin has fallen in price, and so more people have become addicted.
The most important traffickers in this story hail from Xalisco, a county of 49,000 people near the Pacific Coast. They have devised a system for selling heroin across the United States that resembles pizza delivery.
Dealers circulate a number around town. An addict calls, and an operator directs him to an intersection or a parking lot. The operator dispatches a driver, who tools around town, his mouth full of tiny balloons of heroin, with a bottle of water nearby to swig them down with if cops stop him. (“It’s amazing how many balloons you can learn to carry in your mouth,” said one dealer, who told me he could fit more than 30.)
The driver meets the addict, spits out the required balloons, takes the money and that’s that. It happens every day — from 7 a.m. to 7 p.m., because these guys keep business hours.
The Xalisco Boys, as one cop I know has nicknamed them, are far from our only heroin traffickers. But they may be our most prolific. As relentless as Amway salesmen, they embody our new drug-plague paradigm.
Xalisco dealers are low profile — the anti-Scarface. Back home they are bakers, butchers and farm workers, part of a vast labor pool in Xalisco and surrounding towns, who hire on as heroin drivers for $300 to $500 a week. The drug trade offers them a shot at their own business, or simply a chance to make some money to show off back home — kings until the cash goes. Meanwhile, in the United States, they drive old cars with their cheeks packed like chipmunks’, and dress like the day workers in front of your Home Depot.
The heroin delivery system appeals to them mainly because there is no cartel kingpin, no jefe máximo. It is meritocratic — so unlike Mexico. They are “people acting as individuals who are doing it on their own: micro-entrepreneurs,” said one phone operator for a crew who I interviewed while he was in prison. They are “looking for places where there’s no people, no competition,” he said. “Anyone can be boss of a network.” Thus the system distills what appeals to immigrants generally about America: It is a way to translate wits and hard work into real economic gain.
by Sam Quinones, NY Times | Read more:
Image: Jesse Draxler
The End of Higher Education’s Golden Age
Of the twenty million or so students in the US, only about one in ten lives on a campus. The remaining eighteen million—the ones who don’t have the grades for Swarthmore, or tens of thousands of dollars in free cash flow, or four years free of adult responsibility—are relying on education after high school not as a voyage of self-discovery but as a way to acquire training and a certificate of hireability.
Though the landscape of higher education in the U.S., spread across forty-six hundred institutions, hosts considerable variation, a few commonalities emerge: the bulk of students today are in their mid-20s or older, enrolled at a community or commuter school, and working towards a degree they will take too long to complete. One in three won’t complete, ever. Of the rest, two in three will leave in debt. The median member of this new student majority is just keeping her head above water financially. The bottom quintile is drowning.
One obvious way to improve life for the new student majority is to raise the quality of the education without raising the price. This is clearly the ideal, whose principal obstacle is not conceptual but practical: no one knows how. The value of our core product—the Bachelor’s degree—has fallen in every year since 2000, while tuition continues to increase faster than inflation.
The other way to help these students would be to dramatically reduce the price or time required to get an education of acceptable quality (and for acceptable read “enabling the student to get a better job”, their commonest goal.) This is a worse option in every respect except one, which is that it may be possible. (...)
Many of my colleagues believe that if we just explain our plight clearly enough, legislators will come to their senses and give us enough money to save us from painful restructuring. I’ve never seen anyone explain why this argument will be persuasive, and we are nearing the 40th year in which similar pleas have failed, but “Someday the government will give us lots of money” remains in circulation, largely because contemplating our future without that faith is so bleak. If we can’t keep raising costs for students (we can’t) and if no one is coming to save us (they aren’t), then the only remaining way to help these students is to make a cheaper version of higher education for the new student majority.
The number of high-school graduates underserved or unserved by higher education today dwarfs the number of people for whom that system works well. The reason to bet on the spread of large-scale low-cost education isn’t the increased supply of new technologies. It’s the massive demand for education, which our existing institutions are increasingly unable to handle. That demand will go somewhere.
Though the landscape of higher education in the U.S., spread across forty-six hundred institutions, hosts considerable variation, a few commonalities emerge: the bulk of students today are in their mid-20s or older, enrolled at a community or commuter school, and working towards a degree they will take too long to complete. One in three won’t complete, ever. Of the rest, two in three will leave in debt. The median member of this new student majority is just keeping her head above water financially. The bottom quintile is drowning.One obvious way to improve life for the new student majority is to raise the quality of the education without raising the price. This is clearly the ideal, whose principal obstacle is not conceptual but practical: no one knows how. The value of our core product—the Bachelor’s degree—has fallen in every year since 2000, while tuition continues to increase faster than inflation.
The other way to help these students would be to dramatically reduce the price or time required to get an education of acceptable quality (and for acceptable read “enabling the student to get a better job”, their commonest goal.) This is a worse option in every respect except one, which is that it may be possible. (...)
Many of my colleagues believe that if we just explain our plight clearly enough, legislators will come to their senses and give us enough money to save us from painful restructuring. I’ve never seen anyone explain why this argument will be persuasive, and we are nearing the 40th year in which similar pleas have failed, but “Someday the government will give us lots of money” remains in circulation, largely because contemplating our future without that faith is so bleak. If we can’t keep raising costs for students (we can’t) and if no one is coming to save us (they aren’t), then the only remaining way to help these students is to make a cheaper version of higher education for the new student majority.
The number of high-school graduates underserved or unserved by higher education today dwarfs the number of people for whom that system works well. The reason to bet on the spread of large-scale low-cost education isn’t the increased supply of new technologies. It’s the massive demand for education, which our existing institutions are increasingly unable to handle. That demand will go somewhere.
by Clay Shirky | Read more:
Image: Wikipedia
The Right Diagnosis and the Wrong Treatment
Steven Brill has achieved the seemingly impossible—written an exciting book about the American health system. In his account of the passage of the Affordable Care Act (now known as Obamacare), he manages to transform a subject that usually befuddles and bores into a political thriller. There was reason to think he might pull it off; his lengthy 2013 Time magazine exposé of the impact of medical bills on ordinary people was engrossing. But his success also owes much to the Bob Woodward method of writing best sellers about government policy: interviews with hundreds of insiders, many anonymous, some evidently willing to talk to him to increase their chances of being shown in a favorable light.
For example, one of Brill’s principal sources and a great favorite is Liz Fowler, chief health counsel to Senator Max Baucus, chairman of the Senate Finance Committee, which oversaw the legislation. Brill credits her with being “more personally responsible than anyone for the drafting of what became Obamacare.” He is unbothered by the fact that she was vice-president for public policy at WellPoint, the country’s second-largest private insurance company, before taking her job with Senator Baucus, or by the fact that shortly after passage of the law (and a brief stint with the administration), she became head of global health policy at the drug company Johnson & Johnson—even though both of these industries benefited greatly from Obamacare. (...)
Here are a few items in Brill’s indictment. “Healthcare,” he writes, “is America’s largest industry by far.” It employs “a sixth of the country’s workforce. And it is the average American family’s largest single expense, whether paid out of their pockets or through taxes and insurance premiums.” He estimates that the health insurance companies employ about 1.5 million people, roughly twice the number of practicing physicians. Hospital executives preside over lucrative businesses, whether nominally nonprofit or not, and are paid huge salaries, even while they charge patients obscene prices (Brill cites $77 for a box of gauze pads) drawn from “what they called their ‘chargemaster,’ which was the menu of list prices they used to soak patients who did not have Medicare or private insurance.” He tells us that the CEO of New York–Presbyterian Hospital, where he had major surgery shortly after his article appeared in Time, had an income of $3.58 million. And finally, he gives us the really bad news: “All that extra money produces no better, and in many cases worse, results.”
When Barack Obama became president in 2009, reforming the American health system was at the top of his domestic agenda—ahead even of the banking crisis, housing foreclosures, and unemployment. And he was candid about the reason: soaring health costs were undermining nearly everything else. As examples: Medicare—the government program for Americans over age sixty-five—was a growing contributor to federal deficits; businesses that offered health benefits to their workers were at a competitive disadvantage, both domestically and globally; workers were afraid to leave jobs because they would lose health insurance if they did; and medical costs had become the chief cause of personal bankruptcy. In short, the American health system was no longer supportable.
When Obama was a state senator in Illinois, he was on record as favoring a single-payer health system—that is, one in which the government ensures health care for all residents of the country and regulates the distribution of resources in a predominantly nonprofit system. That’s the sort of system every other advanced country has. Even after he became president, Obama acknowledged in a press conference on July 22, 2009, that a single-payer system was the only way to achieve universal health care. Even so, except for that one admission, there was no further consideration of single-payer health care—by Obama or, crucially, by Senator Baucus—during the year Obamacare was crafted.
Instead, the launch of the reform effort was a White House media event in March 2009 that featured spokespersons for the for-profit health insurance and pharmaceutical industries, who pledged to work with the president to reform the system. But not for nothing. As a condition of its support, the insurance industry demanded that all Americans—except those in Medicare and other government programs—be required to purchase private insurance. The central role of the insurance industry would thus be not only preserved, but expanded and enshrined by law. As a condition of its support, the pharmaceutical industry demanded the continuation of two laws that Obama, as a candidate, had promised to try to overturn—one that forbids Medicare from using its purchasing power to control drug prices, and another that forbids Americans from importing cheaper drugs from other countries.
After these deals were struck, there followed a year of congressional wrangling, replete with further deals to mollify conservatives and the health industries. For example, the idea of a “public option,” that is, government-sponsored insurance to compete with private insurers, was scuttled. The final product—the Patient Protection and Affordable Care Act—was signed into law on March 23, 2010, and scheduled to go into effect over ten years, with the major provisions in effect by 2014. (...)
by Marcia Angell, NY Review of Books | Read more:
Image: John Springs
For example, one of Brill’s principal sources and a great favorite is Liz Fowler, chief health counsel to Senator Max Baucus, chairman of the Senate Finance Committee, which oversaw the legislation. Brill credits her with being “more personally responsible than anyone for the drafting of what became Obamacare.” He is unbothered by the fact that she was vice-president for public policy at WellPoint, the country’s second-largest private insurance company, before taking her job with Senator Baucus, or by the fact that shortly after passage of the law (and a brief stint with the administration), she became head of global health policy at the drug company Johnson & Johnson—even though both of these industries benefited greatly from Obamacare. (...)Here are a few items in Brill’s indictment. “Healthcare,” he writes, “is America’s largest industry by far.” It employs “a sixth of the country’s workforce. And it is the average American family’s largest single expense, whether paid out of their pockets or through taxes and insurance premiums.” He estimates that the health insurance companies employ about 1.5 million people, roughly twice the number of practicing physicians. Hospital executives preside over lucrative businesses, whether nominally nonprofit or not, and are paid huge salaries, even while they charge patients obscene prices (Brill cites $77 for a box of gauze pads) drawn from “what they called their ‘chargemaster,’ which was the menu of list prices they used to soak patients who did not have Medicare or private insurance.” He tells us that the CEO of New York–Presbyterian Hospital, where he had major surgery shortly after his article appeared in Time, had an income of $3.58 million. And finally, he gives us the really bad news: “All that extra money produces no better, and in many cases worse, results.”
When Barack Obama became president in 2009, reforming the American health system was at the top of his domestic agenda—ahead even of the banking crisis, housing foreclosures, and unemployment. And he was candid about the reason: soaring health costs were undermining nearly everything else. As examples: Medicare—the government program for Americans over age sixty-five—was a growing contributor to federal deficits; businesses that offered health benefits to their workers were at a competitive disadvantage, both domestically and globally; workers were afraid to leave jobs because they would lose health insurance if they did; and medical costs had become the chief cause of personal bankruptcy. In short, the American health system was no longer supportable.
When Obama was a state senator in Illinois, he was on record as favoring a single-payer health system—that is, one in which the government ensures health care for all residents of the country and regulates the distribution of resources in a predominantly nonprofit system. That’s the sort of system every other advanced country has. Even after he became president, Obama acknowledged in a press conference on July 22, 2009, that a single-payer system was the only way to achieve universal health care. Even so, except for that one admission, there was no further consideration of single-payer health care—by Obama or, crucially, by Senator Baucus—during the year Obamacare was crafted.
Instead, the launch of the reform effort was a White House media event in March 2009 that featured spokespersons for the for-profit health insurance and pharmaceutical industries, who pledged to work with the president to reform the system. But not for nothing. As a condition of its support, the insurance industry demanded that all Americans—except those in Medicare and other government programs—be required to purchase private insurance. The central role of the insurance industry would thus be not only preserved, but expanded and enshrined by law. As a condition of its support, the pharmaceutical industry demanded the continuation of two laws that Obama, as a candidate, had promised to try to overturn—one that forbids Medicare from using its purchasing power to control drug prices, and another that forbids Americans from importing cheaper drugs from other countries.
After these deals were struck, there followed a year of congressional wrangling, replete with further deals to mollify conservatives and the health industries. For example, the idea of a “public option,” that is, government-sponsored insurance to compete with private insurers, was scuttled. The final product—the Patient Protection and Affordable Care Act—was signed into law on March 23, 2010, and scheduled to go into effect over ten years, with the major provisions in effect by 2014. (...)
Practically every serious economic analysis of the American health system has concluded that the most efficient way to provide care to everyone is through some form of single-payer system, such as Medicare for all, and that any other approach will eventually be unsupportable. Why, then, was a single-payer system excluded from consideration and its proponents almost entirely barred from the discussion during the year Obamacare was written? That rejection can only reflect the enormous power of the health industry, which Brill reminds us has the largest lobby in Washington, D.C., and gave millions in campaign contributions to the key legislators. Indeed, Senator Baucus received more money from the health industry that year than anyone else in Congress.
by Marcia Angell, NY Review of Books | Read more:
Image: John Springs
Thursday, April 16, 2015
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