Otto Freundlich, Head (Self Portrait), 1923.
via:
[ed. See also: MF Doom and Gorillaz, November Has Come.]
Wednesday, February 22, 2017
We All Want Healthcare To Cost Much Less — But We Are Asking The Wrong Question
Imagine this: Healthcare — the whole system — for half as much. Better, more effective. No rationing. Everybody in.
Because we all want that. And because we can. This can be done. Let me tell you how.
I’m an industry insider, covering the industry for 37 years now, publishing millions of words in industry publications, speaking at hundreds of industry conferences, writing books, advising everyone from the U.N.’s World Health Organization, the Defense Department, and the Centers for Disease Control to governments around the world to, probably, your local hospital, your doctor, your health plan.
The economic fundamentals of healthcare in the United States are unique, amazingly complex, multi-layered and opaque. It takes a lot of work and time to understand them, work and time that few of the experts opining about healthcare on television have done. Once you do understand them, it takes serious independence, a big ornery streak, and maybe a bit of a career death wish to speak publicly about how the industry that pays your speaking and consulting fees should, can, and must strive to make half as much money. Well, I turn 67 this year and I’m cranky as hell, so let’s go.
Cost: Healthcare in the U.S., the whole system, costs us something like $3.4 trillion per year. Yes, that’s “trillion” with a “T”. If U.S. healthcare were a country on its own it would be the fifth largest economy in the world.
Waste: About a third of that is wasted on tests and procedures and devices that we really don’t need, that don’t help, that even hurt us. That’s the conservative estimate in a number of expert analyses, and based on the opinions of doctors about their own specialties. Some analyses say more: Some say half. Even that conservative estimate (one third) is a big wow: over $1.2 trillion per year, something like twice the entire U.S. military budget, thrown away on waste.
Prices: The prices are nuts. It’s not just pharmaceuticals. Across the board, from devices to procedures, hospital room charges to implants to diagnostic tests, the prices actually paid in the U.S. are three, five, 10 times what they are in other medically advanced countries like France, Germany, and the U.K.
Value: Unlike any other business, prices in healthcare bear no relation to value. If you pay $50,000 for a car, chances are very good that you’ll get a nicer car than if you pay $15,000. If you pay $2200 or $4500 for an MRI, there is pretty much no chance that you will get a better MRI than if you paid $730 or $420. (Yes, these are real prices, all from the same local market.)
Variation: Unlike any other business, prices in healthcare bear no relation to the producer’s cost. None. How can you tell? I mean, besides the $600 price tag on a 69-cent bottle of sterile water with a teaspoon of salt that’s labeled “saline therapeutics” on the medical bill? (Yes, those are real prices, too.) You can tell because of the insane variation. The price for your pill, procedure or test may well be three, five, even 12 times the price paid in some other city across the country, in some other institution across town, even for the person across the hall. Try that in any other business. Better yet, call me: I have a 10-year-old Ford F-150 to sell you for $75,000.
Inefficiency: We do healthcare in the most inefficient way possible, waiting until people show up in the Emergency Department with their diabetes, heart problem, or emphysema completely out of control, where treatment will cost 10 times as much as it would if we had gotten to them first to help them avoid a serious health crisis. (And no, that’s not part of the 1/3 that is waste. That’s on top of it.)
So who’s the chump here? We’re paying ridiculous prices for things we don’t necessarily need delivered in the most inefficient way possible.
Why?
Why do they do that to us? Because we pay them to.
Wait, this is important. This is the crux of the problem. From doctors to hospitals to labs to device manufacturers to anybody else we want to blame, they don’t overprice things and sell us things we don’t need because they are greedy, evil people. They do it because we tell them to, in the clearest language possible: money. Every inefficiency, every unneeded test, every extra bottle of saline, means more money in the door. And they can decide what’s on the list of what’s needed, as long as it can be argued that it matches the diagnostic code.
That’s called “fee-for-service” medicine: We pay a fee for every service, every drug, every test. There’s a code for everything. There are no standard prices or even price ranges. It’s all negotiated constantly and repeatedly across the system with health plans, employers, even with Medicare and Medicaid.
We pay them to do it and the payment system demands it. Imagine a hospital system that bent every effort to providing health and healthcare in the least expensive, most effective way possible, that charged you $1 for that 69-cent bottle of saline water, that eliminated all unnecessary tests and unhelpful procedures, that put personnel and cash into helping you prevent or manage your diabetes instead of waiting until you show up feet-first in diabetic shock. If it did all this without regard to how it is paid it would soon close its doors, belly up, bankrupt. For-profit or not-for-profit makes little difference to this fact.
If we want them to act differently, we have to pay them differently.
Paying for Healthcare Differently
But wait, isn’t that the only way we can pay? Because, you know, medicine is complicated, every body is different, every disease is unique.
Actually, no. There is no one other ideal way to pay for all of healthcare, but there are lots of other ways to pay. We can pay for outcomes, we can pay for bundles of services, we can pay for subscriptions for all primary care or all diabetes care or special attention for multiple chronic conditions, on and on, the list of alternative ways to pay for healthcare is long and rich.
There are now surgery centers that put their prices up on the wall, just like McDonalds — and they can prove their quality. There are hospital systems that will give you a warranty on your surgery: We will get it right or fixing the problem is free.
Look: You get in an accident and take your crumpled fender to the body shop. Every fender crumples differently, maybe the frame is involved, maybe the chrome strip has to be replaced, all that. So there is no standard “crumpled fender” price. But it is not the first crumpled fender the body shop has ever seen. It’s probably the 10,000th. They are very good at knowing just how to fix it and how much it will cost them to do the work. Do you pay for each can of Bondo, each disk of sandpaper, each minute in the paint booth? No. They write you up an estimate for the whole thing, from diagnosis to rehab. Come back next Thursday and it will be good as new. That’s a bundled outcome. It’s the body shop’s way of doing business, its business model.
There are new business models arising now in healthcare (such as reference prices, medical tourism, centers of excellence, “Blue Choice” and other health plan options) that force hospitals and surgical centers to compete on price and quality for specific bundles, like a new hip or a re-plumbed heart.
Healthcare is a vast market with lots of different kinds of customers in different financial situations, different life stages, different genders, different needs, different resources, yet we have somehow decided that in pretty nearly all of that vast market there should be only one business model: diagnostic-code-driven fee for service. Change that, and the whole equation changes. It’s called business model innovation. If we find ways to pay for what we want and need, not for whatever they pile onto the bill, they will find ways to bring us what we want and need at prices that make sense. That’s called changing the incentives.
Because we all want that. And because we can. This can be done. Let me tell you how.
I’m an industry insider, covering the industry for 37 years now, publishing millions of words in industry publications, speaking at hundreds of industry conferences, writing books, advising everyone from the U.N.’s World Health Organization, the Defense Department, and the Centers for Disease Control to governments around the world to, probably, your local hospital, your doctor, your health plan.
The economic fundamentals of healthcare in the United States are unique, amazingly complex, multi-layered and opaque. It takes a lot of work and time to understand them, work and time that few of the experts opining about healthcare on television have done. Once you do understand them, it takes serious independence, a big ornery streak, and maybe a bit of a career death wish to speak publicly about how the industry that pays your speaking and consulting fees should, can, and must strive to make half as much money. Well, I turn 67 this year and I’m cranky as hell, so let’s go.
The Wrong Question
We are back again in the cage fight over healthcare in Congress. But in all these fights we are only arguing over one question: Who pays? The government, your employer, you? A different answer to that question will distribute the pain differently, but it won’t cut the pain in half.
There are other questions to ask whose answers could get us there, such as:
A few facts, the old-fashioned non-alternative kind:
We are back again in the cage fight over healthcare in Congress. But in all these fights we are only arguing over one question: Who pays? The government, your employer, you? A different answer to that question will distribute the pain differently, but it won’t cut the pain in half.
There are other questions to ask whose answers could get us there, such as:
- Who do we pay?
- How do we pay them?
- For what, exactly, are we paying?
A few facts, the old-fashioned non-alternative kind:
Cost: Healthcare in the U.S., the whole system, costs us something like $3.4 trillion per year. Yes, that’s “trillion” with a “T”. If U.S. healthcare were a country on its own it would be the fifth largest economy in the world.
Waste: About a third of that is wasted on tests and procedures and devices that we really don’t need, that don’t help, that even hurt us. That’s the conservative estimate in a number of expert analyses, and based on the opinions of doctors about their own specialties. Some analyses say more: Some say half. Even that conservative estimate (one third) is a big wow: over $1.2 trillion per year, something like twice the entire U.S. military budget, thrown away on waste.
Prices: The prices are nuts. It’s not just pharmaceuticals. Across the board, from devices to procedures, hospital room charges to implants to diagnostic tests, the prices actually paid in the U.S. are three, five, 10 times what they are in other medically advanced countries like France, Germany, and the U.K.
Value: Unlike any other business, prices in healthcare bear no relation to value. If you pay $50,000 for a car, chances are very good that you’ll get a nicer car than if you pay $15,000. If you pay $2200 or $4500 for an MRI, there is pretty much no chance that you will get a better MRI than if you paid $730 or $420. (Yes, these are real prices, all from the same local market.)
Variation: Unlike any other business, prices in healthcare bear no relation to the producer’s cost. None. How can you tell? I mean, besides the $600 price tag on a 69-cent bottle of sterile water with a teaspoon of salt that’s labeled “saline therapeutics” on the medical bill? (Yes, those are real prices, too.) You can tell because of the insane variation. The price for your pill, procedure or test may well be three, five, even 12 times the price paid in some other city across the country, in some other institution across town, even for the person across the hall. Try that in any other business. Better yet, call me: I have a 10-year-old Ford F-150 to sell you for $75,000.
Inefficiency: We do healthcare in the most inefficient way possible, waiting until people show up in the Emergency Department with their diabetes, heart problem, or emphysema completely out of control, where treatment will cost 10 times as much as it would if we had gotten to them first to help them avoid a serious health crisis. (And no, that’s not part of the 1/3 that is waste. That’s on top of it.)
So who’s the chump here? We’re paying ridiculous prices for things we don’t necessarily need delivered in the most inefficient way possible.
Why?
Why do they do that to us? Because we pay them to.
Wait, this is important. This is the crux of the problem. From doctors to hospitals to labs to device manufacturers to anybody else we want to blame, they don’t overprice things and sell us things we don’t need because they are greedy, evil people. They do it because we tell them to, in the clearest language possible: money. Every inefficiency, every unneeded test, every extra bottle of saline, means more money in the door. And they can decide what’s on the list of what’s needed, as long as it can be argued that it matches the diagnostic code.
That’s called “fee-for-service” medicine: We pay a fee for every service, every drug, every test. There’s a code for everything. There are no standard prices or even price ranges. It’s all negotiated constantly and repeatedly across the system with health plans, employers, even with Medicare and Medicaid.
We pay them to do it and the payment system demands it. Imagine a hospital system that bent every effort to providing health and healthcare in the least expensive, most effective way possible, that charged you $1 for that 69-cent bottle of saline water, that eliminated all unnecessary tests and unhelpful procedures, that put personnel and cash into helping you prevent or manage your diabetes instead of waiting until you show up feet-first in diabetic shock. If it did all this without regard to how it is paid it would soon close its doors, belly up, bankrupt. For-profit or not-for-profit makes little difference to this fact.
If we want them to act differently, we have to pay them differently.
Paying for Healthcare Differently
But wait, isn’t that the only way we can pay? Because, you know, medicine is complicated, every body is different, every disease is unique.
Actually, no. There is no one other ideal way to pay for all of healthcare, but there are lots of other ways to pay. We can pay for outcomes, we can pay for bundles of services, we can pay for subscriptions for all primary care or all diabetes care or special attention for multiple chronic conditions, on and on, the list of alternative ways to pay for healthcare is long and rich.
There are now surgery centers that put their prices up on the wall, just like McDonalds — and they can prove their quality. There are hospital systems that will give you a warranty on your surgery: We will get it right or fixing the problem is free.
Look: You get in an accident and take your crumpled fender to the body shop. Every fender crumples differently, maybe the frame is involved, maybe the chrome strip has to be replaced, all that. So there is no standard “crumpled fender” price. But it is not the first crumpled fender the body shop has ever seen. It’s probably the 10,000th. They are very good at knowing just how to fix it and how much it will cost them to do the work. Do you pay for each can of Bondo, each disk of sandpaper, each minute in the paint booth? No. They write you up an estimate for the whole thing, from diagnosis to rehab. Come back next Thursday and it will be good as new. That’s a bundled outcome. It’s the body shop’s way of doing business, its business model.
There are new business models arising now in healthcare (such as reference prices, medical tourism, centers of excellence, “Blue Choice” and other health plan options) that force hospitals and surgical centers to compete on price and quality for specific bundles, like a new hip or a re-plumbed heart.
Healthcare is a vast market with lots of different kinds of customers in different financial situations, different life stages, different genders, different needs, different resources, yet we have somehow decided that in pretty nearly all of that vast market there should be only one business model: diagnostic-code-driven fee for service. Change that, and the whole equation changes. It’s called business model innovation. If we find ways to pay for what we want and need, not for whatever they pile onto the bill, they will find ways to bring us what we want and need at prices that make sense. That’s called changing the incentives.
by Joe Flower, Healthcare in America | Read more:
Image: uncredited
The Fatal Flaw in Subscription Models
[ed. At one time I thought micro-payments might be the answer but I'm not so sure anymore. It seems any subscription service has to provide some additional 'value added' benefit, beyond the quality of its reporting. Think Amazon Prime, which besides free shipping also provides music, streaming tv and original programming. Not sure what the answer is, but if recent trends are an example I expect aggregation or consolidation among numerous news sources to be the most likely option. What that means for a blog like Duck Soup is probably eventual extinction (or a more restricted focus on topics that don't require subscription services.]
Many column inches both here at TheMediaBriefing and elsewhere have been dedicated to revenue models, and how individual publishers can monetise their audiences.Subscriptions are nothing new. Most of the media industry seems to have it all worked out, with millions paying out for Netflix, Spotify, Amazon Prime, Apple Music and more.
But one industry segment hasn’t quite grasped it yet. In a period of rapid change and disruption, news publishers grapple with putting paywalls up, taking them down, growing subscribers and trying to convince people that their content should be paid for.
Subscription’s fatal flaw
Various studies have been done on how people consume news, particularly in the US, but there is very little information on how many different outlets a user will read from. Increasingly, it is the article rather than the source itself which garners attention, with the most widely-known publishers being those who have mastered social distribution.
We put out a snap poll to followers of @mediabrief asking how many different sources they read a day, and the results were telling: (...)
If every publisher put up a hard paywall overnight, and these people then took out subscriptions to each of these sources, the cost could be anything from £80-£120 a month, if not more.
Paywalls rely on publishers assuming that an individual will only have one or two subscriptions, and therefore that theirs is the only content worth paying for. Yes, on a publisher-by-publisher basis, it is critical that the content they produce is valued and paid for. But on an industry level, it isn’t sustainable.
Paying subscribers to these outlets are skewed in terms of age, and the younger generation have never grown accustomed to handing over money for content, according to Business Insider’s Publisher Paywall Report. I would suggest this is because we now read news and content from a huge variety of sources (both reputable and otherwise). The age of loyalty to a single newsbrand is long gone; digital signalled the death of brand monogamy.
Industry parallels
Many people draw comparisons between publishing subscription models and the success media companies like Amazon, Netflix and Spotify have found.
There is, however, a key difference. Imagine 20th Century Fox, Universal Studios and Warner Bros each charged users a monthly fee to access their films. Very quickly, the model would fall over, and smaller film studios would be unable to compete.
Instead, these studios all come together in an aggregator, like Netflix. Paying a monthly fee becomes a lot more valuable for film fanatics, as they can watch as much as they like from different sources.
Pure social distribution isn’t the answer for publishing. The catch in the current situation is that Facebook doesn’t pay publishers to distribute articles on their platform. If Netflix refused to pay its content creators, or even charged them to reach their audience, studios would quickly take their films elsewhere.
Yet the point still stands. The average consumer cannot afford to ‘subscribe’ to individual film studios, no matter how good their films are. Similarly, people listened to a much narrower range of music when it cost £10.99 for an album – a luxury purchase. The music industry was disrupted, and Spotify emerged as a way to listen to artists, and more importantly, discover new music from small labels and independent artists. It’s taken almost a decade for the industry to right itself, but it’s getting there.
It’s not all plain sailing for consumers. Many are happy to sacrifice the tangibility of paying a one-off fee for a physical product (DVDs or CDs) to access unlimited content from different sources (films and music) for a monthly fee. There is no sense of ownership – should Spotify close, all the music and years of accumulated monthly payments disappear. But that is the price many have chosen to pay.
Music and films (for the most part) are also valuable in their exclusivity. No one else is legally reproducing Netflix’s ‘The Crown’ for free. To watch it, and keep up with the water-cooler talk, you must have a subscription to Netflix.
This is another area publishing struggles with. Unless the content is niche or special interest, many stories, particularly in news, are easily replicable and available elsewhere for free.
Subscriptions won’t provide a long-term, sustainable solution. Consumers no longer pay for a physical product, and many read across a variety of sources. Publishers with paywalls have implemented them because they value their content and don’t believe it should be given away for free, and they are right in their belief, but not in the isolationist solution.
by Esther Kezia Harding, Media Briefing | Read more:
Image: uncredited
Tuesday, February 21, 2017
The Next Financial Crisis Might Be in Your Driveway
[ed. Bubbles everywhere... Wall Street, housing, student debt, health care.)
Lured by low interest rates, low gas prices, and a crop of seductive vehicles that are faster, smarter, and more efficient than ever before, American drivers are increasingly riding in style. Don’t be fooled by the curb appeal, though—those swanky machines are heavily leveraged.
The country’s auto debt hit a record in the fourth quarter of 2016, according to the Federal Reserve Bank of New York, when a rush of year-end car shopping pushed vehicle loans to a dubious peak of $1.16 trillion. The combination of new car smell and new credit woes stretches from Subarus in Maine to Teslas in San Francisco.
It’s an alarming number, big enough to incite talk of a bubble. In fact, the pile of debt would cover the cost of 43.4 million Ford F-150 pickups, one for every eight or so people in the country.
Another way to look at: Every licensed driver in the U.S., on average, owes about $6,100 in car payments.
Lured by low interest rates, low gas prices, and a crop of seductive vehicles that are faster, smarter, and more efficient than ever before, American drivers are increasingly riding in style. Don’t be fooled by the curb appeal, though—those swanky machines are heavily leveraged.
The country’s auto debt hit a record in the fourth quarter of 2016, according to the Federal Reserve Bank of New York, when a rush of year-end car shopping pushed vehicle loans to a dubious peak of $1.16 trillion. The combination of new car smell and new credit woes stretches from Subarus in Maine to Teslas in San Francisco. It’s an alarming number, big enough to incite talk of a bubble. In fact, the pile of debt would cover the cost of 43.4 million Ford F-150 pickups, one for every eight or so people in the country.
Another way to look at: Every licensed driver in the U.S., on average, owes about $6,100 in car payments.
by Kyle Stock, Bloomberg | Read more:
Image: uncredited
What We'll Tolerate, And What We Won't
It wasn’t that he told a woman there was something wrong with her for wearing a hijab in America. It wasn’t that he encouraged people to “Purge the Illegals” and gave out ICE’s hotline number at a presentation. It wasn’t that he mocked a transgender college student in front of a crowd, saying he’d still almost bang her because she looked like a man. Instead, it was his discussion of the complexities of his sexual experiences with adults as a gay teenager that caused Milo Yiannopoulos to lose his $250,000 book deal with Simon and Schuster.
The swift recent reversal of Yiannopoulos’s fortunes is in many ways illuminating. The Breitbart editor had spent the last year building a public profile by going around American college campuses giving “lectures” with titles like “Why Do Lesbians Fake So Many Hate Crimes?” and “Why Ugly People Hate Me.” At these events, he would tell people why “feminism is cancer,” refer to various people as “cunts” and “retards,” and make jokes about how Muslims were probably terrorists. When appalled students tried to have the talks canceled, he would insist that the PC left was simply afraid to deal with arguments, facts, and statistics. (The more obvious explanation is that the PC left doesn’t think a person whose idea of elevated political discourse is “100% of fat people are fucking gross”—and who gigglingly posts pictures of the overweight people at his gym—is sincere about wanting to improve political dialogue on campus.)
As Yiannopoulos would continue to bait students with outrageous and cruel remarks, and students would continue to take the bait by giving Yiannopoulos publicity and fueling his persecution narrative, he managed to bring himself mainstream attention. For God only knows what reason, a major publishing house decided to reward him with a six-figure advance. (Actually, we know full well the reason: $) Bill Maher invited Yiannopoulous on Real Time, where the two enjoyed a pleasant back-and-forth about how the left were the real intolerant ones, before agreeing that transgender people were a bunch of sex criminals who couldn’t be trusted in women’s bathrooms. (The only relief during Yiannopoulos’s otherwise unendurable Real Time appearance was provided by Larry Wilmore, who enthusiastically told Yiannopoulos to go fuck himself after Yiannopoulos speculated that his black co-panelists must have low IQs.) Finally, the Conservative Political Action Conference placed a gleaming maraschino atop Yiannopoulos’s recent success by offering him a speaking slot.
Until a few days ago, then, Milo Yiannopoulos was doing quite well for himself. Then the pedophilia tapes surfaced. It turned out that Yiannopoulos had once made a few remarks that were difficult to interpret as anything other than a defense of sex between older men and young boys:
“We get hung up on this sort of child abuse stuff, to the point where we are heavily policing consensual adults. In the homosexual world, particularly, some of those relationships between younger boys and older men — the sort of ‘coming of age’ relationship — those relationships in which those older men help those young boys discover who they are and give them security and safety and provide them with love and a reliable, sort of rock, where they can’t speak to their parents.”
When the interviewer pointed out that this sounded like “Catholic priest molestation,” Yiannopoulos replied: “You know what? I’m grateful for Father Michael. I wouldn’t give nearly such good head if it wasn’t for him…” In another interview, Yiannopoulos confirmed that age 14 he had had sexual interactions with a priest, but said that this “wasn’t molestation,” nor was it pedophilia, because “pedophilia is not a sexual attraction to somebody 13 years old who is sexually mature. Pedophilia is attraction to children who have not reached puberty.”
Conservatives were scandalized. Bill Kristol called the remarks “despicable” and CPAC rapidly rescinded Yiannopoulos’s invitation to speak. Soon after, Simon & Schuster canceled his book deal, and there were reports that Breitbart editors were threatening to resign if he wasn’t fired. During Friday’s Real Time, Bill Maher had said that Yiannopoulos was “only at the beginning of [his] career.” By Monday, it seemed like he was at the end of it.
The rapid undoing of Yiannopoulos was interesting for several reasons. It served as an instructive illustration of what conservatives were and were not willing to tolerate. All the hateful filth about women, Muslims, and transgender people actually made a conservative publishing imprint want to publish his book. These things evidently do not cross a moral line. (To his credit, National Review editor Jonah Goldberg deplored this lack of principle, commenting that “apparently the racism and anti-Semitism wasn’t a deal breaker.”)
As far as CPAC goes, Yiannopoulos’s invitation and dis-invitation shows where the standards lie. For Simon and Schuster, on the other hand, dropping Yiannopoulos may have been strictly business. As Roxane Gay, who withdrew her book from the publishing house in protest of their decision to offer Yiannopoulos a contract, explained: “Simon and Schuster realized it would cost them more money to do business with Milo than he could earn for them. They did not finally ‘do the right thing.’ They were fine with his racist and xenophobic and sexist ideologies.” Indeed, like most publishers, S&S is far more concerned with what they can sell than with whether it’s moral or immoral.
But just as interesting as what didn’t make Yiannopoulos toxic is what did. Ironically, the remarks that finally got him expelled from the mainstream were among his less indefensible. He has been condemned by almost everybody for “defending pedophilia.” But this is not quite fair. In fact, while his comments are shocking, the arguments he is making are not unfamiliar in LGBT discourse. As Current Affairs editor Yasmin Nair explained in a thoughtful and provocative essay in 2005, the intensity of feelings around child abuse often prevent people from appreciating nuanced arguments. Nair was writing about a publisher’s decision to exclude an article on pederasty from a book on the history of same-sex relationships, after right-wing complaints that it would condone “rampant child molestation.” As she writes, there is a long tradition of the right using fears about pedophilia “to condemn all queers, particularly gay men, as predators of children.” It is often impossible to have a discussion about the reality of queer people’s lives, because anyone who speaks of their neutral or positive experiences with older people as a youth is perceived as endorsing pedophilia.
Yiannopoulos says that gay men’s experiences as teens with older men are often complicated, not always easily captured by the available terminology. He says that his own teenage sexual encounters with men did not fit the labels “molestation” and “pedophilia,” especially since pedophilia refers to attraction to the pre-pubescent. He offered a further clarification on Facebook:
I do not support pedophilia. Period. It is a vile and disgusting crime, perhaps the very worst…If I choose to deal in an edgy way on an internet livestream with a crime I was the victim of that’s my prerogative. It’s no different to gallows humor from AIDS sufferers…I did say that there are relationships between younger men and older men that can help a young gay man escape from a lack of support or understanding at home. That’s perfectly true and every gay man knows it. But I was not talking about anything illegal and I was not referring to pre-pubescent boys.
It’s not, on the face of it, an unreasonable explanation. Yiannopoulos may not have made his point very well. But there’s something nuanced and defensible here. First, he’s saying that the relationships between gay men and teenage boys (according to their own accounts) have historically been messier than simple categories allow for. And second, it’s absurd to say that he can’t make dark or crass jokes about his priest if it’s his way of dealing with what happened to him.
Unfortunately for Yiannopoulos, there is no possibility of complexity where it comes to discussions around age, sex, and consent. Fears of pedophilia have made it so that even the slightest hint that one is condoning it brings instant total ostracism. (These same sentiments have also made it so that no punishment is considered too severe when it comes to those convicted of sex crimes against minors. Nobody wants to speak out on behalf of society’s most loathed group of criminals, thus they get shunted under bridges and denied housing rather than given treatment.)
Yiannopoulos has quickly found out which ideas will actually get you booted from the public square, and they’re left-wing ones rather than right-wing ones. It turned out the real people you can’t offend are the conservatives whose latent homophobia make them instantly pounce on a gay man as a defender of pedophilia when he tries to explain his world to them. How fitting that Yiannopoulos should end up subjected to the very kind of vicious misrepresentation of LGBT people that he has spent his time encouraging. How appropriate for him to discover that his friends on the right only supported him so long as he nurtured their prejudices; they loved their campy gay mascot until the moment he challenged them. Then he was a pervert.
The swift recent reversal of Yiannopoulos’s fortunes is in many ways illuminating. The Breitbart editor had spent the last year building a public profile by going around American college campuses giving “lectures” with titles like “Why Do Lesbians Fake So Many Hate Crimes?” and “Why Ugly People Hate Me.” At these events, he would tell people why “feminism is cancer,” refer to various people as “cunts” and “retards,” and make jokes about how Muslims were probably terrorists. When appalled students tried to have the talks canceled, he would insist that the PC left was simply afraid to deal with arguments, facts, and statistics. (The more obvious explanation is that the PC left doesn’t think a person whose idea of elevated political discourse is “100% of fat people are fucking gross”—and who gigglingly posts pictures of the overweight people at his gym—is sincere about wanting to improve political dialogue on campus.)
As Yiannopoulos would continue to bait students with outrageous and cruel remarks, and students would continue to take the bait by giving Yiannopoulos publicity and fueling his persecution narrative, he managed to bring himself mainstream attention. For God only knows what reason, a major publishing house decided to reward him with a six-figure advance. (Actually, we know full well the reason: $) Bill Maher invited Yiannopoulous on Real Time, where the two enjoyed a pleasant back-and-forth about how the left were the real intolerant ones, before agreeing that transgender people were a bunch of sex criminals who couldn’t be trusted in women’s bathrooms. (The only relief during Yiannopoulos’s otherwise unendurable Real Time appearance was provided by Larry Wilmore, who enthusiastically told Yiannopoulos to go fuck himself after Yiannopoulos speculated that his black co-panelists must have low IQs.) Finally, the Conservative Political Action Conference placed a gleaming maraschino atop Yiannopoulos’s recent success by offering him a speaking slot.Until a few days ago, then, Milo Yiannopoulos was doing quite well for himself. Then the pedophilia tapes surfaced. It turned out that Yiannopoulos had once made a few remarks that were difficult to interpret as anything other than a defense of sex between older men and young boys:
“We get hung up on this sort of child abuse stuff, to the point where we are heavily policing consensual adults. In the homosexual world, particularly, some of those relationships between younger boys and older men — the sort of ‘coming of age’ relationship — those relationships in which those older men help those young boys discover who they are and give them security and safety and provide them with love and a reliable, sort of rock, where they can’t speak to their parents.”
When the interviewer pointed out that this sounded like “Catholic priest molestation,” Yiannopoulos replied: “You know what? I’m grateful for Father Michael. I wouldn’t give nearly such good head if it wasn’t for him…” In another interview, Yiannopoulos confirmed that age 14 he had had sexual interactions with a priest, but said that this “wasn’t molestation,” nor was it pedophilia, because “pedophilia is not a sexual attraction to somebody 13 years old who is sexually mature. Pedophilia is attraction to children who have not reached puberty.”
Conservatives were scandalized. Bill Kristol called the remarks “despicable” and CPAC rapidly rescinded Yiannopoulos’s invitation to speak. Soon after, Simon & Schuster canceled his book deal, and there were reports that Breitbart editors were threatening to resign if he wasn’t fired. During Friday’s Real Time, Bill Maher had said that Yiannopoulos was “only at the beginning of [his] career.” By Monday, it seemed like he was at the end of it.
The rapid undoing of Yiannopoulos was interesting for several reasons. It served as an instructive illustration of what conservatives were and were not willing to tolerate. All the hateful filth about women, Muslims, and transgender people actually made a conservative publishing imprint want to publish his book. These things evidently do not cross a moral line. (To his credit, National Review editor Jonah Goldberg deplored this lack of principle, commenting that “apparently the racism and anti-Semitism wasn’t a deal breaker.”)
As far as CPAC goes, Yiannopoulos’s invitation and dis-invitation shows where the standards lie. For Simon and Schuster, on the other hand, dropping Yiannopoulos may have been strictly business. As Roxane Gay, who withdrew her book from the publishing house in protest of their decision to offer Yiannopoulos a contract, explained: “Simon and Schuster realized it would cost them more money to do business with Milo than he could earn for them. They did not finally ‘do the right thing.’ They were fine with his racist and xenophobic and sexist ideologies.” Indeed, like most publishers, S&S is far more concerned with what they can sell than with whether it’s moral or immoral.
But just as interesting as what didn’t make Yiannopoulos toxic is what did. Ironically, the remarks that finally got him expelled from the mainstream were among his less indefensible. He has been condemned by almost everybody for “defending pedophilia.” But this is not quite fair. In fact, while his comments are shocking, the arguments he is making are not unfamiliar in LGBT discourse. As Current Affairs editor Yasmin Nair explained in a thoughtful and provocative essay in 2005, the intensity of feelings around child abuse often prevent people from appreciating nuanced arguments. Nair was writing about a publisher’s decision to exclude an article on pederasty from a book on the history of same-sex relationships, after right-wing complaints that it would condone “rampant child molestation.” As she writes, there is a long tradition of the right using fears about pedophilia “to condemn all queers, particularly gay men, as predators of children.” It is often impossible to have a discussion about the reality of queer people’s lives, because anyone who speaks of their neutral or positive experiences with older people as a youth is perceived as endorsing pedophilia.
Yiannopoulos says that gay men’s experiences as teens with older men are often complicated, not always easily captured by the available terminology. He says that his own teenage sexual encounters with men did not fit the labels “molestation” and “pedophilia,” especially since pedophilia refers to attraction to the pre-pubescent. He offered a further clarification on Facebook:
I do not support pedophilia. Period. It is a vile and disgusting crime, perhaps the very worst…If I choose to deal in an edgy way on an internet livestream with a crime I was the victim of that’s my prerogative. It’s no different to gallows humor from AIDS sufferers…I did say that there are relationships between younger men and older men that can help a young gay man escape from a lack of support or understanding at home. That’s perfectly true and every gay man knows it. But I was not talking about anything illegal and I was not referring to pre-pubescent boys.
It’s not, on the face of it, an unreasonable explanation. Yiannopoulos may not have made his point very well. But there’s something nuanced and defensible here. First, he’s saying that the relationships between gay men and teenage boys (according to their own accounts) have historically been messier than simple categories allow for. And second, it’s absurd to say that he can’t make dark or crass jokes about his priest if it’s his way of dealing with what happened to him.
Unfortunately for Yiannopoulos, there is no possibility of complexity where it comes to discussions around age, sex, and consent. Fears of pedophilia have made it so that even the slightest hint that one is condoning it brings instant total ostracism. (These same sentiments have also made it so that no punishment is considered too severe when it comes to those convicted of sex crimes against minors. Nobody wants to speak out on behalf of society’s most loathed group of criminals, thus they get shunted under bridges and denied housing rather than given treatment.)
Yiannopoulos has quickly found out which ideas will actually get you booted from the public square, and they’re left-wing ones rather than right-wing ones. It turned out the real people you can’t offend are the conservatives whose latent homophobia make them instantly pounce on a gay man as a defender of pedophilia when he tries to explain his world to them. How fitting that Yiannopoulos should end up subjected to the very kind of vicious misrepresentation of LGBT people that he has spent his time encouraging. How appropriate for him to discover that his friends on the right only supported him so long as he nurtured their prejudices; they loved their campy gay mascot until the moment he challenged them. Then he was a pervert.
by Nathan J. Robinson, Current Affairs | Read more:
Image: uncredited
Monday, February 20, 2017
A Biker's Sunday
I’m not going anywhere, in the sense that the point of this journey is the journey. It’s Sunday morning, the roads are dry, the sky isn’t threatening anything and the worst of the road salt has gone. This is going out for a ride just for the sake of the ride. There is a destination; I’m headed for British Camp on the shoulders of the Malvern Hills. There’s a café up there and I know, just know that heading towards it like migrating birds or butterflies drawn in by a particular flower on a particular day, will be dozens of others of my kind; bikers keen to get out and remember what it is about their expensive, sometimes ridiculous and often dangerous passion that drives them to do it.I’m lucky and have a choice of bikes at home. I’ve chosen a Kawasaki Z900 from 1976. I needed a Japanese multi-cylinder engine today, something that connects me directly with the big capacity machines I lusted after as a kid. It’s not perfect, my Z900, but then neither am I and we are working together to overcome our respective shortcomings. The bike’s suspension is crude and baggy compared with modern stuff, but then I am far from being a steely-eyed pilot of a this-minute superbike, so we’ll get along fine. Adjusting the bike’s trajectory by moving a shoulder or shifting a hip, I am reconnecting with the business of working as a team, machine and rider, sharing the goal of playing with the road’s curves and straights and dips and stringing them together to form a perfect whole. I’ve ridden bikes through this winter, yes, but only as transport, only as a cheat, a quicker means of getting to where I need to be. This though, is different, this isn’t anything as mundane as transport, this is biking.
by Richard Hammond, Drivetribe | Read more:
Image: Richard Hammond
A Corporate Defender At Heart, Former SEC Chair Returns to Her Happy Place
Mary Jo White, whose tenure as chair of the Securities and Exchange Commission under President Obama bitterly disappointed those who hoped she would aggressively enforce banking laws, is rejoining the corporate defense team at Debevoise & Plimpton, marking her sixth trip through the revolving door between various government jobs and the white-collar defense law firm she calls home.
Debevoise represents numerous major financial institutions under federal investigation, and White will now help those corporate clients manage their legal exposure.
White got the call to return to Debevoise on Inauguration Day, her last day at the SEC. As Debevoise presiding partner Michael Blair told the Wall Street Journal, “We had been waiting to make that phone call for several years.”
This latest trip through the revolving door is particularly disturbing because White declared in ethics disclosure forms before becoming SEC chair that she was retiring from her partnership at Debevoise, receiving a lump sum retirement payment of over $2 million. Instead of staying retired, she immediately went back to Debevoise after her government service ended, pocketing the money.
It is not, however, surprising.
White auditioned for the job promising to police Wall Street aggressively, and be “bold and unrelenting.” But once installed, she spent her time at the SEC operating like she still worked for Debevoise. Her tenure was marked by persistent delays on finalizing rules mandated by the Dodd-Frank Act, including those on corporate political spending and disclosure of the CEO pay ratio. One anti-corruption rule requiring oil and gas companies to disclose payments to foreign governments got finalized so late that Republicans had the opportunity to scrap it earlier this month with a special review procedure.
Critics have charged that White continued the SEC’s tradition of light enforcement. James Kidney, a former SEC trial lawyer, attacked the agency in a scathing retirement speech in 2014, saying that it “polices the broken windows on the street level and rarely goes to the penthouse floors.”
Kidney added, “I have had bosses, and bosses of my bosses … who made little secret that they were here to punch their ticket. They mouthed serious regard for the mission of the commission, but their actions were tentative and fearful in many instances.”
Under White, the SEC failed to monitor stock buybacks to prevent market manipulation. It failed to stop the epidemic of granting waivers to companies automatically banned from securities activities after settling cases of civil and criminal wrongdoing. White stood with Republican commissioners even as Democratic colleagues tried to stop those waivers from being granted. In a troubling continuance of regulatory capture at the agency, White hired a senior Goldman Sachs attorney as the SEC chief of staff.
Though White made a big show of fighting to force companies to admit guilt in any settlement, a break from past practice, in reality this tool was rarely used. According to a letter from Sen, Elizabeth Warren, of 520 settlements from June 2013 to September 2014, only 19 required admissions of guilt. And in the majority of those cases, the SEC only asked for a broad admission of the facts of the case, rather than admissions of specific securities violations. In one example, the SEC got JPMorgan Chase to admit to breaking a law in 2013, but it wouldn’t say which one.
Perhaps the most notable trend of White’s SEC tenure was how she repeatedly recused herself from cases, not only because of her past association with Debevoise (which forced recusal from cases involving Bank of America), but because her husband John White worked as a corporate lawyer at another white-shoe firm, Cravath Swaine & Moore. It’s been rumored that firms would try to sign up with Cravath just to knock White out of enforcement cases.
In the first two years, White recused herself from over four dozen investigations, according to the New York Times. In several cases, this resulted in a 2-2 split on enforcement decisions among the five-member panel, delaying or sometimes ending the offending banks’ cases.
White got ethics waivers to insert herself into some cases involving former clients, like Credit Suisse, despite the conflict of interest. Enforcement against the Swiss bank has been called cozy and soft; a recent $90 million fine for misleading investors was “almost a win-win for the SEC and Credit Suisse,” according to former SEC enforcement attorney David Chase.
Warren asked President Obama to fire White last October, saying “The only way to return the SEC to its intended purpose is to change its leadership.”
Unlike Obama, President Trump does not even pay lip service to that intended purpose, which is to protect investors. Trump’s choice for White’s replacement, Jay Clayton, is also a former corporate lawyer. Clayton worked for Sullivan & Cromwell, which represented Goldman Sachs, among other financial firms. Clayton’s wife Gretchen is a vice president at Goldman Sachs, leading to yet more conflicts of interest. And even before Clayton’s confirmation, the SEC’s acting chairman, Michael Piwowar, has quietly worked to roll back the power of senior attorneys to open investigations into Wall Street misconduct.
Debevoise represents numerous major financial institutions under federal investigation, and White will now help those corporate clients manage their legal exposure.
White got the call to return to Debevoise on Inauguration Day, her last day at the SEC. As Debevoise presiding partner Michael Blair told the Wall Street Journal, “We had been waiting to make that phone call for several years.”This latest trip through the revolving door is particularly disturbing because White declared in ethics disclosure forms before becoming SEC chair that she was retiring from her partnership at Debevoise, receiving a lump sum retirement payment of over $2 million. Instead of staying retired, she immediately went back to Debevoise after her government service ended, pocketing the money.
It is not, however, surprising.
White auditioned for the job promising to police Wall Street aggressively, and be “bold and unrelenting.” But once installed, she spent her time at the SEC operating like she still worked for Debevoise. Her tenure was marked by persistent delays on finalizing rules mandated by the Dodd-Frank Act, including those on corporate political spending and disclosure of the CEO pay ratio. One anti-corruption rule requiring oil and gas companies to disclose payments to foreign governments got finalized so late that Republicans had the opportunity to scrap it earlier this month with a special review procedure.
Critics have charged that White continued the SEC’s tradition of light enforcement. James Kidney, a former SEC trial lawyer, attacked the agency in a scathing retirement speech in 2014, saying that it “polices the broken windows on the street level and rarely goes to the penthouse floors.”
Kidney added, “I have had bosses, and bosses of my bosses … who made little secret that they were here to punch their ticket. They mouthed serious regard for the mission of the commission, but their actions were tentative and fearful in many instances.”
Under White, the SEC failed to monitor stock buybacks to prevent market manipulation. It failed to stop the epidemic of granting waivers to companies automatically banned from securities activities after settling cases of civil and criminal wrongdoing. White stood with Republican commissioners even as Democratic colleagues tried to stop those waivers from being granted. In a troubling continuance of regulatory capture at the agency, White hired a senior Goldman Sachs attorney as the SEC chief of staff.
Though White made a big show of fighting to force companies to admit guilt in any settlement, a break from past practice, in reality this tool was rarely used. According to a letter from Sen, Elizabeth Warren, of 520 settlements from June 2013 to September 2014, only 19 required admissions of guilt. And in the majority of those cases, the SEC only asked for a broad admission of the facts of the case, rather than admissions of specific securities violations. In one example, the SEC got JPMorgan Chase to admit to breaking a law in 2013, but it wouldn’t say which one.
Perhaps the most notable trend of White’s SEC tenure was how she repeatedly recused herself from cases, not only because of her past association with Debevoise (which forced recusal from cases involving Bank of America), but because her husband John White worked as a corporate lawyer at another white-shoe firm, Cravath Swaine & Moore. It’s been rumored that firms would try to sign up with Cravath just to knock White out of enforcement cases.
In the first two years, White recused herself from over four dozen investigations, according to the New York Times. In several cases, this resulted in a 2-2 split on enforcement decisions among the five-member panel, delaying or sometimes ending the offending banks’ cases.
White got ethics waivers to insert herself into some cases involving former clients, like Credit Suisse, despite the conflict of interest. Enforcement against the Swiss bank has been called cozy and soft; a recent $90 million fine for misleading investors was “almost a win-win for the SEC and Credit Suisse,” according to former SEC enforcement attorney David Chase.
Warren asked President Obama to fire White last October, saying “The only way to return the SEC to its intended purpose is to change its leadership.”
Unlike Obama, President Trump does not even pay lip service to that intended purpose, which is to protect investors. Trump’s choice for White’s replacement, Jay Clayton, is also a former corporate lawyer. Clayton worked for Sullivan & Cromwell, which represented Goldman Sachs, among other financial firms. Clayton’s wife Gretchen is a vice president at Goldman Sachs, leading to yet more conflicts of interest. And even before Clayton’s confirmation, the SEC’s acting chairman, Michael Piwowar, has quietly worked to roll back the power of senior attorneys to open investigations into Wall Street misconduct.
by David Dayen, The Intercept | Read more:
Image: Pete Marovich/Bloomberg News via Getty Images
Put Me In Coach, I'm Ready to Play
My Afternoon With a Masturbation Coach
“Am I pleased with the way I masturbate?”
“Should I stop masturbating the way I have been since I was 13?
“Have I been masturbating the same way since I was 13?”
“Do I even want to masturbate better?”
“Shouldn’t I be more focused on getting laid with someone other than myself?”
These are a few of the questions I’m asking myself as I speed through a rare Southern California monsoon toward Palm Springs on the eve of New Year’s Eve.
My masturbation coach will be expecting answers to these questions.
Or at least to the first four.
I’d heard about the female equivalent on Real Sex years ago and thought of it again recently, after which I Googled “male masturbation coach in California” to see if such a thing existed. The most immediate search results yielded a smattering of SoCal sex therapists (e.g., “Naughty Lifestyle Expert” Sienna Sinclaire), and stories about a San Diego Chargers security guard who was recently filmed masturbating in front of the team’s cheerleading squad. The second page of search results, though, revealed exactly what I was looking for: Masturbation coach Ed Ehrgott, the middle-aged, dual-nipple-ringed owner of Sacred Touch for Men who asks on his website, “Could your solo sexual practice use some juice?”
You bet it could, Ed.
The fact is, save for the occasional lube adjustment, I masturbate exactly the same way I did when I was 13. There’s nothing particularly pleasing about it, though it’s one of the few remaining dopamine dumps my sober brain is permitted, and it helps me fall asleep in the absence of a blissful fog of booze and benzodiazepines. I’m single, so minding my solitary erotic life is relevant. And I’ve resolved to cultivate a number of self-care practices in 2017; in addition to enhancing my wank, I’m exfoliating and trying to drink eight cups of water a day. (...)
So I settled on Ed, who was a mere two hours from my L.A. apartment. After a brief phone call, I scheduled a 90-minute, in-person session at his “studio” — a generous term, since it turned out to be the master bedroom of his beige ranch house in North Palm Springs. Despite the rain, I arrived early and killed 30 minutes or so parked out front, awkwardly waving to passing residents of Ed’s gated community.
Just here to see Coach…
I wasn’t anticipating the loveseat.
It’s an awkwardly cozy seating arrangement — for siblings playing Xbox, let alone a masturbation interview with a stranger. But that’s where we both have a seat and I proceed with my first question: “What’s the most common thing you hear from your clients?”
“‘How can I last longer?’ I get that all the time,” Ed responds without hesitation. He’s in casual, loose-fitting clothes and judging from an occasional coughing fit, seems to be fighting a bit of a cold.
Ed claims the key to lasting longer is learning how to better manipulate your erotic energy, which most men are ashamed of. “We run away from it,” he explains. “Sure, we’ll use sex and eroticism to sell things, and there’s porn, but that’s not an accurate reflection of sexuality. Most people think men’s masturbation is really simple: Five minutes, your hand, some porn and you’re done. That’s true on one level, but really limiting.”
He explains men are just expected to know how to masturbate in our society — no lessons necessary! — and the only time it comes up in conversation is in the form of humor. “We’ll joke about it. We’ll make fun of it. But most guys aren’t gonna seriously talk about it because that would be a blow to their masculinity. We learn to do it quickly, quietly, discreetly and to remove all the evidence as soon as possible. But what worked well in our teens may not work as well as we age since our bodies and tastes change.”
“What was your favorite food when you were 13?” he asks.
“Chicken pot pie,” I respond.
“Is it still?”
Well, I’m trying to cut down on entree-sized pastries these days, I think to myself as he continues, treating it as a rhetorical question.
“That’s where masturbation coaching comes in,” he continues, extending the legs of a massage table. “It’s about taking something you began doing as an adolescent and adapting it to fit your values and needs as an adult.”
He lays down a clean sheet and taps the table.
[ed. Palm Springs.]
“Am I pleased with the way I masturbate?”“Should I stop masturbating the way I have been since I was 13?
“Have I been masturbating the same way since I was 13?”
“Do I even want to masturbate better?”
“Shouldn’t I be more focused on getting laid with someone other than myself?”
These are a few of the questions I’m asking myself as I speed through a rare Southern California monsoon toward Palm Springs on the eve of New Year’s Eve.
My masturbation coach will be expecting answers to these questions.
Or at least to the first four.
I’d heard about the female equivalent on Real Sex years ago and thought of it again recently, after which I Googled “male masturbation coach in California” to see if such a thing existed. The most immediate search results yielded a smattering of SoCal sex therapists (e.g., “Naughty Lifestyle Expert” Sienna Sinclaire), and stories about a San Diego Chargers security guard who was recently filmed masturbating in front of the team’s cheerleading squad. The second page of search results, though, revealed exactly what I was looking for: Masturbation coach Ed Ehrgott, the middle-aged, dual-nipple-ringed owner of Sacred Touch for Men who asks on his website, “Could your solo sexual practice use some juice?”
You bet it could, Ed.
The fact is, save for the occasional lube adjustment, I masturbate exactly the same way I did when I was 13. There’s nothing particularly pleasing about it, though it’s one of the few remaining dopamine dumps my sober brain is permitted, and it helps me fall asleep in the absence of a blissful fog of booze and benzodiazepines. I’m single, so minding my solitary erotic life is relevant. And I’ve resolved to cultivate a number of self-care practices in 2017; in addition to enhancing my wank, I’m exfoliating and trying to drink eight cups of water a day. (...)
So I settled on Ed, who was a mere two hours from my L.A. apartment. After a brief phone call, I scheduled a 90-minute, in-person session at his “studio” — a generous term, since it turned out to be the master bedroom of his beige ranch house in North Palm Springs. Despite the rain, I arrived early and killed 30 minutes or so parked out front, awkwardly waving to passing residents of Ed’s gated community.
Just here to see Coach…
I wasn’t anticipating the loveseat.
It’s an awkwardly cozy seating arrangement — for siblings playing Xbox, let alone a masturbation interview with a stranger. But that’s where we both have a seat and I proceed with my first question: “What’s the most common thing you hear from your clients?”
“‘How can I last longer?’ I get that all the time,” Ed responds without hesitation. He’s in casual, loose-fitting clothes and judging from an occasional coughing fit, seems to be fighting a bit of a cold.
Ed claims the key to lasting longer is learning how to better manipulate your erotic energy, which most men are ashamed of. “We run away from it,” he explains. “Sure, we’ll use sex and eroticism to sell things, and there’s porn, but that’s not an accurate reflection of sexuality. Most people think men’s masturbation is really simple: Five minutes, your hand, some porn and you’re done. That’s true on one level, but really limiting.”
He explains men are just expected to know how to masturbate in our society — no lessons necessary! — and the only time it comes up in conversation is in the form of humor. “We’ll joke about it. We’ll make fun of it. But most guys aren’t gonna seriously talk about it because that would be a blow to their masculinity. We learn to do it quickly, quietly, discreetly and to remove all the evidence as soon as possible. But what worked well in our teens may not work as well as we age since our bodies and tastes change.”
“What was your favorite food when you were 13?” he asks.
“Chicken pot pie,” I respond.
“Is it still?”
Well, I’m trying to cut down on entree-sized pastries these days, I think to myself as he continues, treating it as a rhetorical question.
“That’s where masturbation coaching comes in,” he continues, extending the legs of a massage table. “It’s about taking something you began doing as an adolescent and adapting it to fit your values and needs as an adult.”
He lays down a clean sheet and taps the table.
by C. Brian Smith, MEL | Read more:
Image: Dave van Patten[ed. Palm Springs.]
Inside the Brutal World of Comedy Open Mikes
It takes a special kind of masochist to willingly endure the horrors of performing stand-up at New York City open mikes. And yet, because it is New York City, it isn’t surprising that there is no shortage of exactly this type of person: someone with a high tolerance for awkwardness, embarrassment and insecurity, combined with a tenacious craving to make people laugh and hopefully, if the chips fall exactly right, to do this for a living.
On any given night, there are dozens of open mikes in the five boroughs. They are often in basements and back rooms, tucked out of sight, and there is no compensation. Many times, the comics — most of them male — must pay a small price to get a few minutes — “a tight five.”
These sets serve as the birthplace of jokes that will someday make paying crowds guffaw and as the graveyard of those that don’t. The open mikes draw comedians of all experience levels, and many do more than one per night, testing whether a joke should be nurtured or laid to rest.
The material features a wide collection of topics: heartbreak, the mundane, race, gender, heartbreak, religion, more heartbreak. At a time when most late-night comedy shows and stand-up professionals are focusing on President Trump, these open mikes can be a refuge from politics — a reminder that modern American humorists have not been entirely consumed by the 24/7 news cycle.
The crowds are brutal, making it tougher for comedians to test their material. The audiences are made up almost entirely of fellow comedians. They are often scribbling their own jokes and running through their own sets mentally rather than paying attention to the stage. Sometimes, they’re just not interested in laughing. They want to be the funniest guy in the room.
“A crowd of comedians is tough just because we’re kind of jaded,” said John Donovan, 26, who attends up to 15 shows a week. “I see comedy two or three times a day already. Most of it is at an open-mike level. So you’re not expecting it to be that good.”
We took a tour of some open mikes in Manhattan one evening in the same way some comics do every day, and found ourselves in a dark world of therapeutic passion, discomfort and, sometimes, unbridled joy.
On any given night, there are dozens of open mikes in the five boroughs. They are often in basements and back rooms, tucked out of sight, and there is no compensation. Many times, the comics — most of them male — must pay a small price to get a few minutes — “a tight five.”
These sets serve as the birthplace of jokes that will someday make paying crowds guffaw and as the graveyard of those that don’t. The open mikes draw comedians of all experience levels, and many do more than one per night, testing whether a joke should be nurtured or laid to rest.The material features a wide collection of topics: heartbreak, the mundane, race, gender, heartbreak, religion, more heartbreak. At a time when most late-night comedy shows and stand-up professionals are focusing on President Trump, these open mikes can be a refuge from politics — a reminder that modern American humorists have not been entirely consumed by the 24/7 news cycle.
The crowds are brutal, making it tougher for comedians to test their material. The audiences are made up almost entirely of fellow comedians. They are often scribbling their own jokes and running through their own sets mentally rather than paying attention to the stage. Sometimes, they’re just not interested in laughing. They want to be the funniest guy in the room.
“A crowd of comedians is tough just because we’re kind of jaded,” said John Donovan, 26, who attends up to 15 shows a week. “I see comedy two or three times a day already. Most of it is at an open-mike level. So you’re not expecting it to be that good.”
We took a tour of some open mikes in Manhattan one evening in the same way some comics do every day, and found ourselves in a dark world of therapeutic passion, discomfort and, sometimes, unbridled joy.
by Sopan Deb, NY Times | Read more:
Image: Christian Hansen for The New York Times
Sunday, February 19, 2017
Gates on Bio-Terrorism
[ed. This is my fear. Bugs are easier to spread than bombs.]
A chilling warning that tens of millions of people could be killed by bio-terrorism was delivered at the Munich security conference by the world’s richest man, Bill Gates
Gates, who has spent much of the last 20 years funding a global health campaign, said: “We ignore the link between health security and international security at our peril.”
Gates, the co-founder of Microsoft who has spent billions in a philanthropic drive to improve health worldwide, said: “The next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus ... or a super contagious and deadly strain of the flu.”
US and UK intelligence agencies have said that Islamic State has been trying to develop biological weapons at its bases in Syria and Iraq. However, they have played down the threat, saying that the terrorists would need people with the necessary skills, good laboratories and a relatively calm environment free from the confusion and chaos of conflict zones.
Yet other security specialists say the threat from bio-terrorism has become more realistic over the past decade, particularly the past five years, with changes in molecular biology that make development of biological weapons more accessible.
Gates, making his first appearance at the Munich security conference on Saturday, said: “Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10 to 15 years.”
He added: “It’s hard to get your mind around a catastrophe of that scale, but it happened not that long ago. In 1918, a particularly virulent and deadly strain of flu killed between 50 million and 100 million people.
“You might be wondering how real these doomsday scenarios really are. The fact that a deadly global pandemic has not occurred in recent history shouldn’t be mistaken for evidence that a deadly pandemic will not occur in the future. And even if the next pandemic isn’t on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil that might ensue if something like ebola made its way into urban centres.”
Gates said advances in biotechnology, new vaccines and drugs could help prevent epidemics spreading out of control. “Most of the things we need to do to protect against a naturally occurring pandemic are the same things we must prepare for an intentional biological attack,” he said.
“Getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe. Innovation, cooperation and careful planning can dramatically mitigate the risks presented by each of these threats.”
by Ewen MacAskill , The Guardian | Read more:
Image: The Guardian
A chilling warning that tens of millions of people could be killed by bio-terrorism was delivered at the Munich security conference by the world’s richest man, Bill Gates
Gates, who has spent much of the last 20 years funding a global health campaign, said: “We ignore the link between health security and international security at our peril.”
Gates, the co-founder of Microsoft who has spent billions in a philanthropic drive to improve health worldwide, said: “The next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus ... or a super contagious and deadly strain of the flu.”US and UK intelligence agencies have said that Islamic State has been trying to develop biological weapons at its bases in Syria and Iraq. However, they have played down the threat, saying that the terrorists would need people with the necessary skills, good laboratories and a relatively calm environment free from the confusion and chaos of conflict zones.
Yet other security specialists say the threat from bio-terrorism has become more realistic over the past decade, particularly the past five years, with changes in molecular biology that make development of biological weapons more accessible.
Gates, making his first appearance at the Munich security conference on Saturday, said: “Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10 to 15 years.”
He added: “It’s hard to get your mind around a catastrophe of that scale, but it happened not that long ago. In 1918, a particularly virulent and deadly strain of flu killed between 50 million and 100 million people.
“You might be wondering how real these doomsday scenarios really are. The fact that a deadly global pandemic has not occurred in recent history shouldn’t be mistaken for evidence that a deadly pandemic will not occur in the future. And even if the next pandemic isn’t on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil that might ensue if something like ebola made its way into urban centres.”
Gates said advances in biotechnology, new vaccines and drugs could help prevent epidemics spreading out of control. “Most of the things we need to do to protect against a naturally occurring pandemic are the same things we must prepare for an intentional biological attack,” he said.
“Getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe. Innovation, cooperation and careful planning can dramatically mitigate the risks presented by each of these threats.”
by Ewen MacAskill , The Guardian | Read more:
Image: The Guardian
Saturday, February 18, 2017
Depression
The problem with depression—the thing that makes it so hard to describe, and gives its sufferers a bad conscience—is its resemblance to unhappiness. Unhappiness is part of every life, and most people learn how to cope with it: by changing the conditions that cause it, or by distracting themselves, or by actively repressing it. A person who can’t deal with being unhappy is seen as a moral failure—childish, selfish, “difficult.” It is all too easy to apply the same judgment to a depressed person, as if depression just meant luxuriating in unhappiness. David Foster Wallace wrote a brilliant story, “The Depressed Person,” in which a woman worries that by describing her suffering she will only disgust her friends and even her therapist—a worry which itself feeds into her suffering.
But depression is actually the opposite of unhappiness, because it is precisely not “a part of life.” When you are unhappy, life is pressing you, hurting you, and you are forced to respond to it. An unhappy life is a problem, and to be absorbed in a problem is to be absorbed in existence. When you are depressed, on the other hand, there is no problem, because there is nothing to be solved. Existence itself seems to retreat, to leave you stranded, without purchase on things, people, yourself. In her new memoir, This Close to Happy: A Reckoning with Depression, Daphne Merkin describes it this way:
For Merkin... depression is something that emerges from within, the medium in which she lives. She experiences it as “a yawning inner lack—some elusive craving for wholeness or well-being.” Writing about a lack is difficult, and perhaps no one has ever captured exactly what it feels like to be depressed, simply because one can’t describe a negative. Merkin avoids this problem by writing less about the feeling of depression than about its causes and its remedies. What, she asks, made her so miserable? And what happens when she tries—through therapy, medication, or hospitalization—to cure that misery?
The answer to the first question—what causes depression?—depends largely on the vocabulary you use to ask it. Is depression understood philosophically, as a response to the true nature of reality—its futility, loneliness, despair? Or is it understood medically, as a deficit of certain brain chemicals, which turns it into a disease like diabetes?
by Adam Kirsch, Tablet | Read more:
But depression is actually the opposite of unhappiness, because it is precisely not “a part of life.” When you are unhappy, life is pressing you, hurting you, and you are forced to respond to it. An unhappy life is a problem, and to be absorbed in a problem is to be absorbed in existence. When you are depressed, on the other hand, there is no problem, because there is nothing to be solved. Existence itself seems to retreat, to leave you stranded, without purchase on things, people, yourself. In her new memoir, This Close to Happy: A Reckoning with Depression, Daphne Merkin describes it this way:Now you can no longer figure out what it is that moves other people to bustle about out there in the world, doing errands, rushing to appointments, picking up a child from school. You have lost the thread that pulled the circumstances of your life together. Nothing adds up and all you can think about is the raw nerve of pain that your mind has become—and, once again, how merciful it would be to yourself and others to extinguish this pain.This is the situation that Heidegger called anxiety, and that Sylvia Plath describes as being covered with a bell jar. Nothing matters—not obligations, or commitments, or challenges, or pleasures. It is this failure of mattering that feels so impossible to remedy, and which leads the depressed person to thoughts of suicide. (...)
For Merkin... depression is something that emerges from within, the medium in which she lives. She experiences it as “a yawning inner lack—some elusive craving for wholeness or well-being.” Writing about a lack is difficult, and perhaps no one has ever captured exactly what it feels like to be depressed, simply because one can’t describe a negative. Merkin avoids this problem by writing less about the feeling of depression than about its causes and its remedies. What, she asks, made her so miserable? And what happens when she tries—through therapy, medication, or hospitalization—to cure that misery?
The answer to the first question—what causes depression?—depends largely on the vocabulary you use to ask it. Is depression understood philosophically, as a response to the true nature of reality—its futility, loneliness, despair? Or is it understood medically, as a deficit of certain brain chemicals, which turns it into a disease like diabetes?
by Adam Kirsch, Tablet | Read more:
Image: uncredited
***
Depression is pervasive: In 2015, about 16 million — or 6.7 percent of — American adults had a major depressive episode in the past year. Major depression takes the most years off of American lives and accounts for the most years lived with disability of any mental or behavioral disorder. It is also expensive: From 1999 to 2012, the percentage of Americans on antidepressants rose from an estimated 6.8 to 12 percent. The global depression drug market is slated to be worth over $16 billion by 2020.
The National Institute of Mental Health defines a major depressive episode as “a period of two weeks or longer during which there is either depressed mood or loss of interest or pleasure, and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.” This falls in line with what Matthew Hutson, in a new feature for Nautilus, describes as the disease model of depression: that depression is “a breakdown, a flaw in the system, something to be remedied and moved past.” In his compelling and challenging piece, Hutson profiles several researchers who advance an argument that depression can serve a possibly positive purpose in the lens of evolution. But rather than deifying evolution and trying to scry out what it meant for us, let’s focus on what’s more immediately useful for lived human lives today: that, in some circumstances, depression may be, in the arc of a life, yielding of insights and personal meaning. All of this is in no way meant to minimize the suffering that depression can cause — but to suggest the uses that it may serve.
At the center of Hutson’s piece is Paul Andrews, an evolutionary psychologist at McMaster University in Canada. Andrews argues that depression may be “an adaptation for analyzing complex problems.” He sees it in the condition’s bouquet of symptoms, which include “anhedonia,” or an inability to feel much pleasure; people who are depressed ruminate frequently, often in spirals; and they get more REM sleep, a phase associated with memory consolidation. This reflects an evolutionary design, the argument goes, one that’s to, as Hutson summarizes, “pull us away from the normal pursuits of life and focus us on understanding or solving the one underlying problem that triggered the depressive episode.” Like, say, a “failed” relationship. The episode, then, is a sort of altered state, one different from the hum of daily life, one that’s supposed to get you to pay attention to whatever wounding led to the upset. For example, 80 percent of subjects in a 61-person study of depression found that they perceived some benefit from rumination, mostly assessing problems and preventing future mistakes.
For now, Andrews’s “analytical rumination hypothesis” is just that, a hypothesis, a term that combines the Greek hypo (under) with -thesis (placing). It’s a concept, an observation, one that acts as a structure for further inquiry. Still, already, there is something very powerful, and even actionable, in reconceptualizing (some) depressive episodes as having a function, as presenting a quest toward understanding for the sufferer to undertake. Other research helps to refract the light being shined here: Laura King, a psychologist at the University of Missouri, has spent a couple decades studying people’s experiences of meaning in life, and she told me in an interview at this year’s Society for Personality and Social Psychology meeting that the meaning people derive from difficult experiences depends not on the amount that they’re suffered, but the extent of reflection — or meaning-making — they’ve done on what prompted a given nadir. Following this logic, if the job of a depressive episode is to figure out what’s gone awry, what emotional knots need to be untangled, what attachment patterns need to be identified and addressed, then antidepressants are an incomplete treatment, just like you wouldn’t prescribe Percocet to a heal a broken ankle without also supplying a cast.
The National Institute of Mental Health defines a major depressive episode as “a period of two weeks or longer during which there is either depressed mood or loss of interest or pleasure, and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.” This falls in line with what Matthew Hutson, in a new feature for Nautilus, describes as the disease model of depression: that depression is “a breakdown, a flaw in the system, something to be remedied and moved past.” In his compelling and challenging piece, Hutson profiles several researchers who advance an argument that depression can serve a possibly positive purpose in the lens of evolution. But rather than deifying evolution and trying to scry out what it meant for us, let’s focus on what’s more immediately useful for lived human lives today: that, in some circumstances, depression may be, in the arc of a life, yielding of insights and personal meaning. All of this is in no way meant to minimize the suffering that depression can cause — but to suggest the uses that it may serve.
At the center of Hutson’s piece is Paul Andrews, an evolutionary psychologist at McMaster University in Canada. Andrews argues that depression may be “an adaptation for analyzing complex problems.” He sees it in the condition’s bouquet of symptoms, which include “anhedonia,” or an inability to feel much pleasure; people who are depressed ruminate frequently, often in spirals; and they get more REM sleep, a phase associated with memory consolidation. This reflects an evolutionary design, the argument goes, one that’s to, as Hutson summarizes, “pull us away from the normal pursuits of life and focus us on understanding or solving the one underlying problem that triggered the depressive episode.” Like, say, a “failed” relationship. The episode, then, is a sort of altered state, one different from the hum of daily life, one that’s supposed to get you to pay attention to whatever wounding led to the upset. For example, 80 percent of subjects in a 61-person study of depression found that they perceived some benefit from rumination, mostly assessing problems and preventing future mistakes.
For now, Andrews’s “analytical rumination hypothesis” is just that, a hypothesis, a term that combines the Greek hypo (under) with -thesis (placing). It’s a concept, an observation, one that acts as a structure for further inquiry. Still, already, there is something very powerful, and even actionable, in reconceptualizing (some) depressive episodes as having a function, as presenting a quest toward understanding for the sufferer to undertake. Other research helps to refract the light being shined here: Laura King, a psychologist at the University of Missouri, has spent a couple decades studying people’s experiences of meaning in life, and she told me in an interview at this year’s Society for Personality and Social Psychology meeting that the meaning people derive from difficult experiences depends not on the amount that they’re suffered, but the extent of reflection — or meaning-making — they’ve done on what prompted a given nadir. Following this logic, if the job of a depressive episode is to figure out what’s gone awry, what emotional knots need to be untangled, what attachment patterns need to be identified and addressed, then antidepressants are an incomplete treatment, just like you wouldn’t prescribe Percocet to a heal a broken ankle without also supplying a cast.
by Drake Baer, Science of Us | Read more:
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