Tuesday, September 25, 2018

Maison Margiela Fusion Sneaker


Nordstrom: Maison Margiela Fusion Sneaker - $1,645 (free shipping)
via
Image: Nordstrom

How You Can Invest in Dire Straits Royalities

Starting today, you can invest in a unique manager’s share of sound recording royalties generated by the entire epic catalog of rock legends Dire Straits, as well as the solo catalog of former members Mark Knopfler and John Illsley.

This catalog has been earning royalties since the band released their first album in 1978. Since the beginning, the band sold 140 million records around the world, won four Grammy awards, and was inducted into the Rock & Roll Hall of Fame this year.

The royalties aren’t shabby either.

Although the band broke up in 1995, this catalog keeps earning royalties, and will for the life of the copyright. In fact, the catalog’s royalties grew 60% over the last 2 years.

Keep reading to learn all of the details of the catalog, including the financials, and how you can take part in this offer. (...)

About the Offering

This Private Syndicate investment opportunity features access to the manager’s commission of sound recording royalties earned by the complete recording catalog of legendary British rock band Dire Straits, as well as certain solo releases from band members Mark Knopfler and John Illsley.

This includes all six studio albums (most notably, the smash Brothers In Arms), hits like “Sultans of Swing,” “Money For Nothing,” and “Walk of Life” (along with their music videos), live albums, and any existing or future best-of compilations.

It also includes solo work of frontman Mark Knopfler, which among other releases includes soundtracks to movies like the beloved classics “The Princess Bride,” “Local Hero,” "Wag the Dog," and others. Click here for a list of the full catalog

Like all iconic catalogs — Dire Straits is actually growing faster than the industry at large. We want to bring you assets like this, and that’s why we’re so excited to announce this offer. Popular songs come and go, but classics like those in the Dire Straits catalog have uncommon longevity. As you’ll see in the Financials section below, this catalog’s earnings are not only still growing, but are outperforming the growth of the broader music industry.

Buying units of this Syndicate entitles you to these growing earnings generated from an epic music collection that stands the test of time. We are projecting a 10-year annualized IRR between 12%-15%.* (...)

Unique Earnings

These earnings have several unique elements worth noting.

First, they take the form of the manager’s commission earned by Dire Straits’ and Mark Knopfler’s former manager Ed Bicknell. Unlike typical manager agreements, where commissions expire in the early years after the management contract ends, Mr. Bicknell’s commission lasts for the perpetuity of the copyright — the lifetime of the author plus 70 years. This management agreement has been updated to ensure the Private Syndicate receives these commissions going forward, per an amendment signed by Knopfler and Illsley.

Under this scenario, the Syndicate will own 85% of all payments collected through this agreement as of July 1, 2018.

Second, the catalog collects public performance royalties on the sound recording from terrestrial radio airplay (called neighboring rights) outside the United States. The U.S. is one of the few countries that does not pay public performance royalties on terrestrial radio airplay, and as such U.S. recording artists don’t receive the same for radio airplay outside the U.S. But since Dire Straits is a U.K. act, it receives this royalty for radio airplay outside the U.S.

This is significant because Dire Straits is proportionally more popular outside the U.S. than it is domestically. According to an analysis by ChartMasters.org, the band's European sales alone are nearly triple that of its U.S. sales, which speaks volumes to international demand.

by Private Syndicate, Royalty Exchange |  Read more:
Image: Dire Straits, Brothers in Arms

Alejandro Escovedo


[ed. Nice to see him get the recognition. See: Alejandro Escovedo’s Return to the Border. (And, from the new album: Sonica USA).]

Giving Malaria a Deadline

Malaria is among the world’s worst scourges. In 2016 the disease, which is caused by a parasite and transmitted by mosquitoes, infected 194 million people in Africa and caused 445,000 deaths.

But biologists now have developed a way of manipulating mosquito genetics that forces whole populations of the insect to self-destruct. The technique has proved so successful in laboratory tests that its authors envisage malaria could be eliminated from large regions of Africa within two decades.

A team led by Andrea Crisanti, a biologist at Imperial College, London, altered a gene that disrupts the mosquito’s sexual development; the females become infertile but the males remain able to spread the debilitating gene to an ever-dwindling number of progeny. Dr. Crisanti found that laboratory populations of mosquitoes can be driven to extinction within 11 generations, he and colleagues report in Monday’s issue of Nature Biotechnology. Wild populations could be made to crash in about four years, according to computer models.

The technique involves equipping mosquitoes with a gene drive, a genetic mechanism that forces a gene of choice into all of an organism’s offspring. (Normally, sexual reproduction would pass the gene to only half the progeny.) Genes carried by a gene drive therefore can spread very rapidly through a population, which makes the technique both powerful and potentially dangerous. No gene drive has yet been released in the wild. (...)

Launching a gene drive into the wild is risky. Once released, it can’t be recalled or easily disabled should anything go awry. In 2016, the National Academy of Sciences called for extensive tests and public consultationbefore any gene drive is released.

The theory of how gene drives could be used to control pest populations was laid out in 2003, in an article by Austin Burt, a biologist at Imperial College, London, and a co-author on the new paper. He hopes that a small-scale field trial can be started in Africa in five years.

by Nicholas Wade, NY Times | Read more:
Image: Dr. Tony Brain/Science Source
[ed. Bad idea, and not just because of mission creep. See also: The Law of Unintended Consequences (of which, biological intervention has had more than its fair share of historical failure). As Ian Malcolm would say "life finds a way".]

Public Shaming And The Disposable Society

Hit Like a Girl

This past spring, the internet was gleefully stunned by the drum stylings of Yoyoka Soma, an 8-year-old girl from Japan whose size suggests she could comfortably cradle herself inside her kick drum, if she preferred hide-and-go-seek to rock ’n’ roll. In the viral video, Soma flawlessly traverses the pounding nuances of her favorite song, the Led Zeppelin classic “Good Times, Bad Times.” Knocking the cowbell centerpiece metronomically and grinning widely, the adorably bobbed Soma miraculously mimics the drum track laid 50 years ago by John Bonham, the burly, beer-swigging Brit who’s considered one of the greatest rock drummers of all time. Upon seeing the video — which has garnered well over three million views — Led Zeppelin singer Robert Plant marveled at her talent, saying, “That’s a technically really difficult thing to do.” Speaking on behalf of his departed drummer, Plant added, “I think he’d be amazed.”


Soma’s clip is just one of thousands of videos submitted from around the world over the past seven years to the Hit Like a Girl contest, an amateur female drumming competition designed to inspire female empowerment and spark a rebound in the struggling musical instrument industry. Contestants create a user profile on the Hit Like a Girl website, then upload an approximately three-minute performance video to YouTube. There are several categories — straight drum-set performance, concert percussion, marching percussion and others — and separate contests for adults and girls under 18. A panel of industry executives and esteemed female drummers serve as judges, with the results of public votes also considered. Scholarships to performing arts programs, free gear and other prizes supplied by more than 60 sponsors are up for grabs.

“We have girls from as young as 7 to women as old as 70 that participated in the contest this year,” says Hit Like a Girl co-founder David Levine, who owns the cymbal manufacturer TRX Cymbals. Levine adds that more than 50 countries and a wide variety of musical genres were represented among this year’s 500-plus contestants — an all-time high. He says he hears gratitude for the existence of Hit Like a Girl from participants and others just learning about it, “pretty much every day.”

by Michael Stahl, Narratively |  Read more:
Image: Hit Like a Girl

Monday, September 24, 2018

Joni Mitchell


[ed. Turn it up.]

The European Union Versus the Internet

Earlier this summer the Internet breathed a sigh of relief: the European Parliament voted down a new Copyright Directive that would have required Internet sites to proactively filter uploaded content for copyright violations (the so-called “meme ban”), as well as obtain a license to include any text from linked sites (the “link tax”).

Alas, the victory was short-lived. From EUbusiness:
Internet tech giants including Google and Facebook could be made to monitor, filter and block internet uploads under amendments to the draft Copyright Directive approved by the EU Parliament Wednesday. At their plenary session, MEPs adopted amendments to the Commission’s draft EU Copyright Directive following from their previous rejection, adding safeguards to protect small firms and freedom of expression… 
Parliament’s position toughens the Commission’s proposed plans to make online platforms and aggregators liable for copyright infringements. This would also apply to snippets, where only a small part of a news publisher’s text is displayed. In practice, this liability requires these parties to pay right holders for copyrighted material that they make available. 
At the same time, in an attempt to encourage start-ups and innovation, the text now exempts small and micro platforms from the directive.
I chose this rather obscure source to quote from for a reason: should Stratechery ever have more than either 50 employees or €10 million in revenue, under this legislation I would likely need to compensate EUbusiness for that excerpt. Fortunately (well, unfortunately!), this won’t be the case anytime soon; I appreciate the European Parliament giving me a chance to start-up and innovate.

This exception, along with the removal of an explicit call for filtering (that will still be necessary in practice), was enough to get the Copyright Directive passed. This doesn’t mean it is law: the final form of the Directive needs to be negotiated by the EU Parliament, European Commission, and the Council of the Europe Union (which represents national governments), and then implemented via national laws in each EU country (that’s why it is a Directive).

Still, this is hardly the only piece of evidence that EU policy makers have yet to come to grips with the nature of the Internet: there is also the General Data Protection Regulation (GDPR), which came into effect early this year. Much like the Copyright Directive, the GDPR is targeted at Google and Facebook, but as is always the case when you fundamentally misunderstand what you are fighting, the net effect is to in fact strengthen their moats. After all, who is better equipped to navigate complex regulation than the biggest companies of all, and who needs less outside data than those that collect the most?

In fact, examining where it is that the EU’s new Copyright Directive goes wrong — not just in terms of policy, but also for the industries it seeks to protect — hints at a new way to regulate, one that works with the fundamental forces unleashed by the Internet, instead of against them.

by Ben Thompson, Stratechery |  Read more:
Image: no image
[ed. A Big Deal (and complex). Important.]

Treating the Prodrome

A prodrome is an early stage of a condition that might have different symptoms than the full-blown version. In psychiatry, the prodrome of schizophrenia is the few-months-to-few-years period when a person is just starting to develop schizophrenia and is acting a little bit strange while still having some insight into their condition.

There’s a big push to treat schizophrenia prodrome as a critical period for intervention. Multiple studies have suggested that even though schizophrenia itself is a permanent condition which can be controlled but never cured, treating the prodrome aggressively enough can prevent full schizophrenia from ever developing at all. Advocates of this view compare it to detecting early-stage cancers, or getting prompt treatment for a developing stroke, or any of the million other examples from medicine of how you can get much better results by catching a disease very early before it has time to do damage.

These models conceptualize psychosis as “toxic” – not just unpleasant in and of itself, but damaging the brain while it’s happening. They focus on a statistic called Duration of Untreated Psychosis. The longer the DUP, the more chance psychosis has had to damage the patient before the fire gets put out and further damage is prevented. Under this model it’s vitally important to put people who seem to be getting a little bit schizophrenic on medications as soon as possible. (...)

After learning more about the biology of schizophrenia, I’ve become more willing to credit the DUP model. I can’t give great sources for this, because I’ve lost some of them, but this Friston paper, this Fletcher & Frith paper, and Surfing Uncertainty all kind of point to the same model of why untreated schizophrenia might get worse with time.

In their system, schizophrenia starts with aberrant prediction errors; the brain becomes incorrectly surprised by some sense-data. Maybe a fly buzzes by, and all of a sudden the brain shouts “WHOA! I WASN’T EXPECTING THAT! THAT CHANGES EVERYTHING!” Your brain shifts its resources to coming up with a theory of the world that explains why that fly buzzing by is so important – or perhaps which maximizes its ability to explain that particular fly at the cost of everything else.

Talk to early-stage schizophrenics, and their narrative sounds a lot like this. They’ll say something like “A fly buzzed by, and I knew somehow it was very significant. It must be a sign from God. Maybe that I should fly away from my current life.” Then you’ll tell them that’s dumb, and they’ll blink and say “Yeah, I guess it is kind of dumb, now that you mention it” and continue living a somewhat normal life.

Or they’ll say “I was wondering if I should go to the store, and then a Nike ad came on that said JUST DO IT. I knew that was somehow significant to my situation, so I figured Nike must be reading my mind and sending me messages to the TV.” Then you’ll remind them that that can’t happen, and even though it seemed so interesting that Nike sent the ad at that exact moment, they’ll back down.

But even sane people change their beliefs more in response to more evidence. If a friend stepped on my foot, I would think nothing of it. If she did it twice, I might be a little concerned. If she did it fifty times, I would have to reevaluate my belief that she was my friend. Each piece of evidence chips away at my comfortable normal belief that people don’t deliberately step on my feet – and eventually, I shift.

The same process happens as schizophrenia continues. One fly buzzing by with cosmic significance can perhaps be dismissed. But suppose the next day, a raindrop lands on your head, and there’s another aberrant prediction error burst. Was the raindrop a sign from God? The evidence against is that this is still dumb; the evidence for is that you had both the fly and the raindrop, so your theory that God is sending you signs starts looking a little stronger. I’m not talking about this on the conscious level, where the obvious conclusion is “guess I have schizophrenia”. I’m talking about the pre-conscious inferential machinery, which does its own mechanical thing and tells the conscious mind what to think.

As schizophrenics encounter more and more strange things, they (rationally) alter their high-level beliefs further and further. They start believing that God often sends signs to people. They start believing that the TV often talks especially to them. They start believing that there is a conspiracy. The more aberrant events they’re forced to explain, the more they abandon their sane views about the world (which are doing a terrible job of predicting all the strange things happening to them) and adopt psychotic ones.

But since their new worldview (God often sends signs) gives a high prior on various events being signs from God, they’ll be more willing to interpret even minor coincidences as signs, and so end up in a nasty feedback loop. From the Frith and Fletcher paper:
Ultimately, someone with schizophrenia will need to develop a set of beliefs that must account for a great deal of strange and sometimes contradictory data. Very commonly they come to believe that they are being persecuted: delusions of persecution are one of the most striking and common of the positive symptoms of schizophrenia, and the cause of a great deal of suffering. If one imagines trying to make some sense of a world that has become strange and inconsistent, pregnant with sinister meaning and messages, the sensible conclusion might well be that one is being deliberately deceived. This belief might also require certain other changes in the patient’s view of the world. They may have to abandon a succession of models and even whole classes of models.
A few paragraphs later, they expand their theory to the negative symptoms of schizophrenia. That is: advanced-stage schizophrenics tend to end up in a depressed-like state where they rarely do anything or care about anything. (...)

I think what they are saying is that, as the world becomes even more random and confusing, the brain very slowly adjusts its highest level parameters. It concludes, on a level much deeper than consciousness, that the world does not make sense, that it’s not really useful to act because it’s impossible to predict the consequences of actions, and that it’s not worth drawing on prior knowledge because anything could happen at any time. It gets a sort of learned helplessness about cognition, where since it never works it’s not even worth trying. The onslaught of random evidence slowly twists the highest-level beliefs into whatever form best explains random evidence (usually: that there’s a conspiracy to do random things), and twists the fundamental parameters into a form where they expect evidence to be mostly random and aren’t going to really care about it one way or the other. (...)

The Frith and Fletcher paper also tipped me off to this excellent first-person account by former-schizophrenic-turned psychologist Peter Chadwick:
At this time, a powerful idea of reference also overcame me from a television episode of Colombo and impulsively I decided to write letters to friends and colleagues about “this terrible persecution.” It was a deadly mistake. After a few replies of the “we’ve not heard anything” variety, my subsequent (increasingly overwrought) letters, all of them long, were not answered. But nothing stimulates paranoia better than no feedback, and once you have conceived a delusion, something is bound to happen to confirm it. When phrases from the radio echoed phrases I had used in those very letters, it was “obvious” that the communications had been passed on to radio and then television personnel with the intent of influencing and mocking me. After all betrayal was what I was used to, why should not it be carrying on now? It seemed sensible. So much for my bonding with society. It was totally gone. I was alone and now trusted no one (if indeed my capacity to trust people [particularly after school] had ever been very high). 
The unfortunate tirade of coincidences that shifted my mentality from sane to totally insane has been described more fully in a previous offering. From a meaningless life, a relationship with the world was reconstructed by me that was spectacularly meaningful and portentous even if it was horrific. Two typical days from this episode I have recalled as best I could and also published previously. The whole experience was so bizarre it is as if imprinted in my psyche in what could be called “floodlit memory” fashion. Out of the coincidences picked up on, on radio and television, coupled with overheard snatches of conversation in the street, it was “clear” to me that the media torment, orchestrated as inferred at the time by what I came to call “The Organization,” had one simple message: “Change or die!” Tellingly my mother (by then deceased) had had a fairly similar attitude. It even crossed my (increasingly loosely associated) mind that she had had some hand in all this from beyond the grave […] 
As my delusional system expanded and elaborated, it was as if I was not “thinking the delusion,” the delusion was “thinking me!” I was totally enslaved by the belief system. Almost anything at all happening around me seemed at least “relevant” and became, as Piaget would say, “assimilated” to it. Another way of putting things was that confirmation bias was massively amplified, everything confirmed and fitted the delusion, nothing discredited it. Indeed, the very capacity to notice and think of refutatory data and ideas was completely gone. Confirmation bias was as if “galloping,” and I could not stop it. 
As coincidences jogged and jolted me in this passive, vehicular state into the “realization” that my death was imminent, it was time to listen out for how the suicide act should be committed. “He has to do it by bus then?!” a man coincidentally shouted to another man in the office where I had taken an accounts job (in fact about a delivery but “of course” I knew that was just a cover story). “Yes!” came back the reply. This was indeed how my life was to end because the remark was made as if in reply to the very thoughts I was having at that moment. Obviously, The Organization knew my very thoughts. 
Two days later, I threw myself under the wheels of a double decker, London bus on “New King’s Road” in Fulham, West London, to where I had just moved. In trying to explain “why all this was happening” my delusional system had taken a religious turn. The religious element, that all this torment was willed not only by my mother and transvestophobic scandal-mongerers but by God Himself for my “perverted Satanic ways,” was realized in the personal symbolism of this suicide. New King’s Road obviously was “the road of the New King” (Jesus), and my suicide would thrust “the old king” (Satan) out of me and Jesus would return to the world to rule. I then would be cast into Outer Darkness fighting Satan all the way. The monumental, world-saving grandiosity of this lamentable act was a far cry from my totally irrelevant, penniless, and peripheral existence in Hackney a few months before. In my own bizarre way, I obviously had moved up in the world. Now, I was not an outcast from it. I was saving the world in a very lofty manner. Medical authorities at Charing Cross Hospital in London where I was taken by ambulance, initially, of course, to orthopedics, fairly quickly recognized my psychotic state. Antipsychotic drugs were injected by a nurse on doctors’ advice, and eventually, I made a full physical and mental recovery.
Chadwick never got too far along; he had all the weird coincidences, he was starting to get beliefs that explained them, but he never got to a point where he shifted his fundamental concepts or beliefs about logic in an irreversible way. As far as I know he’s been on antipsychotics consistently since then, and has escaped with no worse consequences than becoming a psychology professor.

by Scott Alexander, Slate Star Codex |  Read more:
[ed. Interesting, how schizophrenia takes hold.]

Hating Big Pharma Is Good, But Supply-Side Epidemic Theory Is Killing People

Addiction experienced in the first-person feels like watching a movie shot entirely in extreme close-ups. No matter how hard you try, you can’t see the world beyond the frame. A tolerance builds after a while and you grow used to the shaky, nauseating ride. We couldn’t have possibly known it at the time, that we weren’t the stars in our very own drama. The content of our stories differed in the details, but the tone was uncannily similar: how prescription painkillers first took hold; after pharmaceuticals became scarce and expensive, how we, as a generation in unison, playing a fucked up game of Red Rover, beelined toward heroin. Another thing we had in common was a lot of dead friends.

Really, we were just extras in a vast plot. Data points in a decadeslong “mass casualty event.” Epidemics are sort-of defined after the fact. After enough emergency room physicians start connecting the dots, after economists quantify labor participation and all-cause mortality, after a small hamlet’s population begins to shrink, after the morgue runs out of freezer space, after the president goes on TV.

What kicked off addiction on such an enormous scale has become an Odyssey for epidemiologists and journalists (like me), as well as parents and siblings who’ve lost loved ones. Grieving families and activists have turned up the heat on politicians and cops, urging a unified public health response that would reverse course. But how we define the origin of the crisis, its root causes, invariably informs which solutions are prioritized. Decades in, with each year deadlier than the one before, and no end in sight, what’s it going to take? The answer depends on who’s asking the questions.
***
Drenched in shame and broken by stigma, the impulse to blame ourselves for our addictions felt like a natural turn inward. Journalist Beth Macy’s new book, Dopesick: Dealers, Doctors, and the Drug Company that Addicted America, isn’t interested in victim blaming, as the title suggests. The villains, familiar to those following the news, are doctors cum dealers duped by Purdue Pharma’s marketing that downplayed the risk of addiction for their blockbuster drug, OxyContin. And after painkillers had their run, the story goes, enterprising heroin dealers tapped a hungry market outside the city, “picturesque” and “bucolic” markets demanding relief after years of physical labor and economic distress metastasized into despair. (...)

The real tragedy of Dopesick isn’t that young people are using drugs. It’s that when they’re drowning and begging for help, they’re callously thrown deflated life preservers. The numerous attempts at treatment throughout the book — typically at abstinence-based facilities, a dangerous move for someone with an opioid use disorder — become maddening. These are places that prefer to give patients heart-shaped rocks instead of the two FDA-approved medications that reduce the risk of fatal overdose by 50 percent or more.

All the treatment failures in Dopesick read like screams into the void of America’s outdated patchwork of shoddy care. Macy finds just the right details that’ll make you pull your hair out. A police officer picks up Jesse’s cellphone at the scene of his fatal overdose, and on the other end is a treatment center (that he’d already been to once before, that doesn’t believe in medication) calling to confirm Jesse’s arrival. If you’re wondering why so many of us are still dying, in-patient, residential “treatment” is one place to start looking. (...)

The villains in Dopesick are the usual suspects. In 2015, Los Angeles Times crime reporter Sam Quinones wrote one of the first major books about the modern day opioid crisis, Dreamland, in which he sketches out the mechanics that drove the first wave of painkiller overdoses in Ohio and the Rust Belt. Quinones calls Ohio the epicenter of the crisis; Macy calls Virginia the epicenter of the crisis. But both Macy and Quinones find the same culprit: Purdue Pharma’s false marketing, which assured doctors that their time-released opioid analgesic rarely addicted patients.

Central to the origin story of the crisis in both Dreamland and Dopesick is the over-supply of OxyContin, dulled out by sometimes well-intentioned but misinformed doctors, or in bulk at greedy pill mills diverted for street sale. Either way, in the late ’90s and into the aughts, during a climate of deregulation and a “patient-centeredness” movement obsessed with smiley-faced rate-your-pain scales, these drugs flooded vulnerable regions of America.

Both Macy and Quinones look intently at the supply of drugs. But did flooding the market with opioids create the demand? Drugs, after all, are like any other product: people have to like and want it or they won’t buy it. So, can a doctor create addiction in their patients? Can a drug company addict an entire country? Only if you believe opioids are like mosquitos carrying Malaria, and whoever touches them comes down with the disease.

The vast majority of people who use opioids do not become addicted to them. A conservative estimate for rates of addiction among pain patients is less than 8 percent (still much higher than Purdue’s < 1 percent claim). But among those who do become addicted, they’re typically using diverted medications that were never prescribed to them, or had misused illicit drugs and were well on their way to addiction prior to receiving a prescription, thanks to trauma, mental health, and other factors that increase one’s risk. Nobody walks into a doctor’s office with a clean slate. (...)

As satisfying the feeling is to rail against Big Pharma and unenlightened doctors, the iatrogenic (doctor-caused) narrative isn’t without caveats and shortcomings, which are becoming painfully evident as the government rolls out strategies to rein in the supply of opioids. A recent study out of Stanford that modeled public health policy shows that aggressively controlling the supply of prescriptions, in the short-term, is actuallyincreasing overdose deaths by the thousands. Other strategies to reschedule drugs like Vicodin also backfired, new studies are finding. In a powerful commentary by public health experts, “Opioid Crisis: No Easy Fix to its Social and Economic Determinants,” they argue wrangling the supply of opioids fails to address root causes. Targeting supply is important, the authors of “No Easy Fix” agree, but doing so without addressing people’s pain is one of the reasons things are this bad. (...)

America’s draconian conception of drug policy has life and death consequences. Jesse, the football player in Dopesick, preferred to inject pharmaceutical oxycodone. This was true for my friends and me. Jesse, like my friend Alex, didn’t survive the leap to heroin. This isn’t retold to condone the misuse of prescription painkillers. The moral world of addiction is shaded with greys. And the fact is, injecting a regulated pharmaceutical of known dose and purity is less risky than injecting a bag of white powder purchased on the street. Bags of dope come with no proof of ingredients. At the end of the day, an 80 milligram OxyContin is always 80 milligrams. It may not be pretty, and Purdue executives might be dead-eyed ghouls, but at least there was measure of safety. That safety’s gone now. Hello, fentanyl.

Unfocused anger at Big Pharma also winds up harming a different vulnerable group, one that’s typically an afterthought in stories about opioids: chronic pain patients. In the name of “battling the epidemic,” patients who need opioids are being abandoned by their doctors. With Jeff Sessions and the DEA breathing down their necks, they’re afraid of prescribing any narcotic. In response to the opioid crisis, the prescribing pendulum has rapidly swung. Doctors who treat pain are receiving threatening letters to prescribe fewer opioids, patient outcomes be damned. As a result, some of these patients are killing themselves, which has caught the interest of investigators at the Human Rights Watch, who are documenting patient abandonment in the new, restrictive climate. A sweeping package of opioid legislation recently passed by the Senate will also be studying whether opioid prescribing limits have led to patient suicide. (...)

Macy calls this game “Whac-a-Mole,” with new dealers and more dangerous products popping-up after each bust, otherwise known as the Iron Law of Prohibition: painkillers replaced by heroin, and heroin replaced by fentanyl. Choking off the supply of prescription painkillers early on in the crisis, without first installing a safety net to catch the fallout, was a major policy failure that worsened America’s opioid problem by orders of magnitude. What would such a safety net look like? In Fighting for Space: How a Group of Drug Users Transformed One City’s Struggle with Addiction, Canadian journalist Travis Lupick exhaustively details the architecture of a demand-centered strategy that prioritizes saving the lives of active drug users.

Lupick rarely mentions supply-side interventions in his book. Instead, he stays close to people actively injecting heroin and cocaine several times per day, learning what makes them desire drugs in the first place, listening to what they say they need. Fighting for Space, more than anything else, is a testament to the organizing power of drug users. In 1997, with the help of compassionate public housing and healthcare workers on the Downtown Eastside, where poverty and trauma are heavily concentrated, drug users came together to form a union called the Vancouver Area Network of Drug Users (VANDU). Rather than flinch at their drug use, Lupick portrays Downtown Eastside users as they truly are: fierce but flawed heroes. Like the manic energy of user-activist Dean Wilson, whose injection cocaine habit made him an untiring debater, dunking all over City Hall’s bureaucrats. He was one of VANDU’s early presidents.

For the uninitiated, Lupick’s harm reduction history might read like inside baseball. But as you slowly come to meet the activists, like the recalcitrant Ann Livingston and the mysterious heroin-poet Bud Osborne, you can’t help but root for them as they break all the undignifying rules that make life a living hell for those addicted on the street. From an American perspective, Lupick’s encyclopedic history also reads as a blueprint.

Treating addiction like the public health issue that it is didn’t happen because Canadians are naturally nicer and friendlier toward drug users. After decades of highly organized, politically strategic activism by a dedicated, at times disabled and tense group of drug users and health care providers, Vancouver’s most marginalized community was seen and heard. They didn’t merely get what they wanted; they got what they needed by fighting for their space: their space to do drugs with dignity, in the presence of radically compassionate nurses, but also space at the policymaking table where decisions about their fate are made. “Nothing about us, without us,” the saying goes. Canadian drug users had the insight to make their needs political, and had the stamina and support to sustain pressure on the city.

Reminiscent of ACT UP during the HIV epidemic of the ’80s and ’90s, VANDU targeted the media and politicians who seldom made a peep about their friends who overdosed alone behind dumpsters in the alley, or others who died from untreated AIDS and Hepatitis C.

by Zachary Siegel, Longreads | Read more:
Image: Jose A. Bernat Bacete / Getty, Illustration by Katie Kosma

Saturday, September 22, 2018

Bob Dylan


An Early Outtake Of Bob Dylan's 'If You See Her, Say Hello'

[ed. Nicely captures the creative process.]

Atmospheric Carbon Dioxide Growth Rate



Atmospheric Carbon Dioxide Growth Rate
via:
[ed. Sorry humans. Not only are you not doing anything to make things better, you're making things worse. Maybe this is a rat-thropic universe after all. See below.]

Anthropic Arrogance

Welcome to the ‘anthropic principle’, a kind of Goldilocks phenomenon or ‘intelligent design’ for the whole Universe. It’s easy to describe, but difficult to categorise: it might be a scientific question, a philosophical concept, a religious argument – or some combination. The anthropic principle holds that if such phenomena as the gravitational constant, the exact electric charge on the proton, the mass of electrons and neutrons, and a number of other deep characteristics of the Universe differed at all, human life would be impossible. According to its proponents, the Universe is fine-tuned for human life.

This raises more than a few questions. For one, who was the presumed cosmic dial-twiddler? (Obvious answer, for those so inclined: God.) Second, what’s the basis for presuming that the key physical constants in such a Universe have been fine-tuned for us and not to ultimately give rise to the hairy-nosed wombats of Australia, or maybe the bacteria and viruses that outnumber us by many orders of magnitude? In Douglas Adams’s antic novel The Hitchhiker’s Guide to the Galaxy (1979), mice are ‘hyper-intelligent pan-dimensional beings’ who are responsible for the creation of the Earth. What if the Universe isn’t so much anthropic as mouse-thropic, and the appearance and proliferation of Homo sapiens was an unanticipated side effect, a ‘collateral benefit’?

For a more general perspective, in The Salmon of Doubt (2002), Adams developed what has become known as the ‘puddle theory’:
[I]magine a puddle waking up one morning and thinking, ‘This is an interesting world I find myself in – an interesting hole I find myself in – fits me rather neatly, doesn’t it? In fact it fits me staggeringly well, must have been made to have me in it!’
It appears that Adams favoured a puddle-thropic principle. Or at least, the puddle did.

But perhaps I should be more serious about an idea that has engaged not just theologians and satirists but more than a few hard-headed physicists. The Australian astrophysicist Brandon Carter introduced the phrase ‘anthropic principle’ at a conference in Krakow, Poland in 1973 celebrating the 500th anniversary of the birth of Copernicus. Copernicus helped evict the Earth – and thus, humanity – from its prior centrality, something that the anthropic principle threatens (or promises) to re-establish. For Carter, ‘our location in the Universe is necessarily privileged to the extent of being compatible with our existence as observers’. In other words, if the Universe were not structured in such a way as to permit us to exist and, thus, to observe its particular traits, then – it should be obvious – we wouldn’t be around to marvel at its suitability for our existence!

In A Brief History of Time (1988), the late British physicist Stephen Hawking described a number of physical constants and astrophysical phenomena that seem at least consistent with the anthropic principle. Hawking noted that ‘if the rate of expansion one second after the Big Bang had been smaller by even one part in a hundred thousand million million, the Universe would have recollapsed before it ever reached its present size’. In short, a change so small it challenges the imagination, and the Big Bang would have turned into a kind of Big Crunch.

Albert Einstein considered the ‘cosmological constant’, which he introduced in 1917, his ‘biggest blunder’. Considering the emergence of the anthropic principle, however, it seems prescient. Einstein was troubled by the fact that gravity would cause the Universe to collapse onto itself (that Big Crunch), so he surmised a constant – essentially out of thin air – that pulled in the opposite direction, causing the cosmos to remain stable. The American physicist Steven Weinberg – not a religious believer – points out that if this now-confirmed constant were just a smidgeon larger, the Universe would be vaporously insubstantial. It would never have stopped expanding at a rate that precludes the formation of galaxies, never mind planets or mammals such as ourselves.

In 1961, providing even more fodder for the anthropic principle, the American physicist Robert Dicke noted that the age of the Universe reflects a kind of Goldilocks principle. Dicke suggested that, at an estimated 14.5 billion years of age, our Universe stands at a ‘golden interval’, neither too young nor too old, but just right. Any younger – ie, if the Big Bang had occurred in the more recent past – and it would not have allowed enough time for nucleosynthesis to stock the Universe with elements heavier than hydrogen and helium. There would be no medium-size, rocky planets and thus, no us. By the same token, if the Universe were substantially older than it is, most stars would have matured into white and red dwarfs. They would be too old to remain part of what astrophysicists call the ‘main sequence’, and unable to support stable planetary systems. The four fundamental interactions connecting mass and energy – gravitation, electromagnetic attraction and repulsion, and the ‘strong’ and ‘weak’ nuclear forces – also appear balanced precisely as needed to produce matter and, ultimately, life. Put it all together and there appears to be a significant case for the anthropic principle.

Not everyone, however, agrees that the necessary conditions for a life-supporting Universe are so delicate. ‘The parameters of our Universe,’ writes the astrophysicist Fred Adams at the University of Michigan, ‘could have varied by large factors and still allowed for working stars and potentially habitable planets.’ What to believe?

It’s important to note that the anthropic principle exists in two primary forms, ‘strong’ and ‘weak’. Over-simplifying, the weak principle is teleological. It holds that, as Carter had pointed out, whatever conditions are observed in the Universe must allow the observer to exist. In short, if these constants weren’t as they are, we wouldn’t be around to worry about them. To this, Hawking added that even slight alterations in the life-enabling constants of fundamental physics in this hypothesised multiverse could ‘give rise to universes that, although they might be very beautiful, would contain no one able to wonder at that beauty’. The weak version of the anthropic principle thus poses a logical conundrum.

The strong version is very different; it is in essence a religious expression, maintaining that some divine being created the Universe for human life. An even stronger version has been called the final anthropic principle, namely that ‘intelligent information-processing must come into existence in the Universe, and, once it comes into existence, will never die out’. Martin Gardner, a former maths and science writer for Scientific American, dubbed it the ‘completely ridiculous anthropic principle’ (CRAP).

The anthropic assertion, whether in its weak, strong or final version, has generated some more serious, and interesting, responses. One is contained within Einstein’s remark: ‘What really interests me is whether God had any choice in the creation of the world.’ Posing whether ‘God had any choice’ was Einstein’s way of asking if the manifold characteristics of the physical Universe, such as the speed of light, the charge of the electron and the proton, etc, are fixed or susceptible to alternatives. If fixed, they might appear to have been organised with carbon-based life in mind, but were actually not ‘free parameters’ in the first place. Note that Einstein was asking if the deep laws of physics might have in fact fixed the various physical constants of the Universe as the only values that they could possibly have, given the nature of reality, rather than having been ordained for some ultimate end – notably, us. At present, we simply don’t know whether the way the world works is the only way it could; in short, whether currently identified laws and physical constants are somehow bound together, according to physical law, irrespective of whether human beings – or anything else – eventuated.

The Universe is a big place and despite our understandable fascination with the anthropic principle, the stark truth is that nearly all of it is incompatible with life – at least our carbon-based, water-dependent version of it. Given the abundance of other possible locations, if humans existed simply as a result of chance alone, we’d find ourselves (very briefly) somewhere in the very cold empty void of outer space, and would be dead almost instantly. Might this, in turn, contribute to the conclusion that our very existence is evidence of a beneficent designer? But we’re not the outcome of a strictly random process: we find ourselves occupying the third planet from the Sun, which has sufficient oxygen, liquid water, moderate temperatures, and so forth. It isn’t a coincidence that we occupy a planet that is suitable for life, if only because we couldn’t survive where it isn’t. It’s no more amazing that the Earth isn’t a hot gas giant than the fact that no matter how tall or short a person might be, her legs are always precisely long enough to reach the ground.

Then there is another question – not necessarily deeper, but perhaps more perplexing. More than three centuries ago, in his chapter on ‘The Principles of Nature and of Grace, Based on Reason’ in Philosophical Papers and Letters (1714), the German philosopher, mathematician and physicist Gottfried Leibniz noted that ‘the first question which we have a right to ask will be, “Why is there something rather than nothing?”’ (Here, I’m especially fond of the American philosopher Sidney Morgenbesser’s reply to Leibniz, that ‘if there were nothing you’d still be complaining!’) But there is something, and of course, if there weren’t, there wouldn’t be any opportunities for complaint. This is not only an answer to the question of whether the Universe has been fine-tuned for us; it also points to a more general merging of statistics, logic and common sense, namely the difference between probabilities before and after an event.

For example, the English-Canadian philosopher Niall Shanks asks us to imagine shuffling a deck of cards and then dealing them out, face down. What is the likelihood that someone could predict the entire sequence, in advance, and without any hanky-panky? The chance of getting the first card correct is 1 in 52. The chance of getting the first two cards correct is 1/52 x 1/51 = 1/2652, so that the probability of guessing the entire deck in the proper order is 1/52 factorial. This is an unimaginably small number, something like 1 in 10 followed by 60 zeros. And yet, among the near-infinity of possibilities, they had to come out some way, and – miracle of miracles – they did!

Consider the probabilities before versus after a simple event, such as the position of a golf ball before compared to after a golfer hits it. It would take a near-miracle to identify precisely where that ball will eventually come to rest. But the outcome – wherever the golf ball ends up – isn’t a miracle at all. Neither is it evidence of divine intervention, nor of the golf course having been designed so as to arrange for that particular eventual placement of the ball, since it had to be somewhere. For us to marvel at the fact of our existing (in a Universe that permits that existence) is comparable to a golf ball being amazed at the fact that it ended up wherever it did.

by David P Barash, Aeon | Read more:
Image: Gregg Newton/Reuters

Three Hawaiian-Shirt-Clad Boomers on Millennials Stealing Their Look

By several accounts, 2018 was the Summer of Sleaze, headlined by Justin Bieber and his arsenal of garish aloha shirts (or, as mainlanders know it, the “Hawaiian” shirt) that made him look like your best friend’s semi-flaky South Beach cocaine dealer, circa 1982. Bieber’s fondness for a particularly, er, loud palette of shirts may put him on the extreme end of the aesthetic, but since celeb style tends to inform consumer trends, Bieber’s fits (or something like them) can now be seen on a male mannequin near you, whether it be via the dirt-cheap fast-fashion retailer H&M or timeless designer favorite Louis Vuitton.

In other words: Aloha shirts are hip for real, whether you’re going lowbrow or highbrow. And millennials in particular can’t seem to get enough of them.

This is an odd but not unexpected turn of events for David Bailey, who has worn an aloha shirt every single day for the last 30 years. Actually, scratch that: “I’ve missed maybe three days,” he says, before cracking a laugh. Bailey, 73, is perhaps the greatest hunter-gatherer of aloha shirts in America, having amassed an estimated 15,000 in his cocoon of a shop, Bailey’s Antiques and Aloha Shirts, which is a 10-minute drive from tourist-thronged Waikiki Beach in Honolulu.

Dig into the endless shelves and spirals of clothing and you might stumble across rarities like a hand-painted vintage rayon shirt from the 1960s, or perhaps a modern reproduction of a classic design worn by Frank Sinatra in From Here to Eternity. Some shirts go for under $5, while many others have appreciated in value since they first came off the sewing line. Anthony Bourdain dropped $3,000 here in 2008 while taping his travel show No Reservations. King of Margaritaville Jimmy Buffett got one for $5,000. Meanwhile, Nic Cage, never one to be outdone, spent $10,000 on a vintage shirt.

“The thought of wearing just a plain white or blue collared shirt is totally boring,” Bailey explains. “What we’re seeing is people who get into aloha shirts by having one, then five, then 50. Manufacturers I talk to are seeing increased sales everywhere, especially on the East Coast and in Europe. We’ve got Hawaii Five-0 and now Magnum P.I. back on TV, showing off the aloha shirt look. The vibe is ripe.”

How the shirt came to be is a matter of academic debate, but there’s agreement around the idea that it was influenced by the colorful Japanese fabrics that were being imported to Hawaii in the early 20th century, and widely used by Japanese families to sew their own clothing. The brightest, most eye-popping colors and patterns were initially reserved for children and young women, says DeSoto Brown, historian at the Bishop Museum in Honolulu. Chinese businessman Ellery Chun had a major influence in the 1930s when he began producing patterned shirts en masse, and Brown credits teens and other young people for fueling the fad of the aloha shirt as a form of local streetwear, during a time when most Americans were dressing conservatively.

“In the late 1930s, there was a brief moment of Hawaii being very fashionable for very wealthy young mainland people, who were part of what was called ‘café society.’ After Doris Duke built her house here, which got a ton of national publicity, other rich young people started vacationing here, or even buying their own houses,” Brown continues. “They wore alohawear in publicity or news photos, which not only helped spread awareness of it, but also made it desirable for other people to copy.”

That blew up in the 1950s and early 1960s, when Elvis Presley and Sinatra donned aloha shirts in films, and the Polynesian tiki-culture craze swept across the U.S., starting on the West Coast. “By the 1970s, old aloha shirts first got recycled by hippies who were trying to look oddball, to break with the established expectations. By the 1990s, the cliché of the ‘Fabulous ‘50s’ was also in place in American culture, and a small part of that was the old-fashioned-style aloha shirt,” Brown explains.

For many boomer men like Bailey, however, the aloha shirt isn’t a summer fad — it’s a long-lasting love built on an earnest appreciation for the practicality and style of a unique clothing tradition. The shirt represents the ultimate compromise between buttoned-up and laid-back — an alternative to the prim look of the midcentury white-collar man, and later, the Gordon Gekko pretension of the 1980s. And so, while millennials are certainly buying into the beachy-cool vibe of the aloha shirt, we found three men who have fallen in love with the garment exactly because it tries not to be hip. Here’s what they have to say…

by Eddie Kim, MEL |  Read more:
Image: uncredited

Friday, September 21, 2018

Why the Kavanaugh Allegation is so Important

The sexual assault allegation against Brett Kavanaugh is both credible and disturbing. But some people have questioned its relevance to his confirmation: After all, it is alleged to have happened when Kavanaugh was 17 years old, and Kavanaugh is now 53. The question of how to treat juvenile crimes can be complicated; with criminal convictions, we seal juveniles’ records. While Anita Hill’s allegations against Clarence Thomas concerned behavior during his professional life, Christine Ford’s allegation against Kavanaugh is from his high school years.

I think there is a very strong argument that the facts of the allegation, assuming they are true, are important in considering whether someone should be a Supreme Court Justice. But before we get to that, there’s another reason why this doesn’t just matter, but matters a lot: Kavanaugh has denied that he did it. That means that the truth or falsity of Ford’s allegation is not just important for assessing what Kavanaugh did in high school. It’s important for assessing what he is doing right now. If Ford’s allegation is true, then Kavanaugh has lied to the public. He didn’t just assault a woman in the 1980s, but he is gaslighting a woman in 2018 and trying to mislead the public and the United States Senate about a crime he committed. We can’t wave this away as being about the distant past, because it’s a question about the present. If the allegation is true, Kavanaugh is not fit to be a justice, not just because of his past actions but because of his shameless public lying.

Here is what Kavanaugh has said about the allegation: “I categorically and unequivocally deny this allegation. I did not do this back in high school or at any time.” That’s pretty clear: Christine Ford is lying or delusional. According to Kavanaugh, she has invented a false story about him. It’s a story she confessed to her husband years ago, and a story that passed a polygraph test. But Kavanaugh says it didn’t happen and that Ford is smearing him. If Ford is telling the truth, then what Kavanaugh is doing right now is unconscionable. Not only did he attack her in high school, but he would be publicly trying to falsely brand her delusional or a liar. It would literally be “insult to injury.” No person with a shred of conscience could vote to confirm such a man to the Supreme Court.

Kavanaugh’s denial means that assessing the truth or falsity of the allegation is now critical to his confirmation. If Kavanaugh had admitted the truth of the allegation and apologized sincerely, talking about what a pig he had been in high school, then the “well, this was a long time ago” crowd would be able to argue that we should focus far more on his hideous record as a jurist than his high school sexual assault. Now, however, there is no choice at all: The question of whether Brett Kavanaugh did this is all-important, because it’s also the question of whether Brett Kavanaugh is trying to slander an assault victim and mislead the Senate.

To reiterate: This is not just about the crime, and it is not just about the past. Never mind “this was a long time ago”: If there is credible evidence that he did this, then he does not belong on the court or in any position of power whatsoever, because he is lying. We don’t need to resolve the question of how important juvenile crimes are in order to conclude that. I’m sorry to repeat myself here, but I think this is very important and the point isn’t being made clearly enough. If you think the allegation is true, then Kavanaugh is unfit for office, regardless of how long ago this was.

by Nathan J. Robinson, Current Affairs |  Read more:
Image: uncredited
[ed. See also: After the Kavanaugh Allegations, Republicans Offer a Shocking Defense: Sexual Assault Isn’t a Big Deal]

Liberty, Security, and Iron Cages

I knew my school would put up prison bars sooner or later. It had been too free to last. I haven’t been back in ten years, but I wasn’t shocked when a friend showed me photos of what it looks like now: all around our once wide-open campus, there are bars and metal security gates. In my day, you could walk on and off as you pleased (and we did). No locked doors could keep you out; it was like a college campus. Now, you have to pass through one of the few official entrances, no doubt manned by security personnel.

I doubt there was any public opposition to putting iron bars around the campus. In fact, I’m sure it was applauded: in my hometown of Sarasota, the school board has frantically been spending millions on “long-overdue” security measures at all of its schools, making sure nobody can just walk into a school and every visitor is tracked and registered. This just makes sense, post-Parkland. At Sarasota High School, there have been long debates about how to close off the last remaining way that the campus can be freely accessed from the street: it’s an intolerable risk, everyone seems to think, not to have a barricade.

I don’t share this instinct. I am horrified by it, actually. The fact that everyone thinks it perfectly reasonable to build a gigantic cage around the school, that they think this is so sensible and necessary that nobody could possibly see anything wrong with it, suggests to me a world gone completely insane. I look at the black barriers around my own Pine View School and I see what is quite obviously a dystopia. We were free, and now the students are behind bars. We used to wander wherever we chose. Now you need to get permission. How can anyone look at that and not be disturbed by it? How could anyone watch them building the barriers and not scream “Stop! What are you doing? This is a school, not a fortress!”

Of course, to the extent anyone was disturbed to watch the gates go up initially, their feelings will subside soon enough. Human beings can get used to pretty much anything, which is one of the reasons terrible things happen and nobody notices they’re abnormal. And soon there will be generations of students who don’t even remember when it wasn’t caged. They won’t even be able to imagine such a thing. A world without the security doors would be inconceivable. In fact, the above photos probably don’t look nearly as disturbing to you as they do to me. You can’t see what I see, because you never saw it differently. I see a path that used to be traveled freely, a place I spent nearly ten years wandering around doing whatever I felt like, hideously deformed with bars and gates. You just see a fence, like any other fence. You might even think I sound demented.

I don’t know. It’s very hard to convey what this means to me without sounding crazy, and that’s what worries me. Increased security measures are so rational that they seem inevitable. School shootings are so awful that we’d be crazy not to put in metal detectors and hire an army of guards and give the teachers guns and build a giant wall. And yet to me it feels so, so wrong. I can’t easily argue against it, but I feel it just mustn’t be allowed to happen. It’s partly because I experienced incredible freedom when I was young, and I know there is nothing like it, and I can’t accept that future students won’t get to have it, because that will mean the world is getting worse, and we have to stop the world from getting worse. Surely the gates are just temporary. Surely we’re all committed to tearing them down eventually, at least. But I know they’re not. Once those fences go up, they never, ever come down. Security measures only ever heighten. They do not get relaxed.

I should mention that I do also think this is a stupid response to the problem of shootings. We are all very familiar with mass shootings, because they are so horrifying and seem to occur so often. As a factual matter, however, students in public schools are not really at much risk. In the 20 years since Columbine, there have been half a dozen shootings with multiple fatalities at elementary, middle, and high schools in the United States. That’s half a dozen too many, obviously. But they are not a problem that justifies turning every school in the country into an armed compound. In fact, many of them could have been prevented if we were committed to sensible gun policy and had a school system that was capable of detecting and dealing with troubled students. The Parkland shooter had been reported to police dozens and dozens of times, and had openly made threats to shoot up the school. That was where the failure was, and that’s what needs to be fixed. The Sandy Hook shooter should never have had access to heavy weaponry. By the time these people get to the schoolhouse, we’ve already failed.

In fact, many security measures on campus are futile. The only way short of an outright total surveillance state to solve these problems is through prevention. The security gates on Pine View’s campus, for example, are utterly useless. Handguns fit in backpacks, and many of these shootings are conducted by students. Unless you commit to putting every student’s possessions through a metal detector every morning (as some schools do), a Parkland situation is still perfectly plausible. (Also, Pine View’s fence might make students less secure. It’s easy for a determined perpetrator to shimmy over, but having the whole place surrounded by a cage, with only a few points of exit, makes it far more difficult for students to flee in an emergency.)

I honestly don’t think the building of gates comes out of a sober assessment of how to actually prevent school shootings. It’s purely reactive: something horrible happened, thus we must have new security. But another thing that disturbs me is that in the “cost-benefit” calculus, “freedom” appears essentially nowhere. The old phrase is that whoever gives up a lot of liberty for a bit of security deserves neither. But it so often feels like people will give up all of their liberty for even the appearance of security. Hardly anyone cares about the little unquantifiable things, like how it felt to be a student that a school that respected its pupils enough to give them complete liberty.

The sociologist Max Weber is associated with the idea of the “iron cage” of rationality: there is a kind of logic that imprisons us and determines our thinking. Capitalism creates an ideological iron cage: if something cannot justify itself economically, it does not have value. Security is similar: there’s no way to argue against locking down the schools; it seems somehow like it must occur because it’s just perfectly rational. In a newspaper article about Sarasota High School’s lock-down measures, I saw an administrator say something like “Well, a school has to be able to keep track of everyone who enters and exits campus.” The fact that that statement isn’t controversial, that it seems obvious: that’s the iron cage. Does a school have to be able to keep track of everyone? Couldn’t everyone just come and go? A teacher has to take attendance, of course. But it’s strange how many people can accept as an unquestionable assumption something that was never true until recently: that everyone must be kept track of, that nothing must be unknown. All of this seems to happen without anybody really willing it: reason travels a path that leads inescapably to the security state.

by Nathan J. Robinson, Current Affairs |  Read more:
Image: uncredited

Thursday, September 20, 2018


Adrian Tomine, Fourth Wall
via:

St. Vincent

Senators Unveil Legislation To Protect Patients Against Surprise Medical Bills

With frustration growing among Americans who are being charged exorbitant prices for medical treatment, a bipartisan group of senators Tuesday unveiled a plan to protect patients from surprise bills and high charges from hospitals or doctors who are not in their insurance networks.

The draft legislation, which sponsors said is designed to prevent medical bankruptcies, targets three key consumer concerns:
  • Treatment for an emergency by a doctor who is not part of the patient’s insurance network at a hospital that is also outside that network. The patients would be required to pay out-of-pocket the amount required by their insurance plan. The hospital or doctor could not bill the patient for the remainder of the bill, a practice known as “balance billing.” The hospital and doctor could seek additional payments from the patient’s insurer under state regulations or through a formula established in the legislation.
  • Treatment by an out-of-network doctor or other provider at a hospital that is in the patient’s insurance network. Patients would pay only what is required by their plans. Again, the doctors could seek more payments from the plans based on formulas set up by state rules or through the federal formula.
  • Mandated notification to emergency patients, once they are stabilized, that they could run up excess charges if they are in an out-of-network hospital. The patients would be required to sign a statement acknowledging that they had been told their insurance might not cover their expenses, and they could seek treatment elsewhere.
“Our proposal protects patients in those emergency situations where current law does not, so that they don’t receive a surprise bill that is basically uncapped by anything but a sense of shame,” Sen. Bill Cassidy (R-La.) said in his announcement about the legislation.

Kevin Lucia, a senior research professor at Georgetown University’s Center on Health Insurance Reforms who had not yet read the draft legislation, said the measure was aimed at a big problem.

“Balance billing is ripe for a federal solution,” he said. States regulate only some health plans and that “leaves open a vast number of people that aren’t covered by those laws.”

Federal law regulates health plans offered by many larger companies and unions that are “self-funded.” Sixty-one percent of privately insured employees get their insurance this way. Those plans pay claims out of their own funds, rather than buying an insurance policy. Federal law does not prohibit balance billing in these plans.

Cassidy’s office said, however, that this legislation would plug that gap.

In addition to Cassidy, the legislation is being offered by Sens. Michael Bennet (D-Colo.), Chuck Grassley (R-Iowa), Tom Carper (D-Del.), Todd Young (R-Ind.) and Claire McCaskill (D-Mo.).

Cassidy’s announcement cited two recent articles from Kaiser Health News and NPR’s “Bill of the Month” series, including a $17,850 urine test and a $109,000 bill after a heart attack.

In a statement to Kaiser Health News, Bennet said, “In Colorado, we hear from patients facing unexpected bills with astronomical costs even when they’ve received a service from an in-network provider. That’s why Senator Cassidy and I are leading a bipartisan group of senators to address this all-too-common byproduct of limited price transparency.”

Emergency rooms and out-of-network hospitals aren’t the only sources of balance bills, Lucia said. He mentioned that both ground and air ambulances can leave patients responsible for surprisingly high costs as well.

by Rachel Bluth, Kaiser Health News | Read more:
Image: via
[ed. Congress? Advancing legislation that would actually help normal, non-rich people (vs. armies of healthcare industry lobbyists)? This makes too much sense not to have a catch. We'll just have to wait and see. It could be nothing more than pre-election virtue signalling, but maybe someone is actually serious. I'm inclined to think the former.]