Who Cares? On Nags, Martyrs, the Women Who Give Up, and the Men Who Don’t Get It

“Just let me do it,” I told Rob as I watched him struggle to fold our daughter’s fitted sheet shortly after he took over laundry duty. It’s a phrase I’m sure he’s heard from me countless times, and even when I’m not saying it out loud, I’ve often implied it with a single you’re-doing-it-wrong stare. I cannot pretend that I have not played a part in creating such a deep divide in the emotional labor expectations in my home. I want things done a certain way, and any deviation from my way can easily result in me taking over. If the dishwasher is loaded wrong, I take it back on instead of trying to show my husband how to load it. If the laundry isn’t folded correctly, I’ll decide to simply do it myself. On occasion I have found myself venting with friends that it is almost as if our male partners are purposefully doing things wrong so they won’t have to take on more work at home.

While I don’t think this has been the case in my own home, for some women this is a reality. A 2011 survey in the UK found that 30 percent of men deliberately did a poor job on domestic duties so that they wouldn’t be asked to do the job again in the future. They assumed that their frustrated partners would find it easier to do the job themselves than deal with the poor results of their half-hearted handiwork. And they were right. A full 25 percent of the men surveyed said they were no longer asked to help around the house, and 64 percent were only asked to pitch in occasionally (i.e., as a last resort).

Even if men aren’t consciously doing a poor job to get out of housework, their lackluster “help” still frustrates. A similar survey conducted by Sainsbury’s in the UK found that women spent a whole three hours per week, on average, redoing chores they had delegated to their partners. The list where men fell short left little ground uncovered: doing the dishes, making the bed, doing the laundry, vacuuming the floors, arranging couch cushions, and wiping down counters were all areas of complaint. Two-thirds of the women polled felt convinced that this was their partner’s best effort, so perhaps it’s not surprising that more than half didn’t bother “nagging” them to do better. They simply followed their partners around and cleaned up after them.

The ways in which women cling to maintaining rigid standards is what sociologists call “maternal gatekeeping,” and what we refer to, pre-baby, as simply “perfectionism.” We actively discourage men from becoming full partners at home, because we truly believe we can do everything better, faster, more efficiently than everyone else. Because we are the ones who control all the aspects of home and life organization for our families and especially our children, we become convinced that our way is the only way. We are hesitant to adjust our personal expectations, especially because we have put so much work into caring about our household systems. We’ve carefully considered how to best keep everyone comfortable and happy, so it seems natural that everyone should conform to the best-thought-out plan available: ours.

This thinking is consistently reinforced by a culture that tells us that we should hold ourselves to this higher standard. That if we don’t strive toward perfectionism, we are failing as women. We feel as if we are letting our families down, we are letting womankind down, we are letting ourselves down when we don’t perform emotional labor in the most intense possible way. Yet this level of perfectionism can be exhausting, and it dissuades those men who would help from even trying. Instead of assuming that men can hold down the fort while we are out of town, we leave a veritable handbook on how they should best care for their own children. Dufu writes in her book that she once wrote a list for her husband titled “Top Ten Tips for Traveling with Kofi,” which included, among other things, a reminder to feed their child. I have left freezer meals and detailed instructions for my husband on how to feed himself when I am out of town so he doesn’t wander into the grocery store and spend $200 on two days’ worth of food, instead of involving him in the process of meal planning so he could take it on himself. It’s not just society but also my maternal gatekeeping that contributes to the mental load I’ve taken on. I don’t leave room for mistakes, and because of that, I don’t leave room for progress. Then again, when I do, I’ve been let down.

***

We had both been warned by my oral surgeon that my wisdom tooth extraction was likely going to put me down for a few days, but instead of the intense prep I would normally do ahead of time, I assumed my husband would take over what I couldn’t do. He’d been slowly but surely picking up his share of emotional labor since my Harper’s Bazaar article had appeared three months earlier. He seemed ready to take on the type of full day I would have put in before he was laid off. The day of the surgery, I felt mostly fine immediately afterward. I took my pain pills but was moving around, had minimal swelling, and spent the evening going over the plans for the next day with Rob. I had worked with our son on his homework, but there was still one page that needed to be finished in the morning. He was allowed to bring in a Game Boy for the special “electronics day” their class had earned. Our daughter needed to go to preschool at 8:30 a.m., but her needs were simple — get her dressed, brush her hair, fill her water bottle. Our son had the option of hot lunch if the morning got out of hand, and I encouraged Rob to use it but just remember to pack him a snack. He had been around and helping with the morning routine for weeks since his layoff. I assumed he could do it alone just this once, though we both thought he wouldn’t have to. After all, I was fine.

Well, I was fine until 11:45 p.m., when I woke up crying and frantically scrambling for pain pills. The left side of my face had swollen to the size of a baseball, and I spent hours awake in excruciating pain. When morning came, the situation was even worse, and I could barely function. Rob woke me at 8:30 a.m. to tell me he was taking our daughter to school along with our youngest. Our six-year-old would have to be walked to school in half an hour. I set an alarm on my phone in case I dozed off, and our son came into the room and talked with me. I asked him if he had everything ready — his lunch, his clothes, his homework. He said yes, and I lay back relieved. I was barely able to get myself out of bed to walk him to school and found myself resenting the fact that his dad hadn’t thought to take all of them to drop off like I had done when he was working. My face throbbed with pain as I slipped on shoes and a jacket, then instructed our son to do the same. Then I came into the living room at the moment we had to leave and realized that my six-year-old had been wrong. His homework hadn’t been done or checked. His lunch hadn’t been packed. He didn’t have a snack or fresh water. He didn’t have an electronic device to bring to school for their special day. Now not only was I suffering the guilt of not getting him ready, but he would have to suffer the consequences of no one helping him. He would have to stay in at recess to complete his homework. He wouldn’t get the thirty minutes of electronic time his friends would have. I was able to grab an orange and throw it in his backpack for a snack, but it was too late for the rest of it. Even though my husband had been the one on duty for the morning, I was the one left with the guilt of taking my son to school ill prepared. I felt like I should have better prepared my husband to take over for me. I should have implemented my system better. If letting Rob take over was going to mean my kids’ needs falling through the cracks, I wasn’t here for it. I needed a better option, and that better option seemed to be doing things my way.

When I later brought up the morning mishap with Rob, he felt guilty also, but not in the way I had. He was able to acknowledge the problem, say he was sorry, and move on. He didn’t beat himself up over his mistake in the way I was beating myself up for not hovering more diligently. Parenting mistakes aren’t a moral failing for him like they are for me. Dads get the at-least-he’s-trying pat on the back when people see them mess up. Moms get the eye rolls and judgment. Everything that happened that morning was still “my fault,” because I wasn’t living up to the standard I should set for myself as a mom: the standard of perfection.

I was still expected to be the one in charge, even when I was incapacitated, because isn’t that just what moms are supposed to do? He wasn’t expected to have the morning routine locked down. He was still a dad — still exempt from judgment. Despite now being the at-home parent, at least for the time being, it still wasn’t his primary job or responsibility. It was mine, just as it had always been. I was trying to treat my husband as an equal partner. I was trying to let go of control, or adjust my expectations, or compromise my standards, but we kept coming up short. We kept missing that elusive balance, and more frustratingly, I was the only one who felt bad about it. I was the one who cared.

by Gemma Hartley, Longreads |  Read more:

Image: Katie Kosma

[ed. Yikes.]

Beijing to Judge Every Resident Based on Behavior by End of 2020

China’s plan to judge each of its 1.3 billion people based on their social behavior is moving a step closer to reality, with Beijing set to adopt a lifelong points program by 2021 that assigns personalized ratings for each resident.

The capital city will pool data from several departments to reward and punish some 22 million citizens based on their actions and reputations by the end of 2020, according to a plan posted on the Beijing municipal government’s website on Monday. Those with better so-called social credit will get “green channel” benefits while those who violate laws will find life more difficult.

The Beijing project will improve blacklist systems so that those deemed untrustworthy will be “unable to move even a single step,” according to the government’s plan. Xinhua reported on the proposal Tuesday, while the report posted on the municipal government’s website is dated July 18.

China has long experimented with systems that grade its citizens, rewarding good behavior with streamlined services while punishing bad actions with restrictions and penalties. Critics say such moves are fraught with risks and could lead to systems that reduce humans to little more than a report card.

Ambitious Plan

Beijing’s efforts represent the most ambitious yet among more than a dozen cities that are moving ahead with similar programs.

Hangzhou rolled out its personal credit system earlier this year, rewarding “pro-social behaviors” such as volunteer work and blood donations while punishing those who violate traffic laws and charge under-the-table fees. By the end of May, people with bad credit in China have been blocked from booking more than 11 million flights and 4 million high-speed train trips, according to the National Development and Reform Commission.

According to the Beijing government’s plan, different agencies will link databases to get a more detailed picture of every resident’s interactions across a swathe of services. The proposal calls for agencies including tourism bodies, business regulators and transit authorities to work together.

The tracking of individual behavior in China has become easier as economic life moves online, with apps such as Tencent’s WeChat and Ant Financial’s Alipay a central node for making payments, getting loans and organizing transport. Accounts are generally linked to mobile phone numbers, which in turn require government IDs.

by Claire Che, David Ramli, and Dandan Li, Bloomberg | Read more:
Image: Anthony Kwan/Bloomberg

Jean-Michel Basquiat, Two heads on Gold
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Hieronymus Bosch, The Garden of Earthly Delights (detail)
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Thinking About Thinking - the CIA Guide

"When we speak of improving the mind we are usually referring to the acquisition of information or knowledge, or to the type of thoughts one should have, and not to the actual functioning of the mind. We spend little time monitoring our own thinking and comparing it with a more sophisticated ideal."

When we speak of improving intelligence analysis, we are usually referring to the quality of writing, types of analytical products, relations between intelligence analysts and intelligence consumers, or organization of the analytical process. Little attention is devoted to improving how analysts think.

Thinking analytically is a skill like carpentry or driving a car. It can be taught, it can be learned, and it can improve with practice. But like many other skills, such as riding a bike, it is not learned by sitting in a classroom and being told how to do it. Analysts learn by doing. Most people achieve at least a minimally acceptable level of analytical performance with little conscious effort beyond completing their education. With much effort and hard work, however, analysts can achieve a level of excellence beyond what comes naturally.

Regular running enhances endurance but does not improve technique without expert guidance. Similarly, expert guidance may be required to modify long-established analytical habits to achieve an optimal level of analytical excellence. An analytical coaching staff to help young analysts hone their analytical tradecraft would be a valuable supplement to classroom instruction.

One key to successful learning is motivation. Some of CIA's best analysts developed their skills as a consequence of experiencing analytical failure early in their careers. Failure motivated them to be more self-conscious about how they do analysis and to sharpen their thinking process. (...)

Herbert Simon first advanced the concept of "bounded" or limited rationality. Because of limits in human mental capacity, he argued, the mind cannot cope directly with the complexity of the world. Rather, we construct a simplified mental model of reality and then work with this model. We behave rationally within the confines of our mental model, but this model is not always well adapted to the requirements of the real world. The concept of bounded rationality has come to be recognized widely, though not universally, both as an accurate portrayal of human judgment and choice and as a sensible adjustment to the limitations inherent in how the human mind functions.

Much psychological research on perception, memory, attention span, and reasoning capacity documents the limitations in our "mental machinery" identified by Simon. Many scholars have applied these psychological insights to the study of international political behavior. A similar psychological perspective underlies some writings on intelligence failure and strategic surprise.

This book differs from those works in two respects. It analyzes problems from the perspective of intelligence analysts rather than policymakers. And it documents the impact of mental processes largely through experiments in cognitive psychology rather than through examples from diplomatic and military history.

A central focus of this book is to illuminate the role of the observer in determining what is observed and how it is interpreted. People construct their own version of "reality" on the basis of information provided by the senses, but this sensory input is mediated by complex mental processes that determine which information is attended to, how it is organized, and the meaning attributed to it. What people perceive, how readily they perceive it, and how they process this information after receiving it are all strongly influenced by past experience, education, cultural values, role requirements, and organizational norms, as well as by the specifics of the information received.

This process may be visualized as perceiving the world through a lens or screen that channels and focuses and thereby may distort the images that are seen. To achieve the clearest possible image of China, for example, analysts need more than information on China. They also need to understand their own lenses through which this information passes. These lenses are known by many terms--mental models, mind-sets, biases, or analytical assumptions. (...)

Not enough training is focused in this direction--that is, inward toward the analyst's own thought processes. Training of intelligence analysts generally means instruction in organizational procedures, methodological techniques, or substantive topics. More training time should be devoted to the mental act of thinking or analyzing. It is simply assumed, incorrectly, that analysts know how to analyze. This book is intended to support training that examines the thinking and reasoning processes involved in intelligence analysis.

As discussed in the next chapter, mind-sets and mental models are inescapable. They are, in essence, a distillation of all that we think we know about a subject. The problem is how to ensure that the mind remains open to alternative interpretations in a rapidly changing world.

The disadvantage of a mind-set is that it can color and control our perception to the extent that an experienced specialist may be among the last to see what is really happening when events take a new and unexpected turn. When faced with a major paradigm shift, analysts who know the most about a subject have the most to unlearn. This seems to have happened before the reunification of Germany, for example. Some German specialists had to be prodded by their more generalist supervisors to accept the significance of the dramatic changes in progress toward reunification of East and West Germany.

The advantage of mind-sets is that they help analysts get the production out on time and keep things going effectively between those watershed events that become chapter headings in the history books.

A generation ago, few intelligence analysts were self-conscious and introspective about the process by which they did analysis. The accepted wisdom was the "common sense" theory of knowledge--that to perceive events accurately it was necessary only to open one's eyes, look at the facts, and purge oneself of all preconceptions and prejudices in order to make an objective judgment.

Today, there is greatly increased understanding that intelligence analysts do not approach their tasks with empty minds. They start with a set of assumptions about how events normally transpire in the area for which they are responsible. Although this changed view is becoming conventional wisdom, the Intelligence Community has only begun to scratch the surface of its implications.

If analysts' understanding of events is greatly influenced by the mind-set or mental model through which they perceive those events, should there not be more research to explore and document the impact of different mental models?

The reaction of the Intelligence Community to many problems is to collect more information, even though analysts in many cases already have more information than they can digest. What analysts need is more truly useful information--mostly reliable HUMINT from knowledgeable insiders--to help them make good decisions. Or they need a more accurate mental model and better analytical tools to help them sort through, make sense of, and get the most out of the available ambiguous and conflicting information.

by Richards J. Heuer, Jr., U.S. Central Intelligence Agency |  Read more:

Subprime Rises: Credit Card Delinquencies Blow Through Financial-Crisis Peak at the 4,705 Smaller US Banks

In the third quarter, the “delinquency rate” on credit-card loan balances at commercial banks other than the largest 100 banks – so the delinquency rate at the 4,705 smaller banks in the US – spiked to 6.2%. This exceeds the peak during the Financial Crisis for these banks (5.9%).

The credit-card “charge-off rate” at these banks, at 7.4% in the third quarter, has now been above 7% for five quarters in a row. During the peak of the Financial Crisis, the charge-off rate for these banks was above 7% four quarters, and not in a row, with a peak of 8.9%

These numbers that the Federal Reserve Board of Governors reportedMonday afternoon are like a cold shower in consumer land where debt levels are considered to be in good shape. But wait… it gets complicated.

The credit-card delinquency rate at the largest 100 commercial banks was 2.48% (not seasonally adjusted). These 100 banks, due to their sheer size, carry the lion’s share of credit card loans, and this caused the overall credit-card delinquency rate for all commercial banks combined to tick up to a still soothing 2.54%.

In other words, the overall banking system is not at risk, the megabanks are not at risk, and no bailouts are needed. But the most vulnerable consumers – we’ll get to why they may end up at smaller banks – are falling apart:

Credit card balances are deemed “delinquent” when they’re 30 days or more past due. Balances are removed from the delinquency basket when the customer cures the delinquency, or when the bank charges off the delinquent balance. The rate is figured as a percent of total credit card balances. In other words, among the smaller banks in Q3, 6.2% of the outstanding credit card balances were delinquent.

So what’s going on here?

The credit card business is immensely profitable, and so banks are willing to take some risks. It’s immensely profitable for three reasons:

• The fee the bank extracts from every transaction undertaken with its credit cards (merchant pays), even if the credit-card holder pays off the balance every month and never incurs any interest expense.
• The fees the bank extracts from credit card holders, such as annual fees, late fees, etc.
• The huge spread between the banks’ cost of funding and the interest rates banks charge on credit cards.

So how low is the banks’ cost of funding? For example, in its third-quarter regulatory filing with the SEC (10-Q), Wells Fargo disclosed that it had $1.73 trillion in total “funding sources.” This amount was used to fund $1.73 trillion in “earning assets,” such as loans to its customers or securities it had invested in.

This $1.73 trillion in funding was provided mostly by deposits: $465 billion in non-interest-bearing deposits (free money), and $907 billion in interest bearing deposits; for a total of $1.37 billion of ultra-cheap funding from deposits.

In addition to its deposits, Wells Fargo lists $353 billion in other sources of funding – “short-term and long-term borrowing” – such as bonds it issued.

For all sources of funding combined, so on the $1.73 trillion, the “total funding cost” was 0.87%. Nearly free money. Rate hikes no problem.

In Q3, Wells Fargo’s credit-card balances outstanding carried an average interest rate of 12.77%!

So, with its cost of funding at 0.87%, and the average interest rate of 12.77% on its credit card balances, Wells Fargo is making an interest margin on credit cards of 11.9 percentage points. In other words, this is an immensely profitable business – hence the incessant credit-card promos.

With credit cards, the US banking system has split in two.

The largest banks can offer the most attractive incentives on their credit cards (cash-back, miles, etc.) and thus attract the largest pool of applicants. Then they can reject those with higher credit risks – having not yet forgotten the lesson from the last debacle.

The thousands of smaller banks cannot offer the same incentives and lack the marketing clout to attract this large pool of customers with good credit. So they market to customers with less stellar credit, or with subprime-rated credit — and charge higher interest rates. 30% sounds like a deal, even if the customer will eventually buckle under that interest rate and will have to default.

That’s why banks take the risks of higher charge-offs: They’re getting paid for them! But at some point, it gets expensive. And if it takes a smaller bank to the brink, the FDIC might swoop in on a Friday evening and shut it down. No biggie. Happens routinely.

The real problem with credit cards isn’t the banks – credit card debt is not big enough to topple the US banking system. It’s the consumers, and what it says about the health of consumers.

The overall numbers give a falsely calming impression. Credit card debt and other revolving credit has reached $1.0 trillion (not seasonally adjusted). This is about flat with the prior peak a decade ago.

Since the prior peak of credit-card debt in 2008, the US population has grown by 20 million people, and there has been a decade of inflation and nominal wage increases, and so the overall credit card burden per capita is far lower today than it was in 2008 (though student loans and auto loans have shot through the roof). So no problem?

But this overall data hides the extent to which the most vulnerable consumers are getting into trouble with their credit cards, having borrowed too much at usurious rates. They’ll never be able to pay off or even just service those balances. For them, there is only one way out – to default.

The fact that this process is now taking on real momentum — as demonstrated by delinquency rates spiking at smaller banks — shows that the group of consumers that are falling apart is expanding. And these are still the good times, of low unemployment in a growing economy.

by Wolf Richter, Wolf Street |  Read more:
Image: Wolf Street

Open-Ended New Bill Criminalizes Whatever Black People Are Up To Right Now

WASHINGTON—Saying the measure would provide a substantial boon to police departments nationwide, members of the House Republican caucus introduced a bill Tuesday containing open-ended language that would criminalize whatever it is black people are up to right now. “This is a long-overdue piece of legislation that will help defend our country against the scourge of black people being in places and doing things,” said Rep. Steve King (R-IA) of H.R. 8164, which would penalize black Americans with a minimum of five years in prison and fines of up to $750,000 for any activity they happen to be engaged in whenever law enforcement arrives. “This measure seeks to bring an end to overly permissive laws that, by allowing black people to simply hang around and do different stuff at will, places an undue burden on the police officers who want to arrest them and throw them in jail. While I believe this bill represents a good first step, we of course also need to enact legislation that outlaws anything Hispanics and Muslims might be doing at the moment.” At press time, sources confirmed House GOP leaders had called Capitol Police to report several African American representatives engaged in the suspicious activity of voting against the bill.

by The Onion |  Read more:
Image: uncredited

Ajejandro De La Garza

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The Decline and Fall of the Zuckerberg Empire

"It’s the public outrage that should be most worrying to Facebook. Other tech giants have managed to escape the opprobrium directed at Facebook because they have obviously useful services. Amazon delivers things to your house. Google helps you find things online. Apple sells actual objects. Facebook … helps you get into fights? Delivers your old classmates’ political opinions to your brain?"

by Max Read, Intelligencer |  Read more:

Image: David Paul Morris/Bloomberg via Getty Images

How To Sound Like Tom Petty Using Pedals and Guitars
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The Japanese Chain That Wants You to Fish for Your Dinner

According to a philosophy known as “compassionate carnivorism,” the most ethical way to eat animals is to kill them yourself, as humanely as possible, thereby fully acknowledging their sacrifice for your sustenance. Does shooting fish in a barrel count? There aren’t barrels, per se, at the first U.S. outpost of Zauo, a novelty restaurant chain with thirteen locations in Japan, and there certainly aren’t guns, but there are open tanks crowded with live fish, and dinky little rods with which you, the diner, are meant to catch them. (...)

No matter how you feel about eating fish, eating at Zauo is a disaster. Where to begin? The endearing Japanese ritual of restaurant staff emphatically greeting all customers feels perverted here: every time someone catches a fish, employees are required to cheer, chant, and strike a taiko drum, resulting in an endless dystopian cacophony. “It’s so extra, but it’s cute!” a hostess said unconvincingly, as she led me to my table on the second floor, which is designed to look like a Japanese fishing boat, suspended in air over the first floor. In order to fish, you have to “apply for a license,” which turns out to mean signing a liability waiver, releasing Zauo Inc. from responsibility if you lose an eye to an errant hook, or drop your phone into a tank. This is not to say that phone use is discouraged at this Instagrammers’ Atlantis. “It’s like Color Factory with murder,” quipped one diner. A selfie-happy gentleman succumbed to the fantasy, hook, line, and sinker. “If this were the fourteen-hundreds, I’d be a hero!” he crowed to his companion. “I’d feed our whole village on a single fish.”

But the restaurant’s greatest offense, to both predator and prey, is the food. In an episode of the Japanese reality show “Terrace House,” a group of characters visit a Zauo in Japan, in search of lobster and mackerel, and make it look almost like eating at a hip, charming fish market. In New York, it feels like getting fleeced on whatever was left over when the market closed. Tables are set with stacks of cards offering descriptions of each ordinary-sounding yet steeply priced fish and crustacean, along with options for how they can be served; once you’ve made your catch, it’s whisked away to the kitchen to be prepared to your specifications.

The card for the rainbow trout—the cheapest fish on the menu, at thirty-eight dollars (forty-five if you opt not to catch it yourself)—reported that such a creature inhabits “rivers with low temperatures, high speeds, and high levels of oxygen”; the one I was about to eat, a server admitted, came from a farm in Pennsylvania. Did it have “a simple flavor with a touch of sweetness”? It was hard to say after half of it had been simmered in soy sauce to a bony mush, the other half grilled in salt until chewy and served with its head still on, propped up with a wooden stake like a Big Mouth Billy Bass about to sing. Muddy-tasting flounder sashimi had a texture that might be best described as “rigor mortis.” And pity the lobster whose succulent flesh is smothered in half an inch of puffy tempura batter.

by Hannah Goldfield, New Yorker | Read more:
Image: David Williams

ContraPoints: What's Wrong With Capitalism (Part 1)

[ed. See also: What's Wrong with Capitalism (Part 2)]

Ping An Good Doctor: Unstaffed, AI-assisted clinics in China

Japanese billionaire Masayoshi Son, the founder and chief executive of technology conglomerate SoftBank Group Corp, is known for making solid bets in China’s hi-tech sector. Around 18 years ago, Son’s company invested US$20 million in a small Chinese online retail platform that rapidly grew to become e-commerce giant Alibaba Group Holding.

Son in July invited the heads of fast-rising Chinese companies Ping An Good Doctor and Didi Chuxing to a party he hosted in Tokyo, in a testament to how far these two firms have grown since SoftBank invested in them.

Wang Tao, the founder, chairman and chief executive of Ping An Good Doctor, acknowledged Son’s contribution amid the Hong Kong-listed online health care provider’s efforts to innovate and extend its operations outside the mainland.

“Mr Son helped us a lot in our international expansion,” said Wang in an interview with the South China Morning Post on the sidelines of the fifth World Internet Conference held earlier this month in Wuzhen, a town in China’s eastern coastal province of Zhejiang.

The overseas foray by Ping An Good Doctor, which is formally known as Ping An Healthcare and Technology Co, is part of its major expansion programme after raising US$8.5 billion in proceeds from its initial public offering in Hong Kong in May.

That programme is led by the development of an extensive network of unstaffed, artificial intelligence-powered clinics on the mainland. The capabilities of this clinic were shown at the conference in Wuzheng.

“We plan to build hundreds of thousands of these unstaffed clinics across the country in three years,” Wang said.

Each clinic, which is about the size of a traditional telephone booth, enables users to consult a virtual “AI doctor” that collects health-related data through text and voice interactions. After the AI consultation, the information gathered is reviewed by a human doctor who then provides the relevant diagnosis and prescription online. Customers can buy their medicine from the smart drug-vending machine inside the clinic.

Ping An Good Doctor’s AI clinic expansion has come amid Beijing’s commitment to drive its “Healthy China” strategy. In April, China’s State Council issued a statement to accelerate the country’s online health care market by establishing proper service systems, a support network and regulatory framework.

That domestic market is expected to reach 100 billion yuan (US$14.4 billion) by 2025, up from 15 billion yuan last year, according to estimates by Frost & Sullivan.

Founded in 2014, Ping An Good Doctor was spun off from the Ping An Insurance Group and operates the biggest online health care platform on the mainland, with 228 million registered users and 48.6 million monthly active users as of June 30.

Its Good Doctor smartphone app, which was launched in 2015, provides diagnosis, treatment and online appointment booking. It also enables users to communicate with health care professionals through text, photos, and video. The app has a database of articles on health care and supports a microblog-style discussion forum on health-related topics. There is also an online store that sells medicine, health care products, cosmetics and gift vouchers for medical services.

The company has described its operations as a “closed loop health care ecosystem”, which enables users to conveniently get medical consultations and drug purchases online, as well as offline follow-up medical treatment.

The planned AI-enabled clinics, each of which costs 30,000 yuan to build, would help further expand Ping An Good Doctor’s reach in the mainland’s growing internet health care market.

by Yingzhi Yang, South China Morning Post |  Read more:

Image: Reuters

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Well Played

Video games have been around as a form of mass culture for just over 40 years, but only recently have they become so prevalent and so embedded in our lives — socially, politically, economically — that they could be fully taken for granted. In spring 2018, Fortnite reached a level of total cultural saturation in the U.S. that’s usually reserved for TV shows, movies, or Harry Potter. The game appears in virtually every classroom, bus stop, and teenage bedroom in the country and has achieved a level of ubiquity that sees professional athletes and pop stars appear on livestreams with star gamers, and teens doing the floss while they wait at crosswalks.

In the past, even as video games steadily wove their way deeper into the fabric of American culture, they tended to breach the national consciousness only as crazes (Pac-Man Fever) or controversies (the graphic violence of Doom or Grand Theft Auto). Video games were covered as a specialist hobby, and when a game would spark a moral panic, people in gaming circles would more or less accurately point out that the vast majority of people talking about games had never played any and had no idea what they were about. In other words, the rare moments when games become noteworthy also reinforced their marginality — and the subcultural prestige of gamers.

But lately the grounds have shifted. It’s becoming increasingly indisputable that video games are just a part of mainstream American life, an established cultural medium in their own right, as central as any of the other major entertainment industries. The money doesn’t lie: In 2014, the video game industry was making more money annually than the film and music industries combined. Last year the industry was valued at $116 billion, putting it in the same ballpark as global sports revenue, which is estimated between $130 billion and $150 billion. If growth patterns continue, video games will eclipse that by 2020.

Video games are often seen as a subdevelopment in the broader revolutions in information and communications technology that have marked the “digital age.” And while games have played a crucial role in driving mass adoption and affection for phones and techno-culture more generally, they have also superseded cinema and TV to be the dominant visual medium of our time.

And so games are increasingly breaking through into mainstream discourse. The rise of Fortnite is illustrative: It has become massively popular without controversy or even much moral panic beyond some pro forma “this new thing teens like, surely it’s bad?!?” coverage. The fact of Fortnite’s game-ness is rarely mentioned: that there would be such a hubbub over a video game is not considered a story. With Fortnite, video games have achieved one form of full cultural maturity, namely, ubiquity to the point where mainstream media explanation is beside the point. Fortnite is not marginal nor is it being marginalized. It’s just a megahit cultural product, like a blockbuster movie or hit single.

Given video games’ newly taken for granted prominence, it’s imperative to analyze how they fit into the mainstream of contemporary economic practices and ideology. Why have video games emerged in this moment, growing as the earlier visual media forms have stagnated, losing audiences and drifting toward the margins of culture? What has the medium’s material role been under capitalism? How has it reflected or shaped the specific ways capitalism has developed since 1973, when the series of crises that would lead to the neoliberal era began? (Incidentally, the first mass-market video game, Pong, was released in 1972.)

by Vicky Osterweil, Real Life |  Read more:

Image: Viktor Timofeev

Rinzing Kelsang
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Opioid Nation

The National Institute on Drug Abuse estimates that 72,000 Americans died from drug overdoses in 2017, up from some 64,000 the previous year and 52,000 the year before that—a staggering increase with no end in sight. Most involved opioids.

A few definitions are in order. The term opioid is now used to include opiates, which are derivatives of the opium poppy, and opioids, which originally referred only to synthesized drugs that act in the same way as opiates do. Opium, the sap from the poppy, has been used throughout the world for thousands of years to treat pain and shortness of breath, suppress cough and diarrhea, and, maybe most often, simply for its tranquilizing effect. The active constituent of opium, morphine, was not identified until 1806. Soon a variety of morphine tinctures became readily available without any social opprobrium, used, in some accounts, to combat the travails and boredom of Victorian women. (Thomas Jefferson was also an enthusiast of laudanum, one of the morphine tinctures.) Heroin, a stronger opiate made from morphine, entered the market later in the nineteenth century. It wasn’t until the twentieth century that synthetic or partially synthetic opioids, including fentanyl, methadone, oxycodone (Percocet), hydrocodone (Vicodin), and hydromorphone (Dilaudid), were developed.

In 1996 a new form of oxycodone called OxyContin came on the market, and three recent books—Beth Macy’s Dopesick, Chris McGreal’s American Overdose, and Barry Meier’s Pain Killer—blame the opioid epidemic almost entirely on its maker, Purdue Pharma. OxyContin is formulated to be released more slowly and therefore lasts longer. The company claimed that the drug’s slow release would make it less addictive than ordinary oxycodone, since the initial euphoria—the high—would be muted. Based on this theory and little else, the FDA permitted OxyContin to contain twice the usual dose of oxycodone and carry on the label this statement: “Delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug.” (The FDA official who oversaw OxyContin’s approval later got a plum job at Purdue Pharma.)

The company launched an extraordinarily aggressive and successful marketing campaign to convince physicians that they had the holy grail of a nonaddictive opioid. It sent hundreds of sales representatives to doctors’ offices to tout OxyContin, and offered doctors dinners and trips to meetings at luxury resorts. And it paid more than five thousand doctors, pharmacists, and nurses to train as speakers to tour the country promoting OxyContin. But like all opioids, OxyContin is addictive. And soon enough, users found that they could crush the pills or dissolve the coating, then snort the drug like cocaine or inject it like heroin. Each pill would then become essentially an instantaneous double dose of oxycodone. (...)

The problem with these three books, and it’s a big one, is that they treat the Purdue story as though it were the whole story of the opioid epidemic. But OxyContin did not give rise to opioid addiction, although it jump-started the current epidemic. Heroin has been a common street drug ever since it was banned in 1924. Morphine has also been widely abused.

Nor would taking OxyContin off the market end the epidemic. The overwhelming majority of opioid deaths are caused not by OxyContin but by combinations of fentanyl, heroin, and cocaine, often brought in from China via Mexican cartels, and frequently taken along with benzodiazepines (such as Valium or Xanax) and alcohol. These drugs are cheaper and stronger, particularly fentanyl. Fentanyl was first synthesized in 1960, and soon became widely used as an anesthetic and powerful painkiller. It is legally manufactured and highly effective when used appropriately, often for short medical procedures such as colonoscopies. The illicit production and street use is relatively new, but it is now the main cause of most opioid-related deaths (nearly 90 percent in Massachusetts).

The steady increase in opioid deaths after OxyContin came on the market has been supplanted by a much faster increase starting around 2013, when heroin and fentanyl use increased dramatically. We now have two epidemics—the overuse of prescription drugs and the much more deadly and now largely unrelated epidemic of street drugs. By concentrating on the first, we are closing the barn door after the horse is long gone. (...)

The opioid epidemic, while horrifying, is still outweighed by alcohol deaths, which are also increasing, according to the Centers for Disease Control. Hampton writes, “If my first drug of choice came with a prescription, the second one, alcohol, was culturally embedded and used to celebrate at every turn of events.” In 2016, when there were 64,000 deaths in the US from the drug epidemic, there were 90,000 from alcohol (including accidents and homicides caused by inebriated people, as well as direct effects, mainly cirrhosis of the liver). Cigarette smoking is estimated to cause 480,000 deaths a year. I do not intend to minimize the opioid epidemic. Far from it. What I want to underscore is the differences in these three epidemics. Alcohol and cigarettes have no medical or practical uses of any kind. Yet we permit their use if regulated. In contrast, opioids do have medical uses, and they are important.

The opioid epidemic is usually seen as a supply problem. If we can interdict the supply of prescription opioids, the thinking goes, we can stanch the epidemic. But that is unlikely to work for two reasons. First, as I pointed out, this is no longer mainly an epidemic of prescription drugs but of street drugs. And second, it creates an onerous obstacle for doctors and outpatients who require pain treatment. More and more, they have to satisfy regulations expressly designed to restrict access to prescription opioids. Some make sense. For example, it’s reasonable to monitor opioid prescriptions to detect pill mills. It’s also reasonable to flag users who “doctor-shop,” that is, see several doctors at once to try to get multiple doses of opioids.

But other requirements are meant simply to inconvenience both doctors and patients until they give up. For example, in Massachusetts doctors must limit their first-time opioid prescriptions to seven days. That can be more than an inconvenience for ill patients in pain. Macy quotes a letter from a friend with severe back pain from scoliosis. “‘My life is not less important than that of an addict,’ my friend wrote,…explaining that her new practitioner requires her to submit to pill counts, lower-dose prescriptions, and more frequent visits for refills, which increase her out-of-pocket expense.” Even more serious is a new shortage of opioids for injection in cancer centers.

For physicians, who are already weighed down by innumerable bureaucratic requirements, these restrictions present one more hoop to jump through, and many simply won’t do it. Instead, they’ll send the patient away with some Advil and hope it does the trick, even though they know it probably won’t. The regulations are having their intended effect. In Massachusetts, opioid prescribing has decreased by 30 percent. Meanwhile, the epidemic of street drugs continues apace. McGreal raises the possibility that reducing access to prescription opioids might feed the demand for heroin. Macy quotes an addiction specialist who laments that “our wacky culture can’t seem to do anything in a nuanced way.”

by Marcia Angell, NY Review of Books |  Read more:

Image: Jerome Sessini/Magnum Photos

Porch Pirates

A PEMCO Insurance poll claims that roughly half of all Washington and Oregon residents have had a delivery stolen from their home.

Combined across Oregon and Washington, 48 percent of over 1,100 people polled said they’d had a package of some kind swiped from their residence.

This data seems to fall in line with a rash of package thefts that hit Seattle.

“There is an epidemic right now in our town of petty thievery, where people are emboldened,” said KIRO Radio’s Ron Upshaw back in October. “It’s a brazenness now that I have never seen.”

Additionally, Seattle and Portland are second and fifth respectively in Googles searches for “Amazon package stolen,” weighted by population and searches per capita by a packaging company known as Shorr.

Even with that being so, PEMCO’s poll also noted that 28 percent of respondents don’t do anything to protect against package theft. The most common measure taken by those who do came from the 38 percent of people who make sure someone is always home to receive deliveries.

For the rest, just 18 percent of people installed security technology, 15 percent “allocated a space for packages that is hidden or hard to see,” 14 percent use a neighbor or their workplace for deliveries, and 12 percent signed up for a “safe delivery service” that allows authorized shippers access inside of homes.

Known colloquially as “porch pirates,” many of these thieves have even been known to follow delivery trucks and grab a package shortly after it reaches its destination.

by My Northwest |  Read more:

Image: My Northwest

Sole and Despotic Dominion

> Thank you for contacting Disher technical support. My name is May and I am pleased to help you with your Disher Experience!

Are you human?

> That's a rather personal question!

Let me talk to a human

> I'd be happy to help you make your Disher Experience the very best one possible

Human

> One moment please! Have a great day!

> Thank you for contacting Disher technical support. My name is May and I am pleased to help you with your Disher Experience!

Are you human?

> Yes sir. I am a live human operator. I am based in Charlestown, Nevis, at Disher's own in-house support center. How may I help you?

My dishwasher won't wash my dishes

> Sir are you using Disher approved products from the Kitchen Store?

Yes

> Sir I show that you have purchased a family starter set of Burberry Gentility dishes with the optional entertaining expansion pack and a cocktail party upgrade from the Disher Dubai store in June 2024. Are these the dishes you are using in your Disher Speckless?

Yes. I left my parents' wedding china in storage because my last dishwasher wouldn't wash them

> Sir yes that is correct. To ensure food safety and the proper delivery of your Disher experience, your Speckless will not switch on if it detects unknown objects; only authorized Disher Kitchen Store products are certified for use with your Disher Speckless

I am using Disher dishes. The ones I bought in Dubai.

> Sir yes thank you. Please stand by while I investigate your account.

> THANK YOU FOR STANDING BY. WE AT DISHER VALUE YOUR TRUST AND STRIVE TO EARN IT EVERY DAY. IF YOU HAVE ANY COMMENTS, CONCERNS OR COMPLIMENTS ABOUT YOUR DISHER EXPERIENCE PLEASE LET US KNOW

> Sir thank you I am back. I see from your IP address and other telemetry that you are in Melstone, Montana. Is that correct?

Yes. I took a new job and got relocated here.

> Sir thank you I see your problem. Your dishes were sold for use within Shia territories in the Middle East and Asian regions. They are not authorized for use in the USA.

What? Are you crazy? They're Disher dishes, this is a Disher dishwasher!

> Sir I am sorry you are unhappy. However, I must correct you. Please allow me to offer this frequently asked question:

Q. ARE PRODUCTS BOUGHT IN FOREIGN KITCHEN STORES USABLE WITH MY DISHER SPECKLESS? 

A. NO. 

The trademarks and other intellectual property in the products sold by different Disher affiliated companies through the regional Kitchen Stores are licensed for use on a territory-by-territory basis. In many cases, different territorial licensors own the exclusive right to manufacture and distribute different brands in the Kitchen Store, and part of Disher's commitment to respecting international laws and intellectual property is our use of the sensors in Disher Speckless systems to optimize your Disher experience by ensuring that our devices do not violate these important contractual arrangements.

You're joking.

> Sir I'm afraid it's not a joke. Please allow me to offer this frequently asked question:

Q. MAY I BRING MY DISHER PRODUCTS FROM ONE TERRITORY TO ANOTHER? 

A. NO. 

Because the trademarks in Kitchen Store products are licensed on a territory-by-territory basis, you may not export them beyond their licensed territories. Taking Kitchen Store products across national borders may create criminal and civil liability for you, under global anti-counterfeiting treaties and national laws. Disher takes no responsibility for any legal problems you may incur as a consequence of exporting products from the Kitchen Store. At Disher, we have zero tolerance for counterfeiting.

Wait wait wait. WHAT? Counterfeits? I bought these in a Disher store! They're licensed product from your own store.

> Sir, I'm very sorry but Disher Dubai and Disher USA are separate firms with their own licensing agreements with Disher Worldwide. You should not have brought these products across an international border. Had they been detected at the customs checkpoint, you could have faced severe penalties.

What was I supposed to do? Sell them before leaving Dubai and buy another set in Montana?

> Sir your license agreement is nontransferable. Sale or other transfer of your Disher Kitchen Store purchases will result in their use in all Disher products being terminated. If you leave a territory, we recommend contacting an appropriate recycling center for safe disposal of your Kitchen Store purchases.

Look, May. I took this job in Montana. I work in shale gas and the company is providing my housing. I'm in the ass-end of nowhere here. Even if I could buy a new dishwasher without this crap in it, they wouldn't let me install it. I've just spent everything relocating halfway around the planet and now you're telling me to throw away my dishes and buy another set?

> Sir may I refer you to a frequently asked question?

by Cory Doctorow, Reason |  Read more:
Image: Shutterstock

Prince