Wednesday, December 21, 2011
Meet the 25 Most Viral People on the Internet
[ed. At least this week.]
Sometimes a story or idea goes viral because it's too big to be ignored. But more often it's because a single human being passes it along to an audience that's either massive, highly influential, or both. There aren't too many people who can do that. These are the ones who can. When they post something to a website, Twitter, or Facebook, it's almost assured of blowing up. Meet the 25 most viral voices on the Internet.
by Mat Honan, Gizmodo | Read more:
Sometimes a story or idea goes viral because it's too big to be ignored. But more often it's because a single human being passes it along to an audience that's either massive, highly influential, or both. There aren't too many people who can do that. These are the ones who can. When they post something to a website, Twitter, or Facebook, it's almost assured of blowing up. Meet the 25 most viral voices on the Internet.
by Mat Honan, Gizmodo | Read more:
The Long Slump and the Great Depression
It has now been almost five years since the bursting of the housing bubble, and four years since the onset of the recession. There are 6.6 million fewer jobs in the United States than there were four years ago. Some 23 million Americans who would like to work full-time cannot get a job. Almost half of those who are unemployed have been unemployed long-term. Wages are falling—the real income of a typical American household is now below the level it was in 1997.
We knew the crisis was serious back in 2008. And we thought we knew who the “bad guys” were—the nation’s big banks, which through cynical lending and reckless gambling had brought the U.S. to the brink of ruin. The Bush and Obama administrations justified a bailout on the grounds that only if the banks were handed money without limit—and without conditions—could the economy recover. We did this not because we loved the banks but because (we were told) we couldn’t do without the lending that they made possible. Many, especially in the financial sector, argued that strong, resolute, and generous action to save not just the banks but the bankers, their shareholders, and their creditors would return the economy to where it had been before the crisis. In the meantime, a short-term stimulus, moderate in size, would suffice to tide the economy over until the banks could be restored to health.
The banks got their bailout. Some of the money went to bonuses. Little of it went to lending. And the economy didn’t really recover—output is barely greater than it was before the crisis, and the job situation is bleak. The diagnosis of our condition and the prescription that followed from it were incorrect. First, it was wrong to think that the bankers would mend their ways—that they would start to lend, if only they were treated nicely enough. We were told, in effect: “Don’t put conditions on the banks to require them to restructure the mortgages or to behave more honestly in their foreclosures. Don’t force them to use the money to lend. Such conditions will upset our delicate markets.” In the end, bank managers looked out for themselves and did what they are accustomed to doing.
Even when we fully repair the banking system, we’ll still be in deep trouble—because we were already in deep trouble. That seeming golden age of 2007 was far from a paradise. Yes, America had many things about which it could be proud. Companies in the information-technology field were at the leading edge of a revolution. But incomes for most working Americans still hadn’t returned to their levels prior to the previous recession. The American standard of living was sustained only by rising debt—debt so large that the U.S. savings rate had dropped to near zero. And “zero” doesn’t really tell the story. Because the rich have always been able to save a significant percentage of their income, putting them in the positive column, an average rate of close to zero means that everyone else must be in negative numbers. (Here’s the reality: in the years leading up to the recession, according to research done by my Columbia University colleague Bruce Greenwald, the bottom 80 percent of the American population had been spending around 110 percent of its income.) What made this level of indebtedness possible was the housing bubble, which Alan Greenspan and then Ben Bernanke, chairmen of the Federal Reserve Board, helped to engineer through low interest rates and nonregulation—not even using the regulatory tools they had. As we now know, this enabled banks to lend and households to borrow on the basis of assets whose value was determined in part by mass delusion.
The fact is the economy in the years before the current crisis was fundamentally weak, with the bubble, and the unsustainable consumption to which it gave rise, acting as life support. Without these, unemployment would have been high. It was absurd to think that fixing the banking system could by itself restore the economy to health. Bringing the economy back to “where it was” does nothing to address the underlying problems.
The trauma we’re experiencing right now resembles the trauma we experienced 80 years ago, during the Great Depression, and it has been brought on by an analogous set of circumstances. Then, as now, we faced a breakdown of the banking system. But then, as now, the breakdown of the banking system was in part a consequence of deeper problems. Even if we correctly respond to the trauma—the failures of the financial sector—it will take a decade or more to achieve full recovery. Under the best of conditions, we will endure a Long Slump. If we respond incorrectly, as we have been, the Long Slump will last even longer, and the parallel with the Depression will take on a tragic new dimension.
Until now, the Depression was the last time in American history that unemployment exceeded 8 percent four years after the onset of recession. And never in the last 60 years has economic output been barely greater, four years after a recession, than it was before the recession started. The percentage of the civilian population at work has fallen by twice as much as in any post-World War II downturn. Not surprisingly, economists have begun to reflect on the similarities and differences between our Long Slump and the Great Depression. Extracting the right lessons is not easy.
by Joseph Stiglitz, Vanity Fair | Read more:
Stephen Doyle
We knew the crisis was serious back in 2008. And we thought we knew who the “bad guys” were—the nation’s big banks, which through cynical lending and reckless gambling had brought the U.S. to the brink of ruin. The Bush and Obama administrations justified a bailout on the grounds that only if the banks were handed money without limit—and without conditions—could the economy recover. We did this not because we loved the banks but because (we were told) we couldn’t do without the lending that they made possible. Many, especially in the financial sector, argued that strong, resolute, and generous action to save not just the banks but the bankers, their shareholders, and their creditors would return the economy to where it had been before the crisis. In the meantime, a short-term stimulus, moderate in size, would suffice to tide the economy over until the banks could be restored to health.
The banks got their bailout. Some of the money went to bonuses. Little of it went to lending. And the economy didn’t really recover—output is barely greater than it was before the crisis, and the job situation is bleak. The diagnosis of our condition and the prescription that followed from it were incorrect. First, it was wrong to think that the bankers would mend their ways—that they would start to lend, if only they were treated nicely enough. We were told, in effect: “Don’t put conditions on the banks to require them to restructure the mortgages or to behave more honestly in their foreclosures. Don’t force them to use the money to lend. Such conditions will upset our delicate markets.” In the end, bank managers looked out for themselves and did what they are accustomed to doing.
Even when we fully repair the banking system, we’ll still be in deep trouble—because we were already in deep trouble. That seeming golden age of 2007 was far from a paradise. Yes, America had many things about which it could be proud. Companies in the information-technology field were at the leading edge of a revolution. But incomes for most working Americans still hadn’t returned to their levels prior to the previous recession. The American standard of living was sustained only by rising debt—debt so large that the U.S. savings rate had dropped to near zero. And “zero” doesn’t really tell the story. Because the rich have always been able to save a significant percentage of their income, putting them in the positive column, an average rate of close to zero means that everyone else must be in negative numbers. (Here’s the reality: in the years leading up to the recession, according to research done by my Columbia University colleague Bruce Greenwald, the bottom 80 percent of the American population had been spending around 110 percent of its income.) What made this level of indebtedness possible was the housing bubble, which Alan Greenspan and then Ben Bernanke, chairmen of the Federal Reserve Board, helped to engineer through low interest rates and nonregulation—not even using the regulatory tools they had. As we now know, this enabled banks to lend and households to borrow on the basis of assets whose value was determined in part by mass delusion.
The fact is the economy in the years before the current crisis was fundamentally weak, with the bubble, and the unsustainable consumption to which it gave rise, acting as life support. Without these, unemployment would have been high. It was absurd to think that fixing the banking system could by itself restore the economy to health. Bringing the economy back to “where it was” does nothing to address the underlying problems.
The trauma we’re experiencing right now resembles the trauma we experienced 80 years ago, during the Great Depression, and it has been brought on by an analogous set of circumstances. Then, as now, we faced a breakdown of the banking system. But then, as now, the breakdown of the banking system was in part a consequence of deeper problems. Even if we correctly respond to the trauma—the failures of the financial sector—it will take a decade or more to achieve full recovery. Under the best of conditions, we will endure a Long Slump. If we respond incorrectly, as we have been, the Long Slump will last even longer, and the parallel with the Depression will take on a tragic new dimension.
Until now, the Depression was the last time in American history that unemployment exceeded 8 percent four years after the onset of recession. And never in the last 60 years has economic output been barely greater, four years after a recession, than it was before the recession started. The percentage of the civilian population at work has fallen by twice as much as in any post-World War II downturn. Not surprisingly, economists have begun to reflect on the similarities and differences between our Long Slump and the Great Depression. Extracting the right lessons is not easy.
by Joseph Stiglitz, Vanity Fair | Read more:
Stephen Doyle
The Intellectual and Politics
Václav Havel, who died on December 18, was that rare intellectual who, rather than forcing his way into politics, had politics forced upon him. In 1998, while serving as President of the Czech Republic, he offered the following reflection on the benefits and dangers of his career path.
PRAGUE – Does an intellectual – by virtue of his efforts to get beneath the surface of things, to grasp relations, causes, and effects, to recognize individual items as part of larger entities, and thus to derive a deeper awareness of and responsibility for the world – belong in politics?
Put that way, an impression is created that I consider it every intellectual’s duty to engage in politics. But that is nonsense. Politics also involves a number of special requirements that are relevant only to it. Some people meet these requirements; others don’t, regardless of whether they are intellectuals.
It is my profound conviction that the world requires – today more than ever – enlightened, thoughtful politicians who are bold and broad-minded enough to consider things that lie beyond the scope of their immediate influence in both space and time. We need politicians willing and able to rise above their own power interests, or the particular interests of their parties or states, and act in accordance with the fundamental interests of humanity today – that is, to behave the way everyone should behave, even though most may fail to do so.
Never before has politics been so dependent on the moment, on the fleeting moods of the public or the media. Never before have politicians been so impelled to pursue the short-lived and short-sighted. It often seems to me that the life of many politicians proceeds from the evening news on television one night, to the public-opinion poll the next morning, to their image on television the following evening. I am not sure whether the current era of mass media encourages the emergence and growth of politicians of the stature of, say, a Winston Churchill; I rather doubt it, though there can always be exceptions.
by Vaclav Havel, Project Syndicate | Read more:
PRAGUE – Does an intellectual – by virtue of his efforts to get beneath the surface of things, to grasp relations, causes, and effects, to recognize individual items as part of larger entities, and thus to derive a deeper awareness of and responsibility for the world – belong in politics?
Put that way, an impression is created that I consider it every intellectual’s duty to engage in politics. But that is nonsense. Politics also involves a number of special requirements that are relevant only to it. Some people meet these requirements; others don’t, regardless of whether they are intellectuals.
It is my profound conviction that the world requires – today more than ever – enlightened, thoughtful politicians who are bold and broad-minded enough to consider things that lie beyond the scope of their immediate influence in both space and time. We need politicians willing and able to rise above their own power interests, or the particular interests of their parties or states, and act in accordance with the fundamental interests of humanity today – that is, to behave the way everyone should behave, even though most may fail to do so.
Never before has politics been so dependent on the moment, on the fleeting moods of the public or the media. Never before have politicians been so impelled to pursue the short-lived and short-sighted. It often seems to me that the life of many politicians proceeds from the evening news on television one night, to the public-opinion poll the next morning, to their image on television the following evening. I am not sure whether the current era of mass media encourages the emergence and growth of politicians of the stature of, say, a Winston Churchill; I rather doubt it, though there can always be exceptions.
by Vaclav Havel, Project Syndicate | Read more:
Tuesday, December 20, 2011
Monday, December 12, 2011
Bill Tapia (1908 -2011)
In 2001 Bill Tapia took one of his guitars to a Southern California music shop to get it fixed. A woman was buying a ukulele, and Mr. Tapia asked to see it. He began playing it, masterfully, with a distinctive jazz inflection.
“Hey, who are you?” the store’s owner asked.
If Mr. Tapia could have seen the future, he might have answered, “Duke of Uke,” the title of an album he recorded in 2005 at the age of 97. But at the time, he knew only that he was sad that his daughter and wife had recently died in quick succession, and that playing the ukulele felt good.
Mr. Tapia, who died on Dec. 2 at the age of 103, first played the instrument as an 8-year-old street musician, then went on to become one of Hawaii’s premier young ukulele players in the 1920s and ’30s. But after World War II he switched to the guitar to get jobs playing jazz, his favorite kind of music, gave away his ukuleles and for a half-century had almost nothing to do with the instrument that had defined his youth and middle age.
Then something astonishing happened: Mr. Tapia was “discovered” as a ukulele virtuoso at a time when the instrument was having a resurgence of popularity. He became a ukulele star, twice making the Top 10 on the jazz charts, wowing concertgoers by playing the ukulele behind his head à la Jimi Hendrix, and making three albums — one of which honored his 100th birthday. He was elected to the Ukulele Hall of Fame.
“Bill Tapia has been involved with the ukulele, jazz and Hawaiian music perhaps longer than any other living person,” the Hall of Fame said when it inducted him.
by Douglas Martin, NY Times | Read more:
Sunday, December 11, 2011
It's Not a Bug, It's a Feature
A young man left $4.85 in his TCF Bank account. TCF assessed him a $9.95 "maintenance fee" for not having enough money in his account. Then they charged him for being overdrawn by $5.10 (ten cents more than he was allowed by their rules). In less than two weeks, they'd assessed so many fees and penalties against the account holder that he owed them $229.10. All for having the temerity to have a low-balance account. The bank said it was his own fault for not having more money. Finally, they relented -- only after being contacted by a newspaper.
by Cory Doctorow, Boing Boing | Read more:
"I try to raise my children the right way and if my son would have overdrawn this account because of spending money he didn't have we would have made him take care of it," she said. "But what TCF did is not right. Money is tight right now and if this is their way of making money, they need to be stopped."
Ganziano said the entire goal of setting up the account was to teach her sons how to be smart with their money.
"When they get zapped this way, why would they trust a bank?" she said.Bank fees that overdraw teen's account have mom seeing red
by Cory Doctorow, Boing Boing | Read more:
The Merkelization of Europe
No so long ago, France was the political driver and Germany the economic motor of the European Union. "Now," remarked former European Commission president Romani Prodi in February, it is Merkel "that decides and Sarkozy that holds a press conference to explain her decisions." This searing image could be embellished with the 24 EU members cowering in the press room -- and Britain now watching through the window.
Now that Britain has sidelined itself from the historic "fiscal compact" concluded in Brussels on Dec. 9, which provides the EU with new powers to enforce stricter discipline in national budgets, the community appears even more fiercely segregated within its own ranks. Pathetically, the Brits walked not because of the starkly deficient democratic procedure or the fact these governance changes wouldn't adequately address the euro quagmire, but rather to protect London's financial services industry from regulations that were part of the deal.
This isn't the way European Union was supposed to work, not at all, and Germany's one-woman show -- ostensibly in Europe's name -- could well doom the continent's beautiful project. Merkel may look like the big winner today, seemingly with Europe at Germany's feet, but this turn of events could well prove to no country's detriment more than than Germany's.
"The prospect is of a joyless union of penalties, punishments, disciplines and seething resentments, with the centrist elites who run the EU increasingly under siege from anti-EU populists on the right and left everywhere in Europe," wrote the Guardian's Ian Traynor.
Merkel's short-sighted, audaciously Germany-first reaction to staunch the eurocrisis is the Germanization of European monetary and fiscal policy, foremost the codification of its obsession with tight money, fiscal purity, and budgetary orthodoxy. In spite of all evidence to the contrary, she insists that what's good for Germany is good for everybody else, too. It's clearly not. And with the world's leaders begging her to do "whatever it takes" to stave off global calamity, she's doing it with Sarkozy at her side and over the heads of the now completely irrelevant European "voters" ("subjects" is the more fitting word). This is a catastrophic mistake, which, politically, vastly expands the EU's centralized authority while robbing it of even the fig leaf of democratic legitimacy it had sported. Moreover, the economics of Berlin's Germanocentric prescriptions for the eurozone compound the very problems that landed Europe's weaker economies in the mess they're in right now.
by Paul Hockenos, Foreign Policy | Read more:
JEAN-PAUL PELISSIER/AFP/Getty Images
On Iowa
On January 3, Iowans will trudge through snow, sleet, sludge, ice, gale-force blizzards -- whatever it takes -- to join their neighbors that evening in 1,784 living rooms, community halls, recreation centers, and public-school gymnasiums in a kind of bygone-era town-hall meeting at which they'll eat and debate, and then vote for presidential candidates along party lines. Chat 'n' Chews, they are called.
These Iowa Caucuses create a seismic shift in the presidential nominating contests. Obama catapulted to the top of the Democrats' dance card when he captured 38 percent of Iowa voters in 2008, and then swept to victory at the Democratic Convention eight months later. Without such a strong initial showing in Iowa, Obama might not have been able to steamroll through subsequent state primaries to win the presidency.
Since Obama is the presumed Democratic candidate in 2012, this year it's the Republican candidates who have trained their attentions on the state these brisk, late-autumn days. They're falling over each other in front of grain elevators and cornfields, over biscuits and gravy in breakfast cafes, and at potluck dinners (casseroles are the thing to bring), glad-handing and backslapping as many Iowa voters they can. Great photo ops, you know. Hoisting a baby in the air is good politics. So's gulping down a brat (short for bratwurst).
Considering the state's enormous political significance, I thought this would be a good time to explain to the geographically challenged a little about Iowa, including where Iowa is, and perhaps more importantly, in both a real and metaphysical way, what Iowa is.
For almost 20 years I've lived in Iowa, where as a professor at the University of Iowa I've taught thousands of university students. I've written a couple of books on rural Iowa, traveling to all 99 counties, and have spent much of my time when not teaching, visiting with and interviewing Iowans from across the state. I haven't taken up hunting or fishing, the main hobbies of rural Iowans, but I'm a fan of University of Iowa Hawkeye football, so I'm a good third of the way to becoming an adopted Iowan. I even have a dog, born and bred in Iowa (more on that later).
by Stephen G. Bloom, The Atlantic | Read more:
Image credit: Jason Reed / Reuters
The Missing Piece
In the next few months, scientists at the Large Hadron Collider at Cern may detect one of the fundamental building blocks of the universe: the elusive Higgs boson. The collider, one of the most ambitious machines ever built—which sends two beams of subatomic particles around an underground circuit 27km in circumference, to crash into each other at close to the speed of light—may already have given them the crucial data.
The Swiss government asks Cern, the joint European research institution, to shut down the circuit in winter, to spare it the demand on the electricity grid; these cold months are used for analysing the torrent of data from the summer’s experiments. If scientists find the Higgs boson, then it will be one of the greatest advances ever in physics. The world’s attention—including that of the Nobel committee, will turn to, among others, Peter Higgs, 82, emeritus professor at the school of physics and astronomy at the University of Edinburgh.
But if they don’t find the particle, the consequences could be even more interesting—as Peter Higgs explains in this interview for Prospect. The particle that he has argued must exist “plays such a role” in the modern theory of the structure of the physical world “that if you tried to modify the theory to take it out, the whole thing becomes nonsense.”
Higgs takes the bus south through Edinburgh to the James Clerk Maxwell building of the science faculty, where a large portrait of him (above) looks out over the main staircase. When I accompany him to a talk given there by a Cern scientist, at one point, the lecturer jokes to the audience that he is attempting to make the discussion accessible to all, “even to you, Peter,” he says, gesturing towards Higgs. There is a communal intake of breath; students crane to look as they realise who is sitting in the front row. After, they crowd round asking to have their photos taken with Higgs, who obliges.
Higgs’s insights are central to the work at Cern. The experiments aim to answer some of the most profound questions, such as where the mass of fundamental particles comes from. For physicists, mass is an expression of a body’s resistance to changes in its velocity (its speed and direction.) In everyday life, we are most aware of an object’s mass through its weight, a concept intuitively linked to our grasp of the physical world. But the individual bits that make up an atom, if weighed separately, would equal less than the mass of the complete atom. So where does that extra mass come from?
by James Elwes, Prospect | Read more:
Painting: Ken Currie
Saturday, December 10, 2011
Jiro Dreams of Sushi
The Movie
Anthony Bourdain
Is Modern Capitalism Sustainable?
[ed. Five reasons why it might not be.]
I am often asked if the recent global financial crisis marks the beginning of the end of modern capitalism. It is a curious question, because it seems to presume that there is a viable replacement waiting in the wings. The truth of the matter is that, for now at least, the only serious alternatives to today's dominant Anglo-American paradigm are other forms of capitalism.
Continental European capitalism, which combines generous health and social benefits with reasonable working hours, long vacation periods, early retirement and relatively equal income distributions, would seem to have everything to recommend it - except sustainability. China's Darwinian capitalism, with its fierce competition among export firms, a weak social safety net, and widespread government intervention, is widely touted as the inevitable heir to Western capitalism, if only because of China's huge size and consistent outsize growth rate. Yet China's economic system is continually evolving.
Indeed, it is far from clear how far China's political, economic and financial structures will continue to transform themselves, and whether China will eventually morph into capitalism's new exemplar. In any case, China is still encumbered by the usual social, economic and financial vulnerabilities of a rapidly growing lower-income country.
Perhaps the real point is that, in the broad sweep of history, all current forms of capitalism are ultimately transitional. Modern-day capitalism has had an extraordinary run since the start of the Industrial Revolution two centuries ago, lifting billions of ordinary people out of abject poverty. Marxism and heavy-handed socialism have disastrous records by comparison. But, as industrialisation and technological progress spread to Asia (and now to Africa), someday the struggle for subsistence will no longer be a primary imperative, and contemporary capitalism's numerous flaws may loom larger.
by Kenneth Rogoff, Al Jazeera via Project Syndicate | Read more:
Photo: Gallo/Getty

Continental European capitalism, which combines generous health and social benefits with reasonable working hours, long vacation periods, early retirement and relatively equal income distributions, would seem to have everything to recommend it - except sustainability. China's Darwinian capitalism, with its fierce competition among export firms, a weak social safety net, and widespread government intervention, is widely touted as the inevitable heir to Western capitalism, if only because of China's huge size and consistent outsize growth rate. Yet China's economic system is continually evolving.
Indeed, it is far from clear how far China's political, economic and financial structures will continue to transform themselves, and whether China will eventually morph into capitalism's new exemplar. In any case, China is still encumbered by the usual social, economic and financial vulnerabilities of a rapidly growing lower-income country.
Perhaps the real point is that, in the broad sweep of history, all current forms of capitalism are ultimately transitional. Modern-day capitalism has had an extraordinary run since the start of the Industrial Revolution two centuries ago, lifting billions of ordinary people out of abject poverty. Marxism and heavy-handed socialism have disastrous records by comparison. But, as industrialisation and technological progress spread to Asia (and now to Africa), someday the struggle for subsistence will no longer be a primary imperative, and contemporary capitalism's numerous flaws may loom larger.
by Kenneth Rogoff, Al Jazeera via Project Syndicate | Read more:
Photo: Gallo/Getty
The Hot Spotters
The critical flaw in our health-care system that people like Gunn and Brenner are finding is that it was never designed for the kind of patients who incur the highest costs. Medicine’s primary mechanism of service is the doctor visit and the E.R. visit. (Americans make more than a billion such visits each year, according to the Centers for Disease Control.) For a thirty-year-old with a fever, a twenty-minute visit to the doctor’s office may be just the thing. For a pedestrian hit by a minivan, there’s nowhere better than an emergency room. But these institutions are vastly inadequate for people with complex problems: the forty-year-old with drug and alcohol addiction; the eighty-four-year-old with advanced Alzheimer’s disease and a pneumonia; the sixty-year-old with heart failure, obesity, gout, a bad memory for his eleven medications, and half a dozen specialists recommending different tests and procedures. It’s like arriving at a major construction project with nothing but a screwdriver and a crane. (...)
The Special Care Center reinvented the idea of a primary-care clinic in almost every way. The union’s and the hospital’s health funds agreed to switch from paying the doctors for every individual office visit and treatment to paying a flat monthly fee for each patient. That cut the huge expense that most clinics incur from billing paperwork. The patients were given unlimited access to the clinic without charges—no co-payments, no insurance bills. This, Fernandopulle explained, would force doctors on staff to focus on service, in order to retain their patients and the fees they would bring.
The payment scheme also allowed him to design the clinic around the things that sick, expensive patients most need and value, rather than the ones that pay the best. He adopted an open-access scheduling system to guarantee same-day appointments for the acutely ill. He customized an electronic information system that tracks whether patients are meeting their goals. And he staffed the clinic with people who would help them do it. One nurse practitioner, for instance, was responsible for trying to get every smoker to quit.
I got a glimpse of how unusual the clinic is when I sat in on the staff meeting it holds each morning to review the medical issues of the patients on the appointment books. There was, for starters, the very existence of the meeting. I had never seen this kind of daily huddle at a doctor’s office, with clinicians popping open their laptops and pulling up their patient lists together. Then there was the particular mixture of people who squeezed around the conference table. As in many primary-care offices, the staff had two physicians and two nurse practitioners. But a full-time social worker and the front-desk receptionist joined in for the patient review, too. And, outnumbering them all, there were eight full-time “health coaches.”
Fernandopulle created the position. Each health coach works with patients—in person, by phone, by e-mail—to help them manage their health. Fernandopulle got the idea from the promotoras, community health workers, whom he had seen on a medical mission in the Dominican Republic. The coaches work with the doctors but see their patients far more frequently than the doctors do, at least once every two weeks. Their most important attribute, Fernandopulle explained, is a knack for connecting with sick people, and understanding their difficulties. Most of the coaches come from their patients’ communities and speak their languages. Many have experience with chronic illness in their own families. (One was himself a patient in the clinic.) Few had clinical experience. I asked each of the coaches what he or she had done before working in the Special Care Center. One worked the register at a Dunkin’ Donuts. Another was a Sears retail manager. A third was an administrative assistant at a casino.
“We recruit for attitude and train for skill,” Fernandopulle said. “We don’t recruit from health care. This kind of care requires a very different mind-set from usual care. For example, what is the answer for a patient who walks up to the front desk with a question? The answer is ‘Yes.’ ‘Can I see a doctor?’ ‘Yes.’ ‘Can I get help making my ultrasound appointment?’ ‘Yes.’ Health care trains people to say no to patients.” He told me that he’d had to replace half of the clinic’s initial hires—including a doctor—because they didn’t grasp the focus on patient service.
by Atul Gawande, New Yorker | Read more:
Photograph by Phillip Toledano
The Special Care Center reinvented the idea of a primary-care clinic in almost every way. The union’s and the hospital’s health funds agreed to switch from paying the doctors for every individual office visit and treatment to paying a flat monthly fee for each patient. That cut the huge expense that most clinics incur from billing paperwork. The patients were given unlimited access to the clinic without charges—no co-payments, no insurance bills. This, Fernandopulle explained, would force doctors on staff to focus on service, in order to retain their patients and the fees they would bring.
The payment scheme also allowed him to design the clinic around the things that sick, expensive patients most need and value, rather than the ones that pay the best. He adopted an open-access scheduling system to guarantee same-day appointments for the acutely ill. He customized an electronic information system that tracks whether patients are meeting their goals. And he staffed the clinic with people who would help them do it. One nurse practitioner, for instance, was responsible for trying to get every smoker to quit.
I got a glimpse of how unusual the clinic is when I sat in on the staff meeting it holds each morning to review the medical issues of the patients on the appointment books. There was, for starters, the very existence of the meeting. I had never seen this kind of daily huddle at a doctor’s office, with clinicians popping open their laptops and pulling up their patient lists together. Then there was the particular mixture of people who squeezed around the conference table. As in many primary-care offices, the staff had two physicians and two nurse practitioners. But a full-time social worker and the front-desk receptionist joined in for the patient review, too. And, outnumbering them all, there were eight full-time “health coaches.”
Fernandopulle created the position. Each health coach works with patients—in person, by phone, by e-mail—to help them manage their health. Fernandopulle got the idea from the promotoras, community health workers, whom he had seen on a medical mission in the Dominican Republic. The coaches work with the doctors but see their patients far more frequently than the doctors do, at least once every two weeks. Their most important attribute, Fernandopulle explained, is a knack for connecting with sick people, and understanding their difficulties. Most of the coaches come from their patients’ communities and speak their languages. Many have experience with chronic illness in their own families. (One was himself a patient in the clinic.) Few had clinical experience. I asked each of the coaches what he or she had done before working in the Special Care Center. One worked the register at a Dunkin’ Donuts. Another was a Sears retail manager. A third was an administrative assistant at a casino.
“We recruit for attitude and train for skill,” Fernandopulle said. “We don’t recruit from health care. This kind of care requires a very different mind-set from usual care. For example, what is the answer for a patient who walks up to the front desk with a question? The answer is ‘Yes.’ ‘Can I see a doctor?’ ‘Yes.’ ‘Can I get help making my ultrasound appointment?’ ‘Yes.’ Health care trains people to say no to patients.” He told me that he’d had to replace half of the clinic’s initial hires—including a doctor—because they didn’t grasp the focus on patient service.
by Atul Gawande, New Yorker | Read more:
Photograph by Phillip Toledano
Friday, December 9, 2011
No Copyright Intended
On October 26, a YouTube user named crimewriter95 posted a full-length version of Pulp Fiction, rearranged in chronological order.
A couple things struck me about this video.
First, I'm surprised that a full-length, 2.5-hour very slight remix of a popular film can survive on YouTube for over six weeks without getting removed. Now that it's on Kottke and Buzzfeed, I'm guessing it won't be around for much longer.
But I was just as amused by the video description:
How pervasive is it? There are about 489,000 YouTube videos that say "no copyright intended" or some variation, and about 664,000 videos have a "copyright disclaimer" citing the fair use provision in Section 107 of the Copyright Act.
Judging by his username, I'm guessing crimewriter95 is 16 years old. I wouldn't be surprised if most of those million videos were uploaded by people under 21.
He's hardly alone. On YouTube's support forums, there's rampant confusion over what copyright is. People genuinely confused that their videos were blocked even with a disclosure, confused that audio was removed even though there was no "intentional copyright infringement." Some ask for the best wording of a disclaimer, not knowing that virtually all video is blocked without human intervention using ContentID.
YouTube's tried to combat these misconceptions with its Copyright School, but it seems futile. For most people, sharing and remixing with attribution and no commercial intent is instinctually a-okay.
Under current copyright law, nearly every cover song on YouTube is technically illegal. Every fan-made music video, every mashup album, every supercut, every fanfic story? Quite probably illegal, though largely untested in court.
No amount of lawsuits or legal threats will change the fact that this behavior is considered normal — I'd wager the vast majority of people under 25 see nothing wrong with non-commercial sharing and remixing, or think it's legal already.
Here's a thought experiment: Everyone over age 12 when YouTube launched in 2005 is now able to vote.
What happens when — and this is inevitable — a generation completely comfortable with remix culture becomes a majority of the electorate, instead of the fringe youth? What happens when they start getting elected to office? (Maybe "I downloaded but didn't share" will be the new "I smoked, but didn't inhale.")
Remix culture is the new Prohibition, with massive media companies as the lone voices calling for temperance. You can criminalize commonplace activities from law-abiding people, but eventually, something has to give.
A couple things struck me about this video.
First, I'm surprised that a full-length, 2.5-hour very slight remix of a popular film can survive on YouTube for over six weeks without getting removed. Now that it's on Kottke and Buzzfeed, I'm guessing it won't be around for much longer.
But I was just as amused by the video description:
"The legendary movie itself placed into chronological order. If you'd like me to put the full movie itself up, let me know and I'll be glad to oblige. Please no copyright infringement. I only put this up as a project."These "no copyright infringement intended" messages are everywhere on YouTube, and about as effective as a drug dealer asking if you're a cop. It's like a little voodoo charm that people post on their videos to ward off evil spirits.
How pervasive is it? There are about 489,000 YouTube videos that say "no copyright intended" or some variation, and about 664,000 videos have a "copyright disclaimer" citing the fair use provision in Section 107 of the Copyright Act.
Judging by his username, I'm guessing crimewriter95 is 16 years old. I wouldn't be surprised if most of those million videos were uploaded by people under 21.
He's hardly alone. On YouTube's support forums, there's rampant confusion over what copyright is. People genuinely confused that their videos were blocked even with a disclosure, confused that audio was removed even though there was no "intentional copyright infringement." Some ask for the best wording of a disclaimer, not knowing that virtually all video is blocked without human intervention using ContentID.
YouTube's tried to combat these misconceptions with its Copyright School, but it seems futile. For most people, sharing and remixing with attribution and no commercial intent is instinctually a-okay.
Under current copyright law, nearly every cover song on YouTube is technically illegal. Every fan-made music video, every mashup album, every supercut, every fanfic story? Quite probably illegal, though largely untested in court.
No amount of lawsuits or legal threats will change the fact that this behavior is considered normal — I'd wager the vast majority of people under 25 see nothing wrong with non-commercial sharing and remixing, or think it's legal already.
Here's a thought experiment: Everyone over age 12 when YouTube launched in 2005 is now able to vote.
What happens when — and this is inevitable — a generation completely comfortable with remix culture becomes a majority of the electorate, instead of the fringe youth? What happens when they start getting elected to office? (Maybe "I downloaded but didn't share" will be the new "I smoked, but didn't inhale.")
Remix culture is the new Prohibition, with massive media companies as the lone voices calling for temperance. You can criminalize commonplace activities from law-abiding people, but eventually, something has to give.
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