Category Archives: Current Affairs

Everyday Barrier

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The following was found on Sasha Dichter's blog and is something that might be a great exercise for all of us. Why? So we can walk a mile in someone else's shoes:

It reminded me of a day I spent over the winter, an exercise called “everyday barriers” that all Acumen staff participate in.  It’s something the Acumen Fellows undertake as part of their training.  Like our Fellows, each Acumen New York staff member came to work and then left everything in the office except for $5 in cash and a round trip Metrocard.  We were to spend the day in New York City and come back with suggestions for how to improve public services.  It’s an exercise in what we call “moral imagination,” cultivating the ability to walk a mile in someone else’s shoes, and to see problems from a new perspective.

Having talked to Acumen Fellows who had participated in this activity in the past, I recalled profound stories of connection, as well Fellows gaining a much deeper understanding of the challenges of being a poor person in New York City.  I recall a Fellow telling a story of a woman who walked everywhere with a giant box filled with papers – they were all of her identification, phone bills, records, etc. because the woman had gotten sick of getting to the front of a long line only to be told that she didn’t have the right paperwork.  Fellows experienced what was and was not working well in the provision of New York city public services, and the day served as a jumping off point for discussions about identity, empathy, and social change.

To me the most surprising part of the exercise came right at the beginning.  After about an hour of walking, feeling pretty relaxed, I started to feel a bit hungry and thirsty, and it hit me that it was 9:30am and I had 8 hours to spend in the city on a cold day with nowhere to go and almost no money in my pocket.   While part of my plan was to go to new neighborhoods, suddenly the very familiar parts of the city started to feel different.   The glass windows of a coffee shop or a high-end clothing store felt like they had “keep out” signs flashing at me with my empty pockets, big parka and heavy boots.  The transformation in my experience of something as simple as walking down the street in an upscale neighborhood was profound and shocking.  How could a shift happen so quickly?  I bought an apple for 50 cents and trudged on, making my way to a church (where the music was uplifting), a homeless shelter (for lunch), and then taking a massive trek (that turned out to be a wild goose chase) to an employment center in Queens, with a lot of time in the NYC subway noticing how everyone except for me was in an iPod / newspaper / book bubble.  Time passed differently, and most of New York City felt like it was for someone other than me.

 

Free Job Advice for Youngsters

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Here's a blog post from Jessica Gottlieb with some great job advice for Millenials, including:

  • Your first job will probably be a crappy job. Don’t wait until you’re 20-something to have that first job. Working is good for you, even when it’s not fun. 
  • No one owes you a job, you’re replaceable so it’s up to you to be better than everyone else (this advice holds true until you’re 75 or so)
  • If you work in a service industry tips should feel like silver and gold raindrops. No one is obligated to give them to you. Customers can sniff out entitlement.

To this I'll add:

  • Be on time.
  • Watch your language. Not just cursing, but grammar. You don't necessarily need to know when to use "who" or "whom", but at least know that you shouldn't say "I'm doing good" when you're asked how you're doing.
  • Dress appropriately and accept that it is perfectly reasonable for your boss to define what is appropriate.
  • Use a firm handshake when you greet people, but don't try to break their knuckles. Also, unless someone's your friend don't give them a hug/bro-hug.
  • This is for guys: shave every day even if you don't think you need it. Believe me, you do. If you have a beard, keep it trimmed and shave where appropriate every day.
  • Flirt at your own risk. It can backfire on you in a big way.

There's plenty more where that came from; things I was once taught and that have never really changed.

Side note: you millenials are exactly where we Generation X/Y, Baby Boomers were at your age. The generations that preceded us thought we were slackers/losers/lost causes too.

Who Says a Colon Exploration Should Take Two Hours?

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The Washington Post has a story on the 'secretive panel' of doctors who come up with the pricing on all medical procedures:

Unknown to most, a single committee of the AMA, the chief lobbying group for physicians, meets confidentially every year to come up with values for most of the services a doctor performs.

Those values are required under federal law to be based on the time and intensity of the procedures. The values, in turn, determine what Medicare and most private insurers pay doctors.

But the AMA’s estimates of the time involved in many procedures are exaggerated, sometimes by as much as 100 percent, according to an analysis of doctors’ time, as well as interviews and reviews of medical journals.

If the time estimates are to be believed, some doctors would have to be averaging more than 24 hours a day to perform all of the procedures that they are reporting. This volume of work does not mean these doctors are doing anything wrong. They are just getting paid at the rates set by the government, under the guidance of the AMA.

So, who's surprised by this? And it gets better:

To determine how long a procedure takes, the AMA relies on surveys of doctors conducted by the associations representing specialists and primary care physicians. The doctors who fill out the surveys are informed that the reason for the survey is to set pay. Increasingly, the survey estimates have been found so improbable that the AMA has had to significantly lower them, according to federal documents…

In the late 1980s and early ’90s, the United States called on a group at Harvard University to develop a more deliberate system for paying doctors.

What they came up with, basically, is the current point system. Every procedure is assigned a number of points — called “relative value units” — based on the work involved, the staff and supplies, and a smaller portion for malpractice insurance…

This point system is critical in U.S. health-care economics because it doesn’t just rule Medicare payments. Roughly four out of five insurance companies use the point system for the basis of their own physician fees, according to the AMA. The private insurers typically pay somewhat more per point than does Medicare.

Once the system developed by the Harvard researchers was initiated, however, the Medicare system faced a critical problem: As medicine evolved, the point system had to be updated. Who could do that?

The AMA offered to do the work for free.

Has no one heard of the fox in the hen house? Sheesh. It's one thing for the doctors' groups to be consulted – they should be – but to drive the entire process? That's absurd.

Race as a Distraction

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In college, way back in the dark ages of the 1980s, I had a roommate from Scotland who was intrigued with the racial discord he observed in America. To him it made no sense that people would hate each other based on their race, but of course it made total sense to him that the Catholics and Protestants back in Scotland were in a constant state of discord. He'd say, and I'm paraphrasing here, "Why do you Americans hate each other for what you are? At least in Scotland we hate each other for what we choose to believe."

Whenever race comes up as a topic I think about those words. Indeed, it's totally illogical for us to hate one another for something we have no control over. In fact it's probably the most absurd reason for people to hate and distrust each other. On the other hand, probably the most logical reason for any group of people to dislike another is if one group has disproportionately more of anything – wealth, food, opportunity, etc. – than the other, particularly if the group with less feels that the other group has gotten it off of their backs.

That's why the new data about the true nature of poverty in America, and the plight of working class whites in particular, should scare the bejeezus out of this country's power structure. Once all of the poor and struggling working class folks from every race realize they have more in common with each other than with the wealthy of their own race they will form a formidable body to deal with. From the article linked above:

As nonwhites approach a numerical majority in the U.S., one question is how public programs to lift the disadvantaged should be best focused — on the affirmative action that historically has tried to eliminate the racial barriers seen as the major impediment to economic equality, or simply on improving socioeconomic status for all, regardless of race.

Hardship is particularly growing among whites, based on several measures. Pessimism among that racial group about their families' economic futures has climbed to the highest point since at least 1987. In the most recent AP-GfK poll, 63 percent of whites called the economy "poor."…

While racial and ethnic minorities are more likely to live in poverty, race disparities in the poverty rate have narrowed substantially since the 1970s, census data show. Economic insecurity among whites also is more pervasive than is shown in the government's poverty data, engulfing more than 76 percent of white adults by the time they turn 60, according to a new economic gauge being published next year by the Oxford University Press.

There's another important societal component contributing to the economic struggle of millions of individuals in this country, and it's one we need to deal with head on: the breakdown of the traditional family. Again from the article:

–For the first time since 1975, the number of white single-mother households living in poverty with children surpassed or equaled black ones in the past decade, spurred by job losses and faster rates of out-of-wedlock births among whites. White single-mother families in poverty stood at nearly 1.5 million in 2011, comparable to the number for blacks. Hispanic single-mother families in poverty trailed at 1.2 million…

Marriage rates are in decline across all races, and the number of white mother-headed households living in poverty has risen to the level of black ones.

As a man who has been happily married for a long time I'm obviously a fan of the family structure. However, whenever the topic of single parent homes comes up for public debate we get pulled into the moral/religious rabbit hole and never address the economics of single parenthood. Why do we insist on approaching this problem from a moral standpoint, haranguing young men and women about their sinfulness and almost guaranteeing they'll tune us out, and not instead concentrate on developing societal structures that will help deal with a very real problem? I'm not smart enough to have a solution here, but it doesn't take a rocket science to realize that the answer is not browbeating people back into church and insisting that they live they way great-Grandma and Grandpa did. 

Our leaders, whether in industry or government, need to begin to deal with the reality that is portrayed in this new data or our country will soon be in even deeper doo-doo. They can no longer hide from the reality that our middle class is disappearing and that our "land of opportunity" could quickly become an empty slogan if they don't change things, and fast.

Interesting Times

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It sometimes takes living in interesting times to make you realize that boring is vastly underrated. The Great Housing Bubble followed by the Great Recession have caused many of us to live through some interesting times, and the reaction by our elected leaders to the fallout of those interesting times has led to even more interesting times.

Here in North Carolina we're starting to get national attention for the way our state leaders are reacting to the aftermath of the recession. The state is a perfect storm of economic hardship and political sea change that makes it a perfect political story on a national level. Unfortunately at the root of those stories is the suffering of real people, some of whom are our friends and neighbors, and the ideological response of the newly dominant political party to the economic reality that those people represent.

Lots of ink has been spilled about new conservative policies that have been put in place this legislative term and the Moral Monday protests that were prompted by those policies.  Quite frankly it's a complicated issue, and in defense of both sides of the arguments it should be noted that they almost certainly feel their way is the best way to address the whole of the problem, but from the point of view of those of us who are neighbors and friends of the very folks who are directly affected now by these policies it's hard to swallow the big picture economic arguments while they suffer.

Probably the best thing I've read about this issue is something a friend linked to on Facebook that addresses the Moral Monday protesters and why their protests are righteous even if you disagree with some of their specific remedies/arguments:

“For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me…The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’” (Matthew 25:35-36, 40)

God is far bigger than a single political party. There are many paths and policies for addressing poverty, reforming our broken immigration system, responding to climate change, and healing the racial divides that continue in our society. But what we cannot accept, nor allow, is for our own leaders to willfully exacerbate our problems and directly harm people who are already suffering — to sacrifice the common good to their own ideological agendas. In such moments and times, people of faith must speak out — not for the sake of politics, but because the beauty and simplicity of the gospel demands it. (Emphasis mine)

For those of us whose faith compels us to do everything we can to help the unemployed, hungry, homeless, etc. we cannot ignore the long-term economic policies that can lead to those states. We must acknowledge that there are many different ways to address the underlying sociological and economic issues that are the root of those problems. We must be ready to admit that perhaps some conservative ideals might be the way to go, or that perhaps some government-led initiatives truly are the only hammer that will work on that nail.  But, and this the crux of the argument for me, it doesn't matter which path is best if people get seriously hurt during the journey. It is our moral imperative to make sure that the least of us is cared for, and if our journey has to take a little longer or follow a crooked path, i.e. involves ideological comprises in order for us to be able to help carry those who need help, then so be it. 

Obligations

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Here in America we spend an awful lot of time discussing our rights, and not nearly as much time discussing the obligations we should meet in exchange for those rights. There's now a movement afoot to try and change that, as outlined by EJ Dionne in his column at the Washington Post:

And here is the sentence we often forget: “And for the support of this Declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our Lives, our Fortunes and our Sacred Honor.”

This, the very last sentence of the document, is what makes the better-remembered sentence possible. One speaks of our rights. The other addresses our obligations. The freedoms we cherish are self-evident but not self-executing. The Founders pledge something “to each other,” the commonly overlooked clause in the Declaration’s final pronouncement…

Last week, the Aspen Institute gathered a politically diverse group of Americans under the banner of the “Franklin Project,” named after Ben, to declare a commitment to offering every American between the ages of 18 and 28 a chance to give a year of service to the country. The opportunities would include service in our armed forces but also time spent educating our fellow citizens, bringing them health care and preventive services, working with the least advantaged among us, and conserving our environment…

The call for universal, voluntary service is being championed by retired U.S. Army Gen. Stanley McChrystal, in league with two of the country’s foremost advocates of the cause, John Bridgeland, who served in the George W. Bush administration, and Alan Khazei, co-founder of City Year, one of the nation’s most formidable volunteer groups. The trio testifies to the non-ideological and nonpartisan nature of this cause, as did a column last week endorsing the idea from Michael Gerson, my conservative Post colleague.

The Unfortunate 14

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North Carolina is one of 14 states that has opted out of the new Medicaid funds linked to Obamacare. What does that mean? According to a new Rand Corporation study it means those states are sailing into a stiff healthcare wind:

The study, by the Rand corporation, looks at the 14 states that have said they will opt out of the new Medicaid funds. It finds that the result will be they get $8.4 billion less in federal funding, have to spend an extra $1 billion in uncompensated care, and end up with about 3.6 million fewer insured residents.

So then, the math works out like this: States rejecting the expansion will spend much more, get much, much less, and leave millions of their residents uninsured. That’s a lot of self-inflicted pain to make a political point.

It’s a truism of health-care politics that the uninsured are impossible to organize. But Obamacare creates an extraordinarily unusual situation. The Affordable Care Act will implemented in states that reject Medicaid. There will be huge mobilization efforts in those states, too, as well as lots of press coverage of the new law. The campaign to tell people making between 133 and 400 percent of poverty that they can get some help buying insurance will catch quite a few people making less than that in its net. And then those people will be told that they would get health insurance entirely for free but for an act of their governor and/or state legislature.

North Carolina is already seeing political activism spearheaded by the state's NAACP chapter against policies of the Republican legislature. Just yesterday the NAACP's ongoing "Moral Monday" campaign led to more than 150 arrests at the state capitol. Quite frankly that action is easy for a lot of people to dismiss as just more of the same from a group trying to justify its existence (when doesn't the NAACP protest?), but if people who normally sit on the sidelines are suddenly spurred to action because their government denied them the opportunity for cheaper (or free!) health coverage then things could get very interesting for the next election cycle here in the Tarheel state.

(h/t to Fec for the link to the story).

Boogeymen

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The following is an excerpt from an article titled The Kentucky Derby is Decadent and Depraved that Hunter S. Thompson wrote in 1970.  To set the scene he's just landed in Kentucky and is speaking with an annoying Texan he's just met in a bar and convinced that he's a photographer for Playboy:

I shook my head and said nothing; just stared at him for a moment, trying to look grim.  “There’s going to be trouble,” I said. “My assignment is to take pictures of the riot.”

“What riot?”

I hesitated, twirling the ice in my drink. “At the track. On Derby Day. The Black Panthers.” I stared at him again. “Don’t you read the newspapers?”

The grin on his face had collapsed. “What the hell are you talkin’ about?”

“Well…maybe I shouldn’t be telling you…” I shrugged. “But hell, everybody else seems to know. The cops and the National Guard have been getting ready for six weeks. They have 20,000 troops on alert at Fort Knox. They’ve warned us–all the press and photographers–to wear helmets and special vests like flak jackets. We were told to expect shooting…”

“No!” he shouted; his hands flew up and hovered momentarily between us, as if to ward off the words he was hearing. Then he whacked his fist on the bar. “Those sons of bitches! God Almighty! The Kentucky Derby!” He kept shaking his head. “No! Jesus! That’s almost too bad to believe!” Now he seemed to be sagging on the stool, and when he looked up his eyes were misty. “Why? Why here? Don’t they respect anything?“

I shrugged again. “It’s not just the Panthers. The FBI says busloads of white crazies are coming in from all over the country–to mix with the crowd and attack all at once, from every direction. They’ll be dressed like everybody else. You know–coats and ties and all that.  But when the trouble starts…well, that’s why the cops are so worried.”

He sat for a moment, looking hurt and confused and not quite able to digest all this terrible news. Then he cried out: “Oh…Jesus! What in the name of God is happening in this country? Where can you get away from it?”

“Not here,” I said, picking up my bag. “Thanks for the drink…and good luck.”

You know if you replace "Black Panthers" with "Radical Islamists" and "white crazies" with "liberals" you could yank someone's chain in exactly the same way today.

Deskilling

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Is a lack of demand for skilled labor contributing to America's stubbornly high unemployment rate?

What explains the current low rate of employment in the U.S.? While there has substantial debate over this question in recent years, we believe that considerable added insight can be derived by focusing on changes in the labour market at the turn of the century. In particular, we argue that in about the year 2000, the demand for skill (or, more specifically, for cognitive tasks often associated with high educational skill) underwent a reversal. Many researchers have documented a strong, ongoing increase in the demand for skills in the decades leading up to 2000. In this paper, we document a decline in that demand in the years since 2000, even as the supply of high education workers continues to grow. We go on to show that, in response to this demand reversal, high-skilled workers have moved down the occupational ladder and have begun to perform jobs traditionally performed by lower-skilled workers. This de-skilling process, in turn, results in high-skilled workers pushing low-skilled workers even further down the occupational ladder and, to some degree, out of the labor force all together. In order to understand these patterns, we offer a simple extension to the standard skill biased technical change model that views cognitive tasks as a stock rather than a flow. We show how such a model can explain the trends in the data that we present, and offers a novel interpretation of the current employment situation in the U.S.

Loophole Hits Close to Home

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Fox8 has a story about a family in Lewisville, NC that’s experiencing hard times due to a loophole in our country’s safety net. We can argue all we want about how our social safety net should function and how we should pay for it, but I think any of us would be hard pressed to argue against families like this being able to tap into it. This is exactly the kind of situation it should cover: