epiphanies?

I've moved!

2005-11-15T08:19:00.000-08:00

There's breaking news, epiphanites! I've officially set up a new blog -- Healthy Policy over at typepad. So for all things Kate, you should head over there.
Why the move? This little blog started as an "everything" blog. As my brain got taken over by health policy, so did the site. So I decided to move the blog to a respectable home over at typepad with special plain colors.

So I hope you'll all make the move and keep coming. It's been wonderful having everyone here -- but let's face it, the new site won't be the same without you as well!

Jumpin' in

2005-11-11T12:17:00.000-08:00

Seems like the blogosphere is having a heyday (see here, here, and here) with Tyler Cowen's assertion that he could never become a democrat because they support single payer health care. Despite his bizzare economic claims:

But since single-payer national health insurance violates every economic law known to mankind, I am again unsure how I could leap on the Democratic bandwagon.

I think it's a reasonable position.

Matt, apparently, does not:

Time to step back. As far as I can tell, the Democratic Party is not in favor of a single-payer health care system. Dennis Kucinich proposed one ("Medicare for all!") in the 2004 primaries and, as you'll recall, he wasn't a major contender. None of the other candidates did. Several of the major liberal think tanks have come up with health care proposals in the past twelve months, and none of them have endorsed a single-payer system. So as an objection to the Democratic Party this is a slightly odd one. It would be like me complaining about the Republican plan to abolish national parks -- I'm sure someone in the GOP wants to do it, but it's hardly a requirement of entry.

This strikes me as a completely false comparison.

If you feel that strongly about single payer health care, it's totally reasonable not to want to vote Democrat. Our best chances of enacting a single payer system are surely with the Democratic party. Think tank plans aside (many of which are written for their plausibility) there's a significant number of Democrats who support single payer. The vast majority of my democratic friends do. Polling suggests that 62% of Americans favor a government-run system. I don't know how many people want to abolish the national parks, but I'm sure it's miniscule. It might not be the party platform, but surely it's a larger issue than Matt makes it out to be.

What's my party-breaking issue? Choice. I will not vote major office Republican if the candidate is a strong anti-choice advocate. Take McCain. He's all sunshine and smiles for Democrats, but were he in office and enacting his ideal legislative agenda I'd be displeased, to say the least. And come to think of it, I wouldn’t vote Republican based on their health care agenda either.

Bizarre argumentation aside, if Tyler feels so strongly about single payer, then no, I would not recommend he vote Democrat.

Update: Jon's got more on the grip of single payer among Democratic leaders.

uninspired

2005-11-11T11:38:00.000-08:00

Hey kids.

I had me a little too much fun (and too little sleep) last night and nothing's catching my eye today. Anyone want to point me in the direction of somethin interesting?

It's how we end up with Vioxx

2005-11-10T11:53:00.000-08:00

Via Health Care Renewal, an interesting post about shifting trends in drug trial review boards. Roy Poses writes:

The articles noted that most (75%) of US drug trials are now done by commercial firms, rather than by academic researchers. In 1991, 80% of trials were done in academia. Most of these trials have been approved by commercial, rather than academic IRBs.

That's quite a turn around. In only 14 years drug trials have gone majority university run to majority privately run. This has numerous implications, from the private company's incentive to produce favorable results to insufficient research methods. Reporters visiting one test site in Miami found some questionable practices, to say the least:

Visits by reporters to a 675-bed trial site in Miami owned by SFBC International revealed the shoddy condition of its physical plant (a bathroom with "chipped white tiles [which] reeks with urine; its floor is covered with muddy footprints and paper towels.")
The reporters suggested that trial subjects are frequently poor. They may ignore study rules to forego alcohol and narcotics. Most trial participants stated that "they barely read" informed consent documents. Reporters noted that "participants in the Miami clinical trials openly talk about how they violate SFBC rules intended to protect the integrity of the research findings."

To be sure, the reporter's investigation is by no means scientific. But I don't doubt their findings. I'm sure we've all heard those radio ads for drug trials obviously targeted towards people in their early twenties. People who wait tables for a job and need an extra buck or 100. I can certainly envision many of my less responsible friends signing up for a drug trial with pot in their system, or going out drinking at night.

The informed consent language also represents a problem. If the majority of people signing up for these trials are low-income, it's likely their literacy levels are correspondingly low, and they might have trouble understanding informed consent. There's been a lot of talk over at the FDA about making drug inserts at a 6th grade literacy level, which is completely reasonable to me. Have you ever tried to read those? I enjoyed looking at them (particularly the drug molecule structure, but that's because I was pre-med for God's sake), but most people get scared off by the chemistry diagrams.

In any case, I'm quite uncomfortable with drug trials being performed on sects of the population that are in no means representative of it. Faulty trials are how we end up with Vioxx and Guidant's heart devices on the market. There's a lot of room for change over at the FDA -- we should be pushing for stricter drug trial standards, too.

More Non-Health Care Blogging

2005-11-09T09:53:00.000-08:00

This Yahoo News piece on Generation Y and the work place is highly hilarious, especially for those of us in said generation. Says Yahoo:

"I knew what a Roth IRA was at 17. I learned about it in economics class," says Hudson, an assistant account executive in Atlanta and a University of Alabama graduate. "My generation is much more realistic. We were in college when we saw the whole dot-com bust."

I can promise you that's not typical. I only learned what an IRA is during the SS-privatization debacle, and most of my friends still don't know what the hell that is.

"Generation Y is much less likely to respond to the traditional command-and-control type of management still popular in much of today's workforce," says Jordan Kaplan, an associate managerial science professor at Long Island University-Brooklyn in New York. "They've grown up questioning their parents, and now they're questioning their employers. They don't know how to shut up, which is great, but that's aggravating to the 50-year-old manager who says, 'Do it and do it now.' "

Are we really that annoying? God, I hope not.

"The millennium generation has been brought up in the most child-centered generation ever. They've been programmed and nurtured," says Cathy O'Neill, senior vice president at career management company Lee Hecht Harrison in Woodcliff Lake, N.J. "Their expectations are different. The millennial expects to be told how they're doing."

And that's a great thing, if you ask me. Everyone needs to be told how well/badly they're doing, it imporves morale and makes expectations clear.

The bottom line is the article is 100% personal anecdote, 0% research. But I got a kick out of it -- go read if you're interested in how our generation is being stereotyped.

Joy.

2005-11-08T15:40:00.000-08:00

Kansas School Board Approves Controversial Science Standards

Hey, the woman I voted for was one of the four against. But I guess it doesn't help when your state is full of complete nutjobs.

Yes They Can

2005-11-07T11:17:00.000-08:00

MedPundit says:

Count me unconvinced that computerized records will be the savior of medicine. It's just managed care in another guise

Huh. That's an interesting take, I suppose, considering the most recent Health Affairs research on electronic medical records (EMRs), which revealed astonishing benefits:

Effective EMR implementation and networking could eventually save more than $81 billion annually—by improving health care efficiency and safety—and that HIT-enabled prevention and management of chronic disease could eventually double those savings while increasing health and other social benefits.

Medpundit is apparently aware of these benefits:

Yes, it's a more efficient method of storing and retrieving information. And yes, it's a method of reducing errors, although it also introduces new system-specific errors.

But then she proceeds to add this jewel:

The government's paramount goal in pushing a nationally-connected healthcare record is to be able to monitor and prescribe what kind of treatment everyone gets.

A little paranoid, no? If anything it's the insurance companies in doctor's and patient's faces trying to dictate care.

Take my Dad, for example. He broke a bone in his foot. His doctor prescribed a nifty little ultrasound machine that is supposed to stimulate bone growth. He took said nifty machine home with him from the doctor's office and began using it. Three weeks later he gets a letter from the insurance company that this device is not, in fact, covered. Care to take a guess for the cost of this little machine? (It's about 6 inches by 6 inches) $3,000.

No one at the doctor's office mentioned that insurance plans won't cover it. They just gave it to him, and now he owes three grand.

Really though, it's clear that MedPundit's concern here has nothing to do with the ways EMR might benefit her patients, only the way it might be a hassle for her.

One of my patients was enrolled in one for diabetes, but along the way he developed liver failure from cirrhosis. He was so malnourished from his liver disease that he no longer needed his diabetic medications and it was a total waste of time and money to order his diabetic labs. But, once a diabetic, always a diabetic, and I couldn't get him disenrolled. They kept bugging me and bugging me for his labs until I just did them. And every time I filled out their forms, I would write on the bottom - "patient severely malnourished from end-stage liver disease." It didn't matter.

Does that sound frustrating? Absolutely. Yet surely there are ways to turn off reminders, etc, if that's what you're concerned about. Or get involved in program development by giving a physician's input in ways to make HIT systems physician-friendly.

It's one thing to oppose the cost of implementing EMRs and HIT (health information technology) advances, which is why the government is leading the charge (see the VA and recent grants for practices to buy HIT software). I'd like to think things like EMRs could help patients avoid problems like my dad's (i.e. the doctor or nurse having a message pop up when they type in a treatment that this patient's insurance does NOT cover this treatment). Of course, if there's only one insurer we take out the guess work.

Medpundit's opposition to HIT exposes a selfish concern for the amount of hassle in learning a new system. I could go on about Medpundit's attitude, but I think her post should make those designing HIT think twice. If we can't come up with user-friendly systems, widespread use of EMR's will remain a fantasy. There are many, many reasons the medical community should support these technological advances. They will reduce their (or their nurse's, or other doctor's) errors, and help make their patients healthier. Don't doctor's with similar view to Medpundit complain over and over about malpractice insurance fees? EMR's offer a much better (and logical) fix than tort reform. Not to mention $81 billion a year in savings.

Reformers have decades of physician interference to learn from -- we've got to make sure system bugs and complicated interfaces don't become the focus of the AMA's next crusade.

Hat tip to Graham for the link.

South Africa , or what we could become

2005-11-03T11:29:00.000-08:00

I know there's been a lot of talk on Consumer Directed Health Care (CHDC) on this site lately. I'm going to continue on that meme today, because there's some fundamental issues worth considering if we're going to continue down that road (we're already on it, you can be sure of that).

David Adler over at The New Republic has an interesting piece on Consumer-directed health care in South Africa. Basically about half of the country's privately-insured are enrolled in high deductible plans. But the introduction of HDHPs (high deductible health plans) has had some unanticipated side-effects:

The result was an unprecedented restructuring of the insurance market. The young and healthy migrated to the new consumer-driven plans and away from traditional employer-based schemes. Meanwhile, the old and infirm were left in traditional insurance schemes.

That seems like a predictable response, right? Is it really such a big deal to have insurance segmented in this way?

The answer is, absolutely. Health insurance in the U.S. went through a massive restructuring after commercial insurers switched to experience rating and drowned Blue Cross in the 1950's. Blue Cross had offered moderately priced health plans to all workers through community rating, but other commercial insurers could offer cheaper plans to select groups of individuals through experience rating. The inevitable result was that all the young and strapping moved over to cheaper plans while the old and infirm had to stay with Blue Cross. Stuck with a bunch of high-cost patients, Blue Cross had no choice but to switch to experience rating as well. Which they did.

Now South Africa has experienced the same thing, except this time it was brought on by HDHPs. It's reasonable to believe the same could happen here as well as more and more people enroll in HDHPs. If that's the case, all these plans are going to do is cause a fundamental restructing of health insurance as more and more people are sectioned off according to their health status. Again.

And what's worse?

At a macroeconomic level, however, there is less cause for celebration. Private health care costs have hardly been contained. In fact, the opposite is the case. Between 1996 and 2001, the cost of specialty care increased 43 percent, and the cost of hospital care rose 65 percent. This represents a marked increase from the inflation rates for the five years prior. There have also been substantial increases in plans' administrative costs.

It's a temporary fix. Look at the graph again. Why, after forty years of trying these different private market solutions, should we believe it's going to be any different this time?

Especially when another country has proved exactly what we fear.

Health TV

2005-11-02T18:49:00.000-08:00

If you're interested in health, PBS is featuring a must-see series "Rx for Survival: A Global Health Challenge". You can still catch an hour tonight, and two more hours tomorrow.

Be prepared to be stunned and demoralized. But I'm someone who doesn't care if it stuns and demoralizes you; you owe it to these people to watch for two hours.

It's that important.

So how can we get people to consume less, anyways?

2005-11-02T10:03:00.000-08:00

Interesting article by Margaret O'Kane over at the San Francisco Chronicle on overuse of health services. I'll be excerpting but I highly recommend you read it. O'Kane writes:

The question is never "Doctor, how little can you do to treat my illness effectively?" And the answer is never, "Let's wait a while." Instead, it's a quick rush to the imaging room, to the surgical suite, or to the pharmacy downstairs. The costs are clear to us all: a $1.7 trillion annual health-care tab that is growing again, and as fast as ever. Today, millions of Americans are getting more and more care whose value is not clear, because it's not based on scientific evidence.

In terms of the "question", I highly recommend to all of you to always ask "What would happen if I don't do this? And what are the other ways of doing it?". It's vitally important.

In terms of the rest, many people will respond that our health system isn't competitive enough to cut out a lot of waste. In this instance, the private sector is surely driving a good deal of unnecessary spending.

Take pharmaceutical companies. They want as many people as possible to take their medicines. Think of all the people that were on Vioxx and Celebrex who had no problem tolerating ibuprofen? And those meds were shown to be no more effective than ibuprofen in relieving pain. I just find it deceitful because Pharma seems to take this "health costs are so expensive but we don't have anything to do with it! We just provide medicine everyone needs!" approach which doesn't ring true to me. Does Pharma provide a necessary service? Of course. We clearly need drugs. Are they responsible for all unnecessary health spending? Absolutely not. But they contribute quite a chunk.

Kane goes on:

Just as we do in so many other areas of consumerism, we need to take a more active role in health-care decision-making, questioning the value or necessity of tests, treatments or procedures.

This a really interesting point. Can people take this role? I mean, considering the amount we spend on all sorts of pretty "useless" things -- ipods, clothing (my particular weakness), video games, etc -- it often feels like there's this culture of spend now, think later. And that's without the emotional vulernability of people with illness that might require surgery, which obviously adds a whole new element to the decision making.

Wasteful spending stemmed in consumerism obviously extends way beyond health care. Think of "branding" -- it's not about quality and price at this point (maybe it was when the brands were first established). I know I'm one of those people that goes to the grocery store and doesn't like to buy the store's brand of stuff --- I feel suspicious even when I know it's theoretically the same.

That said, how can we change these consumer attitudes, which are good for other sectors of the economy (through more spending, income, happiness, etc) in all these other goods, but decidedly not good where health is concerned? This is a place where I agree with CDHC (consumer directed health care) people -- one problem is that we, as patients, do not have enough information.

Evidence-based medicine is in short supply in too many cases. Just think about the doctors who just won the Nobel for their research on ulcers. They knew it was caused by bacteria in the early 80's. The medical establishment refused to believe uclers were caused by a bacteria and it wasn't until the mid 90's that doctors finall woke up and started treating ulcers with antibiotics. It's 2005, and I guarantee if you polled the public (pre-nobel annoucement would have been preferable, but I think you'll find the same thing) on what causes ulcers, most would absolutely say stress.

And again the we have an unnecessary hysterectomy rate of 30% -- which is more tragic because it's automatic menopause and greatly reduces women's sexual function.

The first step is creating standards. We desperately need treatment standards for most every common illness (according to
symptoms, surely many people really do need that triple bypass) -- heart attacks, breast cancer, hip replacements, high cholesterol, birth (can we say completely inflated c-section rates?). I would argue for a federal agency to be responsible with this, but I'm open to other suggestions.

Knowledge is power, people.

Tuesday health stat

2005-11-01T07:00:00.000-08:00

Via isemmelweis. More reasons to fear getting old:

The average couple at age 65 is predicted to need $190,000 in savings to cover medical expenses for the rest of their lives

Ouch.

More to come on the rest of the article.

Toys o' the present

2005-10-31T14:11:00.000-08:00

I was over babysitting for the neighbors this afternoon when lo and behold, there sits a miniature "play" bottle of water on the floor before me.

Are you kidding me!? Play bottles of water!? The toy food sure seems different from when I grew up. Then again, my generation is to blame for Cabbage Patch Kids.

Big Bad Deductibles

2005-10-31T13:07:00.000-08:00

From Jonathan Cohn

According to a survey of large employers released just two weeks ago by Hewitt Associates, the consulting firm, out-of-pocket medical expenses alone is costing workers an average of $1,366 this year, up from $708 in 2000. And that figure is just the average. People who use a lot of medical services this year will likely pay more--in some cases, a lot more.

Italics mine

These stats -- not the sob stories that accompany them -- are the more convincing reasons to be solidly against CDHC (Consumer Directed Health Care) and all the nifty cost shifting devices that accompany it. Honestly -- a 93% increase in four years. Someone want to enlighten me as to what percent of Americans see their salaries increase 93% in four years? I can tell you this -- the median US household income was unchanged for at least two of those years of increase -- 2002 and 2003.

I just don't see how any of these "directives" are anything resembling a solution if they just price people out of health care altogether. I'm sure demand for all that ~~expensive~~ innovative technology will be sky high if hospitals start emptying because no one can afford health care.

Boo!

2005-10-31T09:38:00.000-08:00

Happy Halloween Epiphanites!

Wanna know something scary? At least eight pharmaceutical companies were involved in the UN Oil-for-Food Scandal (via Health Care Renewal)....bwhahahaha

And don't forget the Scalito Alito nomination!

Spooky stuff, indeed.

FDA blogging

2005-10-27T20:36:00.000-07:00

Not really. FDA columning! That's right, column number three is up, and let's just say your Plan A should be to go read it.

Non health care blogging

2005-10-26T20:17:00.000-07:00

I'm sorry to get all live journal on you guys tonight. But I've got a pretty hilarious development at home, and I just have to post pictures.

My dog, due to her self-inflicted nasty ass sore (see above) has gotten her first cone!

It's just too funny. She keeps running into corners (now that her head has inexpicably increased its circumference five fold).

In other news, I have a new top fifteen (I just can't choose ten) favorite movie. Mad Hot Ballroom. This film is incredible. It's a documentary following New York City P.S. fifth graders as they take their required ballroom dance class and the resulting competition. But the children are amazing. So many of them are beautifully wise beyond their years, eloquent, and fabulous dancers. And they're 11! They dance so much better than I ever will. But I'm okay with that because they are such awesome kids!

Seriously though, you should see the film. My cheeks hurt because I smiled through the whole thing. It's inspiring. Go see it! What are you still hanging around this ol' site for?

One more thing: Go read Ezra's post on Wal-mart over at Tapped. I was going to make pretty much the same point, but why waste your time when Ezra does it way better than I would have?

Thanks for indulging this of "epiphanies: live journal edition". I promise to temper these types of posts.

Tuesday health numbers

2005-10-26T10:35:00.000-07:00

Not Via the New York Times,

Via The Wall Street Journal

Just 66% of private full-time workers now have employer-sponsored health insurance, down from 80% in 1989, according to the Bureau of Labor Statistics. Though the U.S. economy has created 3.5 million jobs since 2000, the number of people with commercial health insurance hasn't budged.

Ouch.

monday health stats

2005-10-24T12:25:00.000-07:00

I did some more research after all my smart commentors took issue with the graphs from last week. Here's Kaiser's answer:

Changes in the private market impact the cost-effectiveness of premium assistance programs. Recently, there have been sharp increases in private coverage premiums, and private market costs have been increasing more rapidly than Medicaid on a per-capita basis. If private premiums continue to increase faster than Medicaid, and workers are asked to share a larger percentage of the growing cost, the calculation of whether it is cost-effective for states to buy families into private coverage becomes less and less favorable. States can limit their costs by capping their subsidies, but this shifts the risk of added costs to enrollees.

I think the experts do a better job proving my point.

In other news, anyone know some good articles/sources for Plan B (aka the topic of my next health care column)

Saturday Sick-bed Blogging

2005-10-22T19:06:00.000-07:00

And by sick bed I mean my parents comfortable couch, watching Finding Neverland, which I must admit I'm unimpressed by so far. It's too sentimental; they're trying too hard to contrive moments of childhood bliss (I mean, really, have you ever babysat four boys? They are far from this consistently sweet and charming.) Oh, here's Kate Winslet coughing -- she must have bronchitis too! (Sorry to the film's fans, I know that's not funny)

I finally made it to the doctor after not improving for the fourth day straight, and found out I've got a nasty case of bronchitis. Joy. But I can't stop thinking about the excessive urgent care copayment my insurance company demands.

Under my plan, apparently all urgent care outside of your PCP requires a $50 copay. It being Saturday, and my PCP's office being closed, I had no choice but to use urgent care. I had a pretty bad case of bronchitis (I'd been hoping it was a cold -- I went to urgent care as a student one too many times when feeling awful to discover there was nothing to do about it but wait). The doctor told me if I'd waited until Monday I probably would have developed pneumonia.

So this $50 copay strikes me as a perverse incentive. This wasn't an out-of-network office; my insurance contracts with them to provide urgent care. If I'd waited to see my PCP on Monday, my illness could have progressed to pneumonia, which carries a risk of hospitalization -- much more costly than going to urgent care. So why would the insurance company employ this disincentive to seek care when postponing could easily bring much greater costs? I guess I'm lucky I can afford the $50. The last thing I need while waiting around for my leg surgery is to be hospitalized with pneumonia.

In other news, the doctor who treated me was a self-described "flaming liberal" in favor of national health insurance. It's always encouraging to meet doctors on board for reform. Along with her reformist ideas, she was a huge supporter of managed care (which is quite unusual these days). She claimed it "leveled the playing field" in that it gave the same care to her poor patients as her wealthy patients, all for a small copay. My reply was "only if your employer provides affordable insurance!" I disagree with her conclusions on managed care, but it was an interesting exchange.

I'll close with my health stat o' the day, courtesy of my chief information source, the New York Times (I swear I'll be diversifying soon!):

From 2000 to 2005, employees in the most common type of insurance plan, known as preferred provider organizations, saw their premiums for individual coverage rise 76 percent, to $603 from $342, while their deductibles - the amount they pay out of pocket before insurance kicks in - rose almost 85 percent, to $323 from $175, according to the Kaiser Family Foundation. By 2003, a survey by the Center for Studying Health System Change estimated, 20 million American families had trouble paying their medical bills. Two-thirds of these had health insurance.

Which makes me wonder... what was my urgent care copay in 2000?

TGIF Health Stat

2005-10-21T21:35:00.000-07:00

Via Matthew Holt, some encouraging poll numbers for the weekend from the Wall Street Journal:

The poll also showed high support for policies or practices that are considered more controversial. Eighty-seven percent of those polled say they support funding of international HIV prevention and treatment programs, while 75% favor universal health insurance, compared with 17% who oppose it. Another 70% support embryonic stem-cell research, compared with about 19% who oppose it.

So, encouraging public opinion polling. Not that it's new -- public support for national health insurance, especially in the last five years, has always been overwhelming positive. Just good to see it's still there.

I've been battling a nasty cold the past couple days, and I expect it'll keep my blogging under the weather this weekend. The posts shall come more freely once I can breathe out of my nose again.

The Sad Reality of Repeating Our Mistakes

2005-10-20T12:40:00.000-07:00

Yesterday I mentioned the Not-So-Sad History of Medicare Cost Containment as Told in One Chart", which illustrates the remarkable difference in administrative costs between Medicare and Private administrative costs. Private costs (11.5%) are more than 3 times those of Medicare (3.6%). It's not only due to the lower administrative costs, but to the huge bargaining power of the government, and the efficacy of government regulation. Let's compare.

Here's the chart for overall Health Care Cost Containment:

The Medicare Cost Containment chart is below:

Keep in mind, that's percent change in spending per year. Click on either image if you want a closer look.

Striking as these images are alone, more impressive is the Bush Administration's willingess to apply the zig-zag method for Medicaid. The New York Times reports today that Florida is undertaking a major restructuring of its Medicaid care delivery.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient. . . The Florida plan says, "The state will set aside a specific amount of money for each person enrolled in Medicaid," based on the person's medical condition and historic use of health care.

Essentially, the state is privatizing Medicaid. Enrollees will now be put in private plans, which will receive payments from the state and fed.

What exactly does that mean? Take it from an expert:

Joan C. Alker, a senior researcher at the Health Policy Institute of Georgetown University, said: "Florida's proposal is one of the most far-reaching and radical proposals we've seen to restructure Medicaid. The federal government and the states now decide which benefits people get. Under the Florida plan, many of those decisions will be made by private health plans, out of public view."

This is actually a pretty big deal, considering the government recently scaled back Medicaid enrollees' rights to sue for treatment. I'm assuming that isn't going to change here just because private insurance is in charge of delivery.

The real question, however, is why are we using the failed private market (see cost containment chart above) to reign in costs when the government (see Medicare chart above) is obviously doing a superior job? And as the system prices more and more people out of their employer sponsored (or lack of) insurance, why are pretending that the same ineffectual system is a magic antidote? The worst part is that this isn't even a new idea! There is not a single shred of novelty in the way care is delivered here -- it's just putting Medicaid enrollees into the same kind of sytem most of the U.S. has. Health care just can't seem to escape the cycle of touching the hot stove, burning and disfiguring its hand, then coming back in five years and forgetting that stoves are hot.

And that's all these "been there, done that" measures will do. They burn people and disfigure our ability to deliver health care. I guess this is just one more step, along with so-called consumer directed plans until our system becomes unrecognizable, and sweeping reform can emerge. I just wish it didn't involve so many scars along the way.

Health Stat of the Day

2005-10-19T12:29:00.000-07:00

I'm going to try a new series -- Health Stat of the Day -- which is to say most days I will be attempting to do so.

Today's stat comes from a nifty little essay called "The Not-So-Sad History of Medicare Cost Containment as Told in One Chart", by Thomas Bodenheimer, which brings us an equally nifty stat:

... Private insurance administrative costs continue at their 11.5% rate while Medicare is administered at 3.6%

That's in 2002.

Later today I'll post on the charts.

Blame Canada!

2005-10-17T08:02:00.000-07:00

Last week a little post of mine on frustration with US health care made some noise here and here. I have to admit I was taken by suprise that my bitching got so much attention.

Much of that attention demanded that I give proof for my accusations! Well, if you read the post closely you'd see I wasn't making any claims except the simple fact that our health system has its problems, waiting being one of them. But today I'm going to give all those naysayers some satisfaction by debunking another huge myth about the perils of Canadian medicine: that many thousands of desperate Canadians cross the border every year seeking medical care because of unsatisfactory care at home, be it long waits, lack of new technology, or [insert appropriate false claim about Canadian care here.]

Three years ago, long before this blog came into existence, Health Affairs ran an article on Canadians seeking care in the US. The authors used some nifty methodology, including surveying numerous US hospitals along the border, as well as institutions generally regarded as "America's Best Hospitals". On the Canadian side, they used the National Population Health Survey (which literally asks, "In the past twelve months did you receive any health care services in the United States?" and "Did you go there primarily to get these services?"), as well as querying insurance companies on the Canadian side about the popularity of policies that cover US institutions.

Before I pull back the curtain to reveal their astounding findings, let's make a couple things clear. Many Canadians travel in the US every year. It is expected that this fact will show up in statistics. Further, I assume there are some very wealthy Canadians who will always say "No thanks" to waiting lists, and hop over to the US. I believe that is a reasonable assumption, and a fact of life that I'm comfortable with.

So what did the authors find?

In terms of hospitals along the border offering advanced treatments or special diagnostic technology (i.e. CT scans and MRIs), about 640 Canadians were seen, along with 270 for procedures like cataract surgery. They compare this to about 375,000 and 44,000 similar procedures in the region of Quebec alone during the same period. If you divide the total number of Canadians seeking those treatments in the US, divided by the number in Quebec alone that's about 0.09%. Not even a tenth of a percent.

But the most striking stats come from the Canadian National Population Health Survey (NPHS). From the article:

Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received care in the United States during the previous twelve months, and only twenty had indicated that they had gone to the United States expressly for the purpose of getting that care.

Only 20 of 18,000 sought care in the United States. I can't believe how many people are coming over here! Their system but be truly awful.

But let's give this number some context. We've all heard about seniors getting their prescriptions from Canada. (Hell, even driving to visit my sister at college in rural Kansas, I saw a billboard for "Canada Drug of Topeka!") But how many seniors really do that? Is it exaggerated, like the claims of Canadians coming stateside?

Polling data from 2003 (approximately a year after the Health Affairs article) indicates that 8% answered YES to the following question:

"Have you ever bought prescription drugs from Canada or other countries outside the United States in order to pay a lower price?"

If 8% of the 18,000 Canadians polled in NPHS had expressly sought care in the United States, that would be 1,440. Not 20, as the survey showed.

In other words, we have 72 times the number of Canadians seeking care in the US going to Canada (or at least calling there) to get prescriptions.

Honestly, what's really wrong with this picture?

[Source: Katz, Steven J et al. "Phantoms in the Snow: Canadians' Use Of Health Care Services In The United States." Health Affairs May/June 2002.

That's EBCR0089, bitch

2005-10-14T12:29:00.000-07:00

Continuing its fascinating health care series, the New York Times bring us a piece on health care billing that makes you want to tear your hair out just reading it. It's chock full of quotes like this:

There were so many envelopes - some of them very thick - that at first, Mrs. Klausner, 77, could not bring herself to open them, and she stored them in large shopping bags in her Manhattan apartment.

When she finally did open some of the envelopes, there were pages filled with dozens of carefully detailed items, each accompanied by a service code: "Partial thrombo 2300214 102.00," "KUB Flat 2651040 466.00."

On the 15th page or so of each bill, a "balance forward" line listed amounts in the tens of thousands of dollars. One totaled $77,858.04.

Ouch. But that's just some old lady in the New York Times. I mean, how realistic can this situation be? Let's hear from my commentors:

I had decided against the operation and so the bill was a measily $220; which an insurance phone rep had promised to pay, but then refused to pay until I harrassed them for two whole years.

They kept telling me that they would research it and for me to call back the next month, but when I'd call back, they wouldn't know anything either, and we'd start all over again. And somehow, all my letters kept getting lost, though each phone rep insisted that the letters couldn't get lost, and that I must have sent it to the wrong place. They also insisted that they didn't make mistakes; as did the ortho clinic. And the whole time, I was being harrassed by the clinic. They even sent me to a collections guy, who I finally paid.

And even after the insurer paid, the clinic insisted for four more months that they hadn't been, and wouldn't reimburse me (for some reason,the insurer refused to reimburse me directly). And the clinic eventually ripped me off for the $40 that they had paid the collections people to collect my money. So basically, I paid a collections guy to harrass me for money that I didn't really owe. And the whole time, both the insurance company and the ortho clinic acted as if I was some jerk trying to rip them off; rather than acknowledging that they had ripped me off. I never got an apology from anyone.

And to top it all, I still have the bone chip in my elbow! But I'd rather have the bone chip than the large bills I would have gotten, had I elected for the surgery.

Hmm...maybe there are people other than old ladies with this trouble. Wait, what's this?

"I'm the president's senior adviser on health information technology, and when I get an E.O.B. for my 4-year-old's care, I can't figure out what happened, or what I'm supposed to do," said Dr. David Brailer, National Coordinator for Health Information Technology, whose office is in the Department of Health and Human Services. "I can't figure out what care it was related to or who did what."

Oh my God. When I do finally have this surgery, I'm screwed.

Luckily I've been down this road before. It took me a year (in 2003) to get my insurance company to actually pay for physical therapy visits that they approved in the first place.

But hey, it's the best system in the world, I mean, I'm totally satisfied, aren't you?

Navigating the health care system

2005-10-12T08:37:00.000-07:00

Well, this morning I'm full of complaints, so reader beware.

You know, when people complain about wait lists in Canada it really gets my proverbial panties in a knot. That's not because there aren't wait lists in Canada -- there are. That's not because I don't think things could be improved over there -- they could.

It's this idea that our health care system is so flawless, that we can just go into the doctor here and set up surgery. And that couldn't be further from the truth if you have anything out of the ordinary.

I have to have complex and unusual surgery on my femur (thigh bone). I found this out August 31st. I've been trying to arrange surgery since then, and I've gotten almost nowhere. First, trying to even figure out which surgeons specialize in what I need is a nightmare. I need a pediatric orthopedic surgeon. That shouldn't be too hard, right? Try finding a pediatric surgeon that will still operate on someone over 18!

Next, in the extremely slow communication world of over-worked nurses, it takes a week emailing back and forth to even approach answers to my questions.

What's this? Finally a doctor in KC who might be able to see me?! Oh, yes, he can help you but his next availabe appointment is February 16th!

Okay great.

I need to have this surgery, which I fully expected to have by now, and I'm just finding that any type of plans I make keep being smashed to pieces before my eyes. It's been such a frustrating ordeal, not in the least because I'm just sitting around, waiting for news, unable to plan what the next however many months of my life are going to be like. I don't think I've ever been so frustrated in my life, and all I can do is wait. And the waiting is hell.

Column #2

2005-10-12T08:35:00.000-07:00

My second column is up over at Campus Progress. Go check it out!

I've done it!

2005-10-03T10:28:00.000-07:00

Eegads, I've done it!

By which I mean I set up the wireless connection in my home, and now I can happily blog from any place in my house. This is much preferred to sitting in our terribly insulated playroom, which is either hot and humid or freezing depending on the unpredictable KC weather.

The best thing is the Kansas City weather prediction for the next three days:

Monday
Partly cloudy. Chance of showers and thunderstorms in the late morning and afternoon. Highs in the upper 80s. South winds 10 to 20 mph. Gusts up to 30 mph in the afternoon. Chance of precipitation 30 percent.

Tuesday
Partly cloudy. Highs in the upper 80s. South winds 10 to 20 mph. Gusts up to 30 mph in the afternoon.
Tuesday Night
Partly cloudy. Chance of showers and thunderstorms after midnight. Lows in the lower 60s. South winds 10 to 15 mph and gusty. Chance of precipitation 50 percent.

Wednesday
Mostly cloudy with chance of showers and thunderstorms in the morning...then partly cloudy in the afternoon. Breezy. Much cooler. Highs in the upper 60s. Northwest winds 15 to 25 mph with gusts to around 35 mph. Chance of precipitation 30 percent.

Yes! Chance of thunderstorms every day! Thunderstorms are my absolute favorite, and after four years in coastal California, with a grand total of three thunderstorms...let's just say I'm liking the forecast.

In other news, I'm off to figure out who the hell this Harriet Miers is. I heard something about being a lawyer? And thinking that the president was the most brilliant man she had ever met. Yeah, something like that.

No Spam, thank you ma'am

2005-10-02T11:30:00.000-07:00

So my comments are being spammed. Much as I want to know about "cancer uterine" and "camera spy gadgets", I'm not sure you all share my enthusiasm! Anyone know a solution?

Thanks!

My first column!

2005-09-28T15:14:00.000-07:00

Finally, some good news for Kate!

My very first column is up! Column, what column?

My Health Care Column

Go read it!

It's a biweekly thing, so I'll be linking when they come.

At Last!

2005-09-27T21:23:00.000-07:00

Well, after 7 days, 2300 miles, and 9 states, I've completed the circuitous journey from Los Angeles to Kansas City.

Now I'm parked at my parent's house until January (more details on that to come). I finally got their internet to work. It took about 5 hours on the phone with Time Warner Cable, with a total of four people giving me conflicting information, thankyouverymuchforthat. But I'm finally online! On my own computer! This makes me so happy (it's really the little things right now).

I'm stealing a poem from my friend Shaina to put up here.

"Song"

by Adrienne Rich.

You're wondering if I'm lonely:
OK then, yes, I'm lonely
as a plane rides lonely and level
on its radio beam, aiming
across the Rockies
for the blue-strung aisles
of an airfield on the ocean.

You want to ask, am I lonely?
Well, of course, lonely
as a woman driving across country
day after day, leaving behind
mile after mile
little towns she might have stopped
and lived and died in, lonely

If I'm lonely
it must be the loneliness
of waking first, of breathing
dawns' first cold breath on the city
of being the one awake
in a house wrapped in sleep

If I'm lonely
it's with the rowboat ice-fast on the shore
in the last red light of the year
that knows what it is, that knows it's neither
ice nor mud nor winter light
but wood, with a gift for burning.

At least people care

2005-09-13T15:50:00.000-07:00

I must say it's been heartening to see different community and business responses to Katrina. I just have two small examples, but I think they're representative of the American spirit, and offer some hope and sense of good during such confusing and dark times.

I want to preface that these examples are from Kansas City, not LA. I haven't seen the same happening in LA but I'm sure it's there.

First, the homey little coffeeshop up the street has a sign saying "Thank you for helping us raise $1,300 for the Red Cross". Considering I'm the only customer in here, and this place seems pretty slow in general, that's no small accomplishment.

Moreso are the small homages that people all over the country are paying to the city of New Orleans. At my mom's tiny mysteries-only bookstore, they've made a display with all authors who are from NO or books that take place there. I don't know if they're donating money, but people are trying, in whatever small way they can, to say "We care, and we're thinking about it." And these acts, while insignificant on their individual level, become more than the sum of their parts. They represent care, care taken to honor those who have lost everything, including their lives, and become little altars to make others take a moment and think as well. I'm thankful for that.

Funny how things change

2005-09-10T12:01:00.000-07:00

From NYT

At mid-afternoon on that Monday, a few hours after Katrina made landfall, state and federal leaders appeared together at a press conference in Baton Rouge in a display of solidarity.

Governor Blanco lavished her gratitude on Mr. Brown, the FEMA chief.

"Director Brown," she said, "I hope you will tell President Bush how much we appreciated - these are the times that really count - to know that our federal government will step in and give us the kind of assistance that we need." Senator Mary L. Landrieu pitched in: "We are indeed fortunate to have an able and experienced director of FEMA who has been with us on the ground for some time."

Mr. Brown replied in the same spirit: "What I've seen here today is a team that is very tight-knit, working closely together, being very professional doing it, and in my humble opinion, making the right calls."

I think you all know what happened next.

In retrospect, it's unimaginable that there was ever a moment like this. But before lake Pontchartrain started dumping its murderous waters into the city, it seemed the worst had been spared, and the city had escaped once again.

If only it'd stayed that way.

Poll for thought

2005-09-07T22:41:00.000-07:00

Excellent post over at Health Care Renewal on a recent health care opinion poll.

I'm not going to cite the whole thing, but go look. The key here is two conflicting opinions on health care costs. (At least if you're a liberal and want to enact serious reform).

The good news:

71% cite high profits made by drug companies and insurance companies as major causes of increasing health care costs.

The bad news:

58% cite the number of malpractice lawsuits as a major cause of increasing health care costs.

So, we've successfully convinced the public that drug and insurance companies make too much money and abuse clients. But we haven't been able to pound in the malpractice-costs-mean-nothing-argument.

Remember folks, all malpractice costs add up to less than ONE HALF OF ONE PERCENT of health care spending in the US.

More on this later.

Words fail

2005-09-01T22:56:00.000-07:00

In light of my last post, I must put something up. It's nothing, it's the smallest possible gesture, but I have to make it, because my heart is breaking right now hearing, watching, and reading the unbelievable nightmare befalling one of our cities.

There is no room for thinking about everyday things, and any suffering I am undergoing is beyond miniscule in comparison. I wish so much that I lived near this area so I could open my home to these people. I wish so much that I could do more than sit here, aghast at this fucking country, and the cruelty of this world that lets the privileged escape disaster while the poor and black might starve by the thousands as they're being completely ignored.

I am so angry, and so sad, and I hate that the only thing I can do is give money. God help us all.

I can't really say

2005-08-31T20:22:00.000-07:00

Well, although I trumpeted a celebrated return, I'm sorry to say that it's going to take longer than I thought to regain full speed.

I just want to tell the few of you who read this humble corner of the virtual ether to keep checking back, cuz I'm not giving up. I've just gotten item after item of bad news this summer, and just when I thought that I was ready to get back in the blogging game, disaster struck again.

To be sure, I'm not a resident of Louisiana or Mississippi, and I can't compare my individual struggles with the catastrophic loss of life and property there.

I'm just a girl with a small public space. I want to keep these epiphanies going, but I'm afraid too many of them will depress you.

I'll leave you with this snippet:

I'm so passionate about health care in the US because I've been a patient way too often. And it looks like I'm in for another big round. Stay tuned.

p.s. I lasted 8 days on the the South Beach Diet before decided that I was still way too hungry and I must have carbs. My dinner tonight? Crackers, cheese, fruit and wine. Now that's what I call a diet!

That's your big federal bureaucracy, eh?

2005-08-22T21:23:00.000-07:00

Excellent piece on the VA system from Wapo.

I've heard (and read) a fair amount about the great quality of the VA system, but this piece lays out key points quite effectively. What are said key points, you ask? Some pretty amazing statistics about the quality improvement of the VA system in 10 years, including:

• Since 1995 the number of patients has doubled to about 5.2 million. This is while over 12,000 staff were cut and the cost per patient was reduced by half.

• Amazing Health Information Technology (HIT) program with electronic patient records, including lab tests, prescriptions, and nifty scannable bracelets. (For anyone who takes more than two prescriptions, how great would it be to just be scanned rather than spell everything out every time you go! I'm psyched!)

• Performance typically better than the private sector -- check out these results "In 1990, before Baltimore began tracking its performance, rates of screening for breast and cervical cancer were 50 percent and 17 percent, respectively. In 2003, they were 88 percent and 87 percent." Let me tell you, 87% for cervical cancer is amazing by private practice standards.

And of course, the crowning glory on why we need single-payer care:

Medicare officials point out that the VA has the advantage of being an integrated delivery system -- that is, a health plan in which most of the doctors are salaried employees and all care is coordinated and tracked. In Medicare, physicians work for themselves and patients are free to pick and choose their services.

Exactly. Which is why Medicare (and Medicaid, for that matter) are sending the deficit sky-high, not to mention drowning in quality assurance and fee reimbursement quarrels.

So I guess my response to ginormous bureaucracy healthcare would have to be -- thank you government!

Have a nice life

2005-08-22T21:13:00.000-07:00

So in my internship this summer, I basically sit around and come up with creative ways to describe low-income people without health insurance. Today's result:

"Socioeconomic and environmental health risks weigh heavier on the poor, often compounding their effects. Health access barriers of low-income, immigrant, homeless and underserved communities are most acutely evident in their poor health outcomes. Those with little education in American society are more likely to be poor, to labor in physically demanding or dangerous jobs and to live in sub-standard housing. These challenges are multiplied by limited resources, language and cultural differences and low literacy levels, particularly related to health care."

That's really just an extremely glossed-over way of saying, "Sorry, but your life sucks, and it's pretty much because you're an immigrant. But good luck to ya!"

Ugh.

Here We Are

2005-08-18T19:48:00.000-07:00

In a nationwide survey of more than 2,000 adults published last fall, 55 percent of those surveyed said they were dissatisfied with the quality of health care, up from 44 percent in 2000; and 40 percent said the quality of care had gotten worse in the last five years.

italics mine

This survey, by researchers at Harvard, the federal Agency for Healthcare Research and Quality and the Kaiser Family Foundation, illuminates the sorry state of the "best healthcare system in the world".

For the first time since the implementation of medicare, over half of Americans are dissatisfied with their health care. It's a seething indictment-- telling us what the average patient already knows -- health care is no good, and it's only getting worse.

The survey is couched in this New York Times piece on the emotional degradation of patients. I won't speak to that, because it's an enormous subject I have strong opinions on, and besides the point of this post. I suggest you read it, but it's not the topic here.

Instead I want to explore some points from Jill Quadagno's recent book, One Nation Uninsured, that give context to the attitudes expressed in this poll. How the hell, with this country's many incarnations of health care delivery, did we get to 55% unfavorable? What's made Americans swallow one substandard form of care after another?

Quadagno's book explores innumerable events that led us down this thorny path. I just want to focus on two decisions from 1942-43. These key shifts in health care law and delivery are inextricable from our current system.

The first major event came in the form of the Revenue Act of 1942, enacted during WWII as a means of keeping corporations from profiteering. Under the law, excess profits (defined as higher than before the war) were taxed at 80- 90% (!). However, health care was counted as a tax-deductible expense, and many employers started hiding profits in generous trust funds for fringe benefits.

So what, exactly, does that mean? Basically the government indirectly encouraged employers to offer health insurance and fringe benefits as a way of avoiding penalization for excess profit. After the war, many corporations had this infrastructure in place, and continued to offer healthcare, enjoying the tax-deductible benefits.

Quadagno’s next revelation jumps on the back of the 1942 decision. It’s the story of how the labor movement kept the U.S. from a national health insurance program by demanding employers provide health insurance. And its effects reach much further, directly creating the situation today, where 45 million people are uninsured. It’s also led to the unrest cited in the poll above, as employers shift insurmountable insurance risk and cost to their employees.
Quadagno on page 50:

The second important ruling was a 1943 decision by the National War Labor Board that employer contributions to employee benefit plans would not be counted as wages. The trade unions had been unable to demand higher wages because they were bound by their no-strike pledge. The board’s decision gave them the opportunity to negotiate health and pension benefits in their collective bargaining agreements as a substitute for wage increases.

This ruling granted unions a new and influential bargaining tool, one that was immediately utilized for their betterment. Over 50% of strikes in 1949 and 70% of strikes in 1950 were over benefits. The ruling also served as a powerful incentive for new members. Employees were much more likely to join unions if they could receive health insurance.

Employers, in turn, were willing to provide benefit packages instead of higher wages because they were tax exempt. And with these (and other) changes, the number of people with health insurance increased from 6 million to 75 million between 1940 and 1966.

So there you are, the two main reasons we have employer based health insurance. Any plan that calls for change must consider these incentives. If rearrangements occur, like removing the tax deductible status of health care (which would certainly fix that budget deficit), expect employer-linked health insurance to dissolve. On the other hand, don’t expect big business to jump on the national health insurance wagon. Any changes that lessen the employer’s burden in the meantime will destroy chances for a nationalized plan. We desperately need the aid of employers in the face of such bitter enemies as the AHA, AMA, and Pharma.

I'm back!

2005-08-18T00:41:00.000-07:00

Please read that title with the appropriate James Brown impression in mind.

Well, after an over-extended absence (I haven't been so great about those vacations, huh?), I've returned to my humble iamstellaness abode. I feel amply prepared. And I know you all have been waiting at the edge of your keyboards for my return. If you're nice enough, I just might stay this time.

So a few things.

First, a wave of "must find new songs-- now!" has pulled me under, and I've gone i-tunes crazy tonight. I can't begin to express my contented joy sitting on my comfy bed, with my beautiful i-book, my super librarian glasses, and a great collection of stupendous emotion-provoking music pouring into my ears. Do you ever get those moments? Where you've found a beautiful new song, and you feel drunk? (Really? Or are you looking at me right now with that I-have-no-clue-what-you're-talking-about-it's-just-music face?)

So, said songs?

1. Glass, Concrete and Stone by David Byrne
(I had to include a lyric snippet)
"Everything's possible
when you're an animal
not inconceivable
How things can change, I know

So I'm puttin' on aftershave
nothin' is out of place
gonna be on my way
Try to pretend, it's not only

Glass and concrete and stone
That it's just a house, not a home.
And its glass and concrete and stone"

2. En Tus Pupilas -- Shakira (did any of you catch that girl crush article from the NYT last week? I have a serious case of that con Sra. Shakira)

3. Photobooth -- Death Cab for Cutie

4. One -- Cowboy Junkies (I'm also perpetually in love with Sweet Jane)

5. We both go down together -- The Decembrists

6. Zebra- John Butler Trio

In light of the list, it's important you don't get a false impression. I am not an audiophile. By any means. My favorites bands have pretty much been the same for 8 years (which I imagine reflects badly on me). Audiophiles irritate me. Your music is not better than my music! I love my music just fine thankyouverymuch. I just want to share some flashes of inspiration in case anyone was interested. That's all.

Second, and now I know you are getting the wrong impression of me -- I'm starting the South Beach Diet tomorrow.

Okay, before you go all postal, I have real bonafide reasons for doing this besides any coincidental cosmetic benefits.

Oh man, I almost convinced myself there!

Actually I'm not lying. In the past year I've been unbelievably hungry. I eat a completely normal amount of food for someone my size and I'm always starving within 45 minutes. It's honestly like I didn't even eat. This is also an incredibly annoying problem because my appetite is pretty much insatiable. I don't eat ginormous meals every 45 minutes (although I would like to!) so I just end up spending a majority of the day starving.

So, Kate, exactly what does this have to do with the South Beach Diet?

Well, dear reader, I'm so glad you asked! Apparently what happens to me is a consequence of eating too many foods with high glycemic indexes (I love me my carbs)! These pesky high glycemic index foods are creating all these drops in my insulin levels! If I stop eating ALL carbs for 2 weeks -- yes 14 days-- then eat a lot more whole wheat products, I won't be so hungry!

Hey, it's worth a try. And I'll keep you all posted throughout my torture experiment. I hope it works, otherwise I'm off to the endocrinologist. I'd prefer to try changing my eating before I going on any meds.

So, enough about me, how are you?

So Very American

2005-07-07T21:43:00.000-07:00

Well, I guess it's time for me to weigh in on the American Apparel question. Ezra's already given away the ending, but I came to my position via a different road.

I'd been passionately debating the merits of shopping at American Apparel the past few nights with a friend. My original cause for concern was a New York Times article detailing CEO Charney's strange exploitations, followed by a jaunt to the website to check out the so-called "natural" models. I agree with other's characterizations of the ads as low-fi basement porn. Some of the ads seemed to have such an overtly sexual overtone you'd think you'd accidentally gotten a peek of a pre "Girls Gone Wild!" de-shirting.

Ads aside, I found Charney's behavior abhorrent, and labor issues aside, AA seemed up to no good.

But a new store just opened down the street, and despite my protests that AA was unacceptable, a sort of morbid curiosity swept over me (the kind where you know you're not supposed to do something, so then you have to do it), I grabbed Ezra and stomped down the block to check it out. The store was totally different from its demonic reputation, and that fact was more than enough to sway my formerly cemented views.

When you look through the photo albums on the web, they are enormous, gritty, and in quick succession. Not so when you enter the store, bombarded by a juicy color palette comprised of twenty or so different shirt/dress/pant styles. Compared to the bright, cheery style of the clothing, the pictures are hardly noticeable. In fact, most are displayed in small montages that, due to their dark aesthetic, blend in to the background.

Second, the clothes, especially the t-shirts, are really modest. Charney's clearly not trying to outfit a subset of club-hopping girls with their newest backless top (unlike other trendy stores-- can we say Bebe?). And the best part -- the montage in the dressing room featured a pale, frizzy haired, pudgy girl. There were articles about the company on the wall by the dressing rooms, including the critical NYT piece I'd mentioned.

As for Charney, I'm still a bit torn, but have a few responses. First, I've no doubt, especially at fashion companies like AA, there's a fair amount of sleeping with the boss and sexual harassment. Further, I think we're all forgetting the agency of the women working at the office here, in that they, especially at this point, have some knowledge of the work atmosphere. A career in the office at AA is not by any means the end all be all, and I think it might be attracting some women who might have some comfort, or at least indifference, to the office practices (see Amanda's comment thread.) That said, I hope that the exposure of these practices could lead to some good, like a call for an end to the sleazy behavior, or at least educate the women working there/applying there about the company culture, so they can choose for themselves if they want to participate. Ideally we're talking lawsuits, because frankly, the behavior is illegal, and I do hope it ends.

But boiled down, my simple view is this: American Apparel is no different from any other mainstream/trendy fashion establishment except in one facet: its labor policies. If it can set a standard of profitability through living wages, super affordable healthcare, and other generous benefits, that puts it a head above the rest. Really, what are my other shopping options? Super cheap Target clothes which were no doubt produced in a sweatshop, super revealing clothes with sexual ads and sweatshop production, or sexual ads, modest clothes, and living wages?

I think I'll choose door number 3.

Activist schmactivist

2005-07-06T17:01:00.000-07:00

New NYT op-ed on the science behind judicial activism. The authors define activism:

We've identified one reasonably objective and quantifiable measure of a judge's activism, and we've used it to assess the records of the justices on the current Supreme Court.

Here is the question we asked: How often has each justice voted to strike down a law passed by Congress?

They then use this definition to rate the Justices, and come up with the following stats:

Thomas 65.63 %
Kennedy 64.06 %
Scalia 56.25 %
Rehnquist 46.88 %
O’Connor 46.77 %
Souter 42.19 %
Stevens 39.34 %
Ginsburg 39.06 %
Breyer 28.13 %

The authors find this outcome surprising, but it makes perfect sense to me.

Congress has passed many a crazy law in its time. How about banning partial birth abortion without an exception for the mother's life? I doubt many Americans are too thrilled about the Bankruptcy bill. Congress is supposed to be representative of the majority, but there's no question they pass a number of bills that would be rejected (for better or worse) if the electorate was allowed to vote on them directly.

Take Thomas for instance. He was appointed in 1990, when Democrats had the House and Senate. Not to mention Clinton was in office from 1992 til 2000. Wouldn't it make sense that a conservative judge might object more often to the laws passed by an overall left-leaning House and Senate?

I appreciate the author's intent, which I believe is to prove that the right's claims of judicial activism are bunk. But let's not forget the whole concept of judicial activism is fabricated by the right as a means of gaining support for their goals. It's not the Supreme Court who even caused all recent uproar in the first place! It was judges in San Francisco, Massachusetts, and most notably, Florida.

But this piece's strongest point isn't that the right is hypocritical, but that "judicial activism" is normal, and frankly, necessary. Their stats reveal that conservatives are just as (in fact more) likely to overturn laws. That makes "activism" seem a hell of a lot less partisan.

Get off my NYT!

2005-07-06T09:49:00.000-07:00

Has anyone else noticed the increasingly pop image of the New York Times online? For God's sake, they have an ad titled "Where can you find Tom, Angelina, & Nicole this summer?", including papparazi-like photos. Another ad implores you to "Hit the Beach!" apparently by "Check[ing] out these dream homes in the Hamptons".

What irritates me so much about these ads is that they are ads for other sections within the NYT. The celebrity love fest is for NYT Movies, and the barbie's dream house page is for NYT real estate. I checked out these dream homes in the Hamptons, btw, and the first house is priced at $50 million. $50 fucking million!

So, what's up NYT? Are you trying to cater to my So-Cal audience? Wanting to dumb down some of your content, or at least try to appeal to the masses? I love reading your news and analysis, but the ads are not cool. I feel like I'm reading a cousin to US Weekly.

It's called compassion, stupid

2005-07-02T21:51:00.000-07:00

The Washington Post has a piece on the feminist response to O'Connor's retirement. Unfortunately, some feminists are deriding her decision to step down in the wake of her husband's Alzheimer's. From the article:

But not the Chief Woman Lawyer of America -- she shouldn't quit to take care of her family, should she? What kind of message does that send?

"I was on a radio show and someone called in to say, 'Would we ever see a man retire to take care of his spouse?' " says Suzanna Sherry, a law professor at Vanderbilt University who has written about O'Connor. "This is why she's never been considered a feminist's feminist. A feminist would say: 'Well, why would she do that?' "

I find this argument ridiculous and offensive. Any reasonable person would want to stop working when a) they've been doing it for decades b) are 10 years past standard retirement age, and c)their husband has Alzheimer's. Her husband's mind is detiorating before her eyes, and frankly, she should spend the last months/years of his semi-sentience with him. Anyone who has experience with the heart breaking complexities of Alzheimer's care knows that. Hell, you don't need real life experience, anyone who's ever even heard of Alzheimer's knows that. Her retiring to take care of her husband is not a feminist issue, and it shouldn't be framed as one.

In fact, screw you militant feminists. A recent string of indicidents over at Ezra's blog prove this point. There is a place, a truly important place, for feminist dialogue in this country. The protection of abortion rights, especially related to Supreme Court nominees, is one of them. Without feminist voices (and dollars), Democrats would have a difficult time avoiding a reputation as horrible obstructionists. But that feminist voice does not belong in critiqueing the logical and personal decisions of someone who often showed herself an enormous ally.

I truly believe in the ideals of feminism. I've marched with NARAL and Planned Parenthood. But the feminist movement in this country gets itself on slippery footing when it demonstrates a complete lack of compassion, as is the case in the Post article. It doesn't help anyone either to run around in blog comment threads demanding the author account for any anti-feminism in a film based on a comic book (A film, that, in my opinion, was one of the least sexist action movies I've seen in a long time). Feminists have done a damn good job turning people off left and right. Any movement that makes 50% of the population feel consistently attacked needs to do some serious reevaluating. To truly achieve feminist ends, we've got to improve that hearts and minds campaign. As it is, we're akin to our Army dropping packages that could be food or bombs-- men don't know when they should run, and it's made them rather skittish in our presence.

Radio Idealism

2005-06-28T12:57:00.000-07:00

I feel as if I've lost my innocence.

As some of you know, I have an irrepressible love for all things NPR. It's my entertainment preference-- music is great and all, but NPR provides me with at least half of my current events knowledge and 90% of my interesting anecdotes. (If I had a nickel for everytime I started a story "I heard on NPR....") Despite all these most respectable and venerable qualities of NPR, I have one complaint: Stop showing photographs of your hosts without forewarning!!!

My personal favorite NPR show is Day to Day. It's the radio version of Slate, featuring Alex Chadwick, a seemingly young, dashing man with a fantastic voice. Not so, deemeth the internets! I logged on to NPR.org today to listen to the show, and there, without any warning, was a picture of Alex Chadwick! And let me tell you, he is not young or dashing. My illusion was shattered! I felt angry, betrayed, why, oh why, did you not warn me, NPR? Let me choose for myself if I want my false notions disproven! I would choose ignorance! But I was given no choice. You, dear reader, are. If you want your notions of your favorite NPR host demolished, go to the Day to Day link above and scroll down. But beware.

Incidentally, if you ever see a book by Garrison Keilor, RUN. Do not, I repeat, do not! look at him. He is a very strange looking man indeed. Keep your innocence, lest you become like me and everytime you hear his voice from now on you cannot help but imagine is enormous round eyes spaced entirely too far apart. Save yourselves, because I am ruined.

But in all seriousness, Day to Day is the best NPR show ever. Go listen.

Sick blogging

2005-06-26T20:02:00.000-07:00

I know I'm way over-due here, but as I've been doing whirlwind tours of Kansas and California this little blog has laid on the back burner. Unfortunately those whirlwind tours left me with a nasty cold, which I'm sure I picked up at Universal Studios (goddamn children! Breeding grounds for disease! Goddamn tourist paragon Universal Studios!) I'm blogging from my sick bed, which happens to be a nice bed settled in the middle of nice Westwood, with a nice boyfriend who makes me nice dinner. It really ain't half bad being sick here. As I've no super enlightening thoughts for today, I thought I'd point you folks to the stuff I've been entertaining myself with from said sick bed:

-- This great Slate article about all those crazy internet sites that get endlessly forwarded by those bored at work. Read it if you're like me, a lucky young person unchained to an office (as of yet) and hence without said bored forwarding network. I was particularly enthralled by/scared of the Pixie Land guy.

-- Heartbreaking, but fascinating WaPo piece on a 675 pound man. Good ol' human interest stuff.

-- I also, though I'm unsure how, got a spark to edumacate myself about Sid Vicious from Wikipedia (aka the best new internet toy ever.) I was one of those people who had a lot of punk/alternative type friends, the kind who actually knew the history of punk music (I hate to admit I'm still ignorant), who enjoyed sipping coffee and smoking cigarettes while discussing the complexities of [insert punk band here]'s lyrics or [insert punk singer here]'s representation of self through clothing, etc. Anyways, go read about Sid if you are ignorant like me, it's a helluva story.

That ends this sick blogging session, but stay tuned for my thoughts on Batman Begins.

Un Apologia

2005-06-15T21:32:00.000-07:00

Dear reader,

I know I owe you an explanation about my absence. It's my obligation to inform you about the exciting happenings of the last week. I know you feel neglected and jealous due to my failure to update. I'm terribly sorry, and promise not to do it again. Please don't get angry like you did last time...I'm so sorry.

First of all, I had to attend a debutante ball. It was a big high society affair, and though I respect your unique and special...qualities, I'm just not sure you would have fit in. I tried to get the committee to invite all 50 or so of you, but they just felt they couldn't accomodate so many incredibly interesting people. Their loss, believe me.

Then I had to go to Santa Cruz early the next morning for my graduation. I know some of you felt angry that I didn't invite you, but it was all the way in California, and I really didn't know how you'd behave, and let's just say I was proved right. I know three of you showed up as streakers, running down the hill, and finally taking a big, ostentatious bow for your naked feat, all to get me back for my thoughtlessness.

And it was you, wasn't it, that made my family dawdle and miss the final tour of the Hearst Castle! After driving for 6 hours, I know you saw that pitifully sad look of disappointment on our faces when we found out we'd missed the last tour by 15 mintures. But you just had to have your fun....

Oh, I see your plan unfolding. You caused the horrible traffic as I arrived in LA this afternoon! It's you, sabotaging my every move because you believe I've forgotten you.

Listen reader, I know I didn't invite you along on all my plans and adventures, but my hands were tied! I can't help my enormously busy schedule! I care dearly about you, but if you sabotage this vacation one more time... if I get so much as a splash of water of me at Universal Studios tomorrow, it's over.

And yes, I've moved to Los Angeles.

Love,

Kate

Blogging, Kansas style

2005-06-11T15:17:00.000-07:00

I come to you from Kansas in this edition of epiphanies: midwestern style

I'm off to a debutante ball tonight, and since my hair's been done for 3 hours and I don't leave for another two, I'm limited on moving around too much.

Ezra likes to make fun of me when I go home because I get a "Kate at home syndrome"; basically I get bored, tired, and my brain turns to mush. So, in order to stave off this malady, I made myself get on our old-ass unstable PC and start exercising my mind.

I just want to mention a couple things:

First, Gilead by Marilynne Robinson is fantastic so far. Her meditative prose is wonderful and comforting; you feel you've been transported inside the narrator's mind, viewing his descriptions as if watching homemade movies.

Second, this article on dental problems associated with methamphetamine use is fascinating and disgusting. The more I read about meth, the more I'm convinced we've got a huge problem on our hands with this drug. Seriously read it, and in the off-chance you were considering trying it, this will definitely make you think again.

Last, this post by Sue is hilarious. I've had a lot of trouble lately getting obnoxious men to leave me alone. I tend to be a nice, approachable person, and open for conversation, but too many gross men have taken advantage of that. I hate being rude and avoiding eye contact with people, but at a certain point, if you want to retain any privacy or peace when you go out, especially to a bar or coffeeshop, you just have to learn to be a bitch. And even then, as Sue has obviously found, some still won't listen. It's terribly obnoxious boys, so unless a girl keeps looking your direction, save her some trouble. And if any girls have advice on keeping weirdos at bay, let me know. I have a feeling that the general weirdness of Santa Cruz doesn't help the situation. Hopefully it will be better elsewhere.

As for me, soon I will be off to the debutante ball, that lovely tradition where daughters are presented to society (originally for the purpose of marriageability). Now it's just some luxe bash. I'm not the debutante, btw, it's my sister, I'll be the one drinking gin and tonics, trying to find someone unpretentious entertain me for the night.

Stop Complaining

2005-06-06T00:00:00.000-07:00

Hilarious article from the free local paper on a guy who compares NPR to Clear Channel. My favorite quote by far:

Like a weed growing up through the sidewalk, Thorn is trying to find space to grow between the inane pablum of drive-time commercial radio and the sober monotony of NPR and its many imitators. And that space is hard to find.

Oh man, great weed analogy. No reporter bias here.

But really, is it any suprise that that space is hard to find? This guy is bitching the whole time about how there's no space for any other public radio, but is somehow completely blind to the fact that there just isn't demand for it. Even NPR would be a bit strapped for cash were it not for its enormous $200 million endowment from Joan Kroc.

So what, exactly, is his argument?

But what is the single most powerful force for media consolidation in America? Sure, it might be Clear Channel, but it also might be National Public Radio.

Alright buddy, you've gone too far. Listen to me good: I'm an NPR junkie. I'll take it over music anyday. My favorite birthday present by far was the NPR memorabilia (courtesy of Ezra, a Morning Edition mug and an NPR t-shirt)

Obsession aside, I also happen to be as liberal as the next girl (well, the next girl in Santa Cruz). Comparing NPR to Clear Channel? That's just delusional. First, NPR's mission is not the broadest possible share of the market, in part because they are not-for-profit. Second, they do not control the news cycle, as there are hundreds of print sources, many with much more influence. Whereas Clear Channel practically dictates if a musician can, well, can even become an musician.

Buddy, you seem frustrated. A bit.. self-aggrandizing. I think you got a little lost in the Santa Cruz grass and woke up in...well, frankly, I don't think you woke up. It's definitely time to get out of the Santa Cruz bubble.

Aw Yeah!

2005-06-05T22:16:00.000-07:00

Folks, I just finished my last college paper EVER. Wow. I would celebrate if it weren't time to study for my two finals.

Countdown to graduating: two days.

Holy Shit.

Delicious Paaaastries

2005-06-05T01:15:00.000-07:00

Suburban Guerilla catches Fafblog! up to their usual comedic genius:

So You're Being Tortured To Death In An American Military Prison!

Q: Help! I'm being tortured to death in an American military prison! What should I do?
A: First of all, you should get your facts straight. You're not being tortured to death in an American military prison; you're being interrogated to death in an American detainment facility. America does not tolerate torture.

Q: Is there any sort of legal representative or due process I could get before being beaten to death?
A: No. Lawyers, open legal procedures, and basic civil liberties are all tools the enemy can use to escape justice - the justice of being beaten to death in a prison camp.
Q: It's just that my name is Musab Mohammed Khan, the pastry chef, and I believe you have me confused with Musab Muhammed Khan, the al Qaeda associate also known as "The Fist of Jihad."
A: First, there are many terrorist pastry chefs, just as there are many terrorist pastries. Second, competent intelligence and accurate prison records are both tools the enemy can use to escape justice.

Q: I seem to be losing all feeling in my lower body. Is there a doctor in the gulag?
A: Please: we find the term "gulag" absurd and offensive. A "gulag" is Russian. You are not being interrogated to death by Russians. You are being interrogated to death by the greatest country in the world.
Q: Is there a more accurate term you'd pre- aaaa! AAAAAAAA!
A: We prefer "outpost of liberty" or "island of freedom." Stringing together Guantanamo Bay, Abu Ghraib, and Bagram Airbase creates the Freedom Archipelago.
Q: So! Much! FreeedaaaAAAAARRRRRGGGGGGH!!!

Q: When I die in a few minutes, will my death help the cause of freedom?
A: Not really. But in a way, isn't death itself just freedom from life - the greatest prison of all?
Q: Wow... you've *HRAAACK* totally blown my mind - and my lung and ribcage and my kneecaps!
A: Oh, don't thank us - it's all part of being tortured to death in an American military prison!

Genius.

Stunned

2005-06-05T00:46:00.000-07:00

Loving Post Secret. I had to link to this one, it just.. wow. I have a friend who is very liberal, a times a socialist, but her boyfriend is conservative and serving in Iraq. I can't possibly conceive being in her/the author's shoes.

Saturday Night Blogging

2005-06-04T20:13:00.000-07:00

Tis the weekend, so I'm trying out various recipes. Tonight's was the Whole Wheat Fettucini with Raw Tomato Sauce from The Complete Book of Pasta and Noodles. Making this recipe led to an important discovery: I do not like raw tomato sauces. Now, to be sure, I'm thankful for this discovery. No longer will I go to a restaurant, and God Forbid, waste money on a raw tomato sauce dish I hate. But all the same...after all the chopping and anticipation, I'm pretty disappointed. The author talks a lot about the sorry state of tomatoes in the U.S., and actually prefers to make tomato sauces with canned tomatoes (apparently fresh are really that bad). I just hate making a dinner and then well...hating it. In any case, the book is quite good, I highly recommend it.

I've also been tuning in to the Food Network recently. Can I just bitch about something?

I hate Emeril. Emeril drives me crazy. The idea of a cooking show with a live, all black jazz band, just strikes me as so...contrived. But moreso, his persona irritates me. You can tell he really believes he's hot stuff. The audience is even worse -- they clap and cheer in an totally absurd manner. In the episode I watched tonight Emeril was adding vodka to the dish, and everytime he did the audience went wild. Who are these people? Are they an AA group brought for kicks? I mean, really, it's just alcohol. But they were acting like kids at a frat party when a new keg comes in.

One more thing: does anyone know if they have a vegetarian cooking show on Food Network? The recipes primarly depend on meat, which leaves this vegetarian out in the cold.

Well, that's all for now...guess I'll scrounge around the kitchen to redeem my taste buds...

XXX-tra, XXX-tra, read all about it

2005-06-02T23:27:00.000-07:00

It's 11:28 and I've only got 1/2 a page of a 4 page paper done. Do not despair for me, dear reader, because I've got great news for you. While perusing Google News (yes I was procrastinating...) I came across this great headline:

Code-Abiding Porn to Get .xxx Domain

If sites like "xxxhotsluts.com" or "cumshots.com" weren't enough to identify porn, the internets has made it even easier! All porn will have a .xxx domain! Now that's one giant leap for porn stars, one small step back for mankind...

Back to the proverbial pen, readers. Hope you're sleeping, heads full of fantasies about all the new .xxx sites you'll get to visit (don't even deny it. I know you pretend to be interested in politics and culture, but deep down you're just as perverted as the rest. )

Have a nice life, bitches

2005-06-02T17:29:00.000-07:00

Last line from my ridiculously bureaucratic graduation email:

"If you fail to return your cap, gown and hood, you will be billed.
We love you--good bye!! Have a meaningful life!!"

Um, thanks?

Google-y-eyed

2005-06-01T22:35:00.000-07:00

Fun article on people's grievances toward their google searches. I, for one, do not exist according to google, which makes me very sad. But I'm harboring hope that someday I too can have my very own awkward college picture on the web forever, courtesy of google.

Nice move

2005-06-01T22:16:00.000-07:00

So, in my efforts to ascertain the motives for France's and the Netherlands' no votes, I came to a realization: Europeans are awesome. Apparently they're feeling a bit upset with their leaders, so they vote in a way that reflects that.

This is a very curious practice to me, as an American. Far as I can tell, when my leader screws up really bad he gets more votes.

Just one thing you guys: could you maybe, um, not derail the whole EU constitution with your complaints, and vote your mind during normal elections? Cuz, while we refuse to change our leaders and get more of the same, you all are seriously fucking with progress.

Quote o' the day

2005-06-01T19:35:00.000-07:00

"We're like a Peace Corps, but it's surfers."

From the New York Times article on surfers who are doing mission work. Gotta love the comparison.

Case in point

2005-05-31T19:31:00.000-07:00

New York Times has a New article today on how drug companies aren't fulfilling their promise of making their studies available to the public.

Some of the women I worked with last summer were in favor of state-operated pharmaceutical compaines. Generally I'm uncomfortable with that notion -- I still believe the market can, in many cases, do things better and more efficiently than the government. My chief exception is healthcare, which I whole heartedly believe belongs in the government's, not the market's, hands. But my free-market feelings towards drug companies are changing, and this excerpt isn't stopping that evolution:

Eli Lilly and some other companies have posted hundreds of trial results on the Web and pledged to disclose all results for all drugs they sell. But other drug makers, including Merck and Pfizer, release less information and are reluctant to add more, citing competitive pressures. (Italics mine)

In this case, the market is keeping the companies from disclosing vital information. It's especially troubling because Merck's Vioxx fueled ths controversy more than any other drug. Yet they still refuse to comply.

The pharmaceutical companies don't need to be de-privatized in order to remedy this; we just need the new FDA branch to actually come into existence. If we can establish an arm of the FDA specifically targeting safety and efficacy, many of these problems could be fixed. This new branch is more feasible than ever, thanks to all the controversy, it's up to Congress and the Administration now. Unfortunately that allocation of responsibility doesn't give me much hope.

Deep whatever

2005-05-31T16:14:00.000-07:00

Anyone else feeling a bit disappointed with Deep Throat's identity? I mean, just some FBI guy. I was hoping it was Rehnquist. Ezra and I rented "All the Presidents Men" about a month ago, and since then I've been incredibly curious about Deep Throat's identity. Now I'm totally uninterested.

Tis Magic!

2005-05-30T23:13:00.000-07:00

In the final edition of Epiphanies: So-cal style, a post from The O.C.

Ezra and I are hanging out at his mom's when she brings out two gigantic boxes. Inside these boxes is the legendary Magic Bullet , mom explains, which Ezra's little sister has been coveting for many weeks. She finally broke down during her umpteenth viewing of the infomercial, and because she called in next 18 minutes(!!!!) got two.

Within five minutes Ezra's sister bursts in the door squealing with joy at the Magic Bullet's much anticipated arrival. She begins struggling with one of the 3 foot high boxes, finally pulling out the styrofoam innard. At this point, my curiosity is peaked -- what, oh what could this gadget be? Is it truly magic? Does it come with a gun to put its magic bullets in?

She opens up the styrofoam casing, revealing an assemblage of plastic cups and black bottoms.

Wait a minute-- this is no magic gun! There are no magic bullets!!! It's a food processor/blender in disguise! All for a hefty price tag of $140, mind you.

Ezra's sister immediately fondles the different parts, ooing and aahing. I grab the "Magic Bullet 10 Second Recipes" booklet. Inside I found some fascinating information about the unbelievable technology behind the Magic Bullet. For instance, did you know that the Magic Bullet has a pulse function? This feature is unique to the gadet's magical blending power. Yes, to engage the pulse function, you simply push down on the button for a second. The booklet admits this technique is a bit tricky, but once you master it, you will not believe how useful it is (after all, can't have all our food blended to mush). I thought better of telling his sister that my blender had an actual pulse button.

Next, she proceeds to raid the kitchen for any food that might taste good blended together. The first experiment? A banana and a cream popsicle. She engages the Magic Bullet -- it creates a pinkish gray gummy concoction, which she eats, giving the rest of us spoonfuls. She's about to shove a spoon in Ezra's mouth when he points out a huge chunk of banana that appears to have escaped the magic blending powers.

We leave her to her blending frenzy, overhearing all kinds of whirring and chopping sounds. A few minutes later, she exclaims "I MADE PESTO!!!!!" Now, Ezra and I are a bit perplexed by this development because, last we checked, there weren't any pesto ingredients in the house. I'm thinking -- pesto out of thin air! It is magic!

"What do you mean you made pesto???"

"I took the salad, and the gorgonzola, and the Italian dressing, and I put it in the Magic Bullet!"

"That's not pesto, you just blended a salad!"

Oh God. Before we can stop her, she's rushed into the living room, gigantic serving spoon in hand, and a cup full of green mush. She tries to shove it in Ezra's mouth, but can't seem to fit the enormous spoon in between his convulsions of laughter.

A good ten minutes later, with a sore stomach and wet eyes, Ezra gives his final commentary on the evening:

"Isn't 'magic bullet' also the name of a popular vibrator???"

Indeed.

I'll miss thee, Miss Universe

2005-05-30T21:08:00.000-07:00

I have a horrible, terrible confession: I watched the opening of the Miss Universe pageant. I believe some explaining is in order.

When my sister and I were little, the pageants were much anticipated tv-watching events. Miss America, Miss Teen USA, Miss Universe -- we watched them all with bated breath. I honestly dreamed that I could compete in Miss Teen USA . The fact that I was extremely short (my adult height is 5'0") and everyone else in the competition would be statue-esque -- no matter! I would beat them all with my unbelievable wit in the Q&A round.

Fast forward 10 years, and I'm having my usual weekend call with my parents. My dad informs me that they are watching the Miss Universe pageant (not that I didn't have any hints -- my dad kept saying things in the background like "is that Miss Sweden???"). Truly, I fear for my parents' sanity now that my sister and I have left home -- they watch Miss Univese sans daughters.

So, they planted the seed in my mind, and come 9pm, I'm not busy...so I turn it on. The parade that ensues is quite impressive. But it wasn't the visions of growing up to compete in the pageant that held my attention this time -- it was the embedded political messages that I couldn't ignore.

First off is the presentation of the countries. Obviously most of the Western and Latin American countries we're familiar with were included, along with a few African and Asian countries. But the countries themselves are completely depoliticized -- we have Miss Korea, though North or South is unspecified, it's certainly South. There's Israel, but no Palestine. According to our dear President, Iraq and Afghanistan are free -- though their most beatiful women must not be. I also have a feeling that it's against Muslim codes to parade around in the Swimsuit Competition. Further, every woman says her country's English name, not its name in her native tongue. You can tell some of them are really struggling to say the English name. For some reaosn this makes me angry.

Next on my pissed-off checklist is the unbelievably obvious class stratification these women embody. I'm sorry, but Miss Dominican Reublic??? She looks whiter than me. I've been to the Domincan Republic (or should I say Republica Domicana?) I've handed out medications in the poor villages at the center of the island. Domicans do not look like this woman -- they are very dark. The women are also educated eough to answer the final question round in English -- not exactly rags to riches beauties.

And last, the token Western beauty standard complaint. I'm sorry, but these women all have the exact same body, just different hair/eye colors. And they all look like Barbie.

So, I bid the girl in me's pageant dreams goodbye. I'm on to bigger and better things (health policy in D.C.!) while our Miss USA has no college degree and has studied Fashion Design.

Guess we can't each have it all...

Conflict of Interest

2005-05-26T21:05:00.000-07:00

Roy Poses over at Health Care Renewal has a troubling post about the relationships between medical schools and pharmaceutical companies. Basically a survey was given to 122 med schools, asking if "In your best judgment, would your office allow a clause in a multi-center clinical-trial agreement saying that [x]," ... where [x] was questions like "The sponsor will own the data produced by the researcher" or "The sponsor will store the data and release portions to the investigator". The results of the study basically found:

In the aggregate, this data suggests that some medical school research administrators will approve contracts with industry that prevent the ostensible academic investigators from having meaningful control over the research project. Some will allow the for-profit companies that nominally only serve as funding sources for the trial to manipulate the design, analysis, and interpretation of results so that the results are likely to come out the way they want.

Further, researchers at medical schools are often responsible for coming up with their own project funding after their first couple years on staff. Many will turn to pharmaceutical comapanies and other for-profit entities to foot the bill. This just perpetuates the conflict of interest cycle, from the researcher's petri dish to the doctor's prescription pad -- Big Pharma has their hand in all of it. And they're assisted by the AMA, which for decades has proven it has nothing but its own best interest at heart.

I'm a newbie at the serious policy answers, and I'm unsure what political actions here are viable or realistic. It seems the best answer to the "what can we do about this?" question is to publicize it. We need to keep driving home that many, many doctors are in bed with pharmaceutical companies, and hopefully public outcry will lead to more ethical practices. So, go read the post, and tell your friends.

From Virtual to Reality

2005-05-26T20:32:00.000-07:00

I bring you blogging from Los Angeles, the land of milk and honey... or is it traffic and breast implants?

In today's edition of blogging: So Cal style, I bring you the wonders of the US economy.

Ebay, the virtual auction block, the online giant, has spawned an in-the-concrete business (if that's not irony, I don't know what is). It's called (I kid you not) "I sold it on Ebay!" Apparently you bring your goods to the store and they'll sell them on Ebay for you. The wonders of this "service" economy...

Ode to Victoria's Secret

2005-05-24T00:12:00.000-07:00

Due to somewhat vague feminist reasoning, I've refused to set foot in Victoria's Secret for the last five years. I've always felt that this was a sacrifice on my part, and that I was denying myself the best lingerie money can buy so as not to compromise my feminist values.

I do have a happy history with ol' Vickie's. My two best friends and I spent many afternoons in 7th and 8th grade gathering up the nerves to go into Victoria's Secret and try things on! Although the most exciting ensemble I ever purchased was matching bra and underwear with a citrus pattern. That's right, the pure, unadulterated passion of lemons and limes. On my underwear.

I can only imagine the disappointment of those poor unsuspecting boyfriends/husbands/partners who happened upon the citrus set, excitedly undressing their partner only to discover the worst attempt at cute lingerie in the history of Victoria's Secret.

So last Saturday, while I was waiting around during my cell phone debacle (fear not dear reader, I'll tell that one another day), I decided to break my rule and check out what Victoria's Secret is up to these days. I'm happy to report I'm not missing much.

So, I thought my lemon/lime ensemble was the worst attempt at cute lingerie until I saw the downright vestigial underwear they're selling today. Why any woman would by this stuff is beyond me.

First, it is the most ultra-fem lingerie you can imagine. Vickie's has apparently abandoned their sexy vixen theme and moved on to what Barbie would design for her underwear if she had the materials delivered from Strawberry Shortcake. I'm not kidding, it's really that bad. This stuff was the pinkest, frilliest, puke-inducingest I have ever seen. And I browse the Ross lingerie, so I've seen some bad attempts. Here's case in point, if you're interested. I must admit that even this example is nothing compared to what was in the store. We're talking lace, bows, AND polkadots, folks.

Second, the material was mostly mesh. Rough mesh. All the women reading this can tell you that rough mesh makes for quite uncomfortable lingerie. It's a bit akin to wearing sandpaper.

Third, I called the bras vestigial because they are truly like vestiges of what real lingerie used to be. There's no possibility of ever wearing this stuff out of the house (unless it's to a lingerie party), because any shirt over the layers of bows and frills of these bras would make it look like you were sprouting bizarre unruly chest hair or some other oddity. Which leads me to my final objection:

These vestigial, ultra-fem, sorry excuses for lingerie cost between $40 and $50. I'm sorry, but most sane women of normal means would not pay $50 for a bra you can't even wear out of the house.

In sum, I'm completely delighted that now I can wear my non-Victoria's Secret lingerie in peace.

Best Quote

2005-05-23T10:38:00.000-07:00

From a PBS clip we watched my econ class this morning, which interviewed congressmen who had recently returned from a committee trip to China:

One congresswoman, with complete awe in her voice:

"It was like one giant construction site!!"

-- Nita Lowey (D-NY)

Books I left Behind

2005-05-22T16:19:00.000-07:00

Well, I've been tagged in a gratuitously favoritist manner by Ezra (thanks!) to list books I never read but feel like I should, or books I started but never finished. This is my very first meme-type thing, and I have a feeling I won't be so excited about it from now on. So while I'm still giddy, here it goes:

1. The Feminist Canon.

I am an ardent feminist, but I have serious issues when it comes to the literary grounding of my views. I own but have not read The Feminine Mystique and The Second Sex. And all the other feminist canon stuff. I'm terrible about that.

2. I did not finish One Hundred Years of Solitude. The book started out wonderfully; the world was so unique, the events so magical, and I was completely enthralled for 150 pages. Then I got really confused about the names and family relations, but perservered to about 250 pages. Finally I decided this book wasn't as great as everyone else thought it was, and I put it down and read American Dreams by Jason Deparle (it was time for a non-fiction).

3. I'm especially embarrassed about this one, and I'm unsure I should even mention it. I, Kate, started but could not get into ... Catch 22. There. I said it. I don't know why, but this book had no appeal to me. I read a good 60 pages and never felt a spark of inspiration, and generally disliked it.

4. I've never read Lolita and always felt I should. Like Ezra, I'm totally ignorant of classics, never read Faulkner, Joyce, etc. I'd also like to pick up something by Virginia Woolf.

5. Unlike Ezra, I was raised protestant and have read numerous sections of the bible (see post below). I have no desire to read the book in its entirety, because I fear my head will explode. I would, however, really like to read something by the Dalai Llama. I'm so struck by the beautiful tenents of Buddhism, and would like to explore the spiritual practices further.

Alright, done! That said, I am embarking, starting June 20, on an ambitious summer reading list. I suppose I must add some of the former to it. Any suggestions for my multi-disciplinary reading list are greatly appreciated.

I'm passing the torch to:

Sue, of Sue and not U because she is unbelievably hilarious and interesting, and I have to know what she reads.

And my friends Hannah and Callie

Crazy Crusaders

2005-05-22T11:30:00.000-07:00

I just finished the NY Times article on evangelical ministries in Ivy League institutions. Fascinating stuff, and brought back some memories.

I went on my first youth group trip summer before freshman year of high school. It was a beach trip, we drove all the way from Kansas City to Jekyll Island, GA (a two day drive) in 15 passenger vans. Needless to say, tt was enormously fun. I was one of the youngest on the trip, so I felt all cool hanging out with upperclassmen. Mostly I played in the ocean and awkwardly flirted with this 17 year old guy. And on the side there was worship, which consisted of fun songs, games, and a little prayer and bible study.

This trip is the genius of evangelical institutions. You become completely indoctrinated without really noticing it; because, hey, you were there for the beach and the cute guys. Upon my return to Kansas City, I began attending youth group an average of three days a week. I loved it. Mostly because I got to see my best friends so often, the cute guys so often, and there were food and ridiculous games and songs. It was a bit like part-time camp.

Now, those same insitutions (well not quite the same; I attended youth group at my local church) are taking a similar tact and injecting it into all aspects of life. Truly, making church part of every sector of your life (home, work, vacations, school) is brilliant. It's made God inescapable. It also makes turning away from the church nearly impossible. At one time (say 20 years ago, I don't mean in the 50's) you could divorce yourself from God by just leaving your church. Now your entire social fabric, your colleagues, your education -- it's all steeped in Evangelicalism, which is good if you want it, but damned how you'll get out of it should you change your mind.

It's all a bit scary to me. The knowledge that Evangelicals are building these networks backed by millions of dollars feels distinctly threatening. But I guess I should feel comforted that their percent of the population (a whopping 25) has remained unchanged. For now...

Enough!

2005-05-20T23:51:00.000-07:00

Dearest Downstairs Neighbors,

I want to take this opportunity to give you my heart felt thanks for sharing your excellent taste in music with me. I'm unsure how you found out that loud rhythmic base coming through the ceiling is my absolute fav, but you did! I appreciate that you make the effort to play my favorite music many times a week, often two or three times a day! That is dedication.

I also wanted to tell you how much I admire your perserverance!! Really, I'd no idea that someone who got visits from the police every other week for months would stick to their routine like superglue. Well, Downstairs Neighbors, you did it! I know you might think I'm sending the police to check out your genius music, but after the first ticket, I would have thought you'd get the hint. You truly deserve an award for refusing to change your music/party habits!

And the screaming...your vocal abilities are simply stunning! I'd no idea that people could make so many interesting sounds! Truly, dear Downstairs Neighbors, you've opened my eyes. I'm so, so grateful for all the things you've taught me by simply living below me. It's such great fun.

And, oh, one more thing:

Fuck You!

Sincerely,

Kate

SATC Bye Bye

2005-05-20T22:39:00.000-07:00

I just finished the last four episodes of Sex and the City. I feel dumb blogging about it, but I figure I should get off my storytelling meme and prove I have feelings too! (Well, feelings that aren't related to coffee, that is)

I'm just making that leap forward, into being a "real bon-a-fide woman". This is evoking an unprecedented flow of sentimentality. As my favorite professor would say, I'm "sentimental to the fifth!" (sentimental^5... okay you might not get it, Ezra didn't) It's just.. I'm graduating. I'm leaving California in a couple months, I'm not going to be in school for the foreseeable future. That is so enormous on its own, simply because I've been attending school every year since I was five. I found this cd of all my favorite songs when I was 17. And I am in terrible touch with many of my old friends (hence the SATC sentimentality).

So watching the last episodes, where everyone is in flux, made me sentimental to the sixth. I guess I've been like Petrovsky was to Carrie, to myself. Santa Cruz has been terrible for me this year. I felt completely isolated, and I didn't do much about it. I gave in to feelings of mild depression by wasting a lot of time; in front of the tv, staring at my computer, sleeping. I was supposed to go out with a bang this year, with all A's and hopefully some solid career plans. The bang only lasted through fall quarter, and here I am withdrawn from one class, adding another in the fifth week, and amorphous career plans. The only things that kept me up to the plate this year were Ezra and the Gilmore Girls.

But, like everything came together in this great, ecstatic, beautiful pastiche in SATC, I think this summer will for me. Ezra and I will finally be back together, which makes such a difference in my day-to-day happinesss, it's stunning. I'll be working at an incredible organization, the Venice Family Clinic. I'm cutting myself off from television and starting an ambitious reading list. I will be done with school and homework, and best of all, it will be summer.

So, here's to a beautiful sunset on my time in California.
Here's to a new beginning as a career woman in DC,
Here's to love everlasting,
And so I never forget, here's to me.

Nanny, anyone?

2005-05-20T22:38:00.000-07:00

It's a gorgeous day in Santa Cruz, so I, naturally, am ignoring the fact that the beach is two miles away and lounging around the pool at my apartment complex.

A mid thirties mom and three 6 year old girls arrive soon after. The girls begin furious assessments of the temperature of the pool, and whether they should get in the pool or hot tub ("the pool is cold like a real ocean!" "the hot tub has bubbles!")

Later, girls and mom, having decided bubbles are better than real ocean-temperature, are sitting in the hot tub, and another woman joins them. She has a thick accent and begins asking the girls their names. Unfortunately, the girls have non-standard English names, like "Claire" and "Sage", and I feel badly listening to the woman try to pronounce them. Mom asks the woman where she's from, and a peculiar conversation follows:

Woman: I'm from Turkey
Mom: Really, oh well we have two nannies from Turkey
Woman: Yes? What are their names?
(Mom says two Turkish names)
Woman: How much do you pay them?
Mom: Um, five dollars and hour
Woman: Do they have visas?
Mom: Um, I really don't know. They might have student visas
Woman: Where do they live?
Mom: Oh, they live on the Eastside
Woman: Ah, I have visa.

At this point, the mom must be in a panic. Is the woman going to barter with her for a nannying price? Is she feeling guilty that she's only paying $5/hr to watch her children, and that she doesn't even know if her below-minimum-wage laborer is in the country legally? Is she worried that this woman is a spy for the Homeland Security?

I'd like to say I know what followed, but at that point I was starting to look red and headed in. I can only imagine though...

Nevermind

2005-05-19T10:58:00.000-07:00

Okay, Coffeetopia. Listen to me, and listen good.

I spent the last post, a whole twenty minutes, extolling the virtues of your honorable coffee imbibing establishment. You even have a website! But funny, you forgot to mention on said website what I saw pasted on your carmel colored walls when I came in today:

"New Hours coming!
Starting Wendesday, June 1st, Coffeetopia will be open 6am to 6pm seven days a week.
We thank you all for your patronage and support!"

Oh no you didn't.

First of all, don't take that pleasant, cheery, god-awful tone with me. "New Hours Coming!!!" I thought you were going to make my dreams come true, to extend your way too early closing time of 9pm to perhaps 10, or even later!

But no. This is really just a slap in the face. I can't believe you'd go behind my back and change your hours without consulting me, your loyal Kate. But that's what you did. And not only are you closing earlier, you're pushing back to a Mormon-like hour of 6pm. 6 pm!!!!! I certainly do not study before 6pm. I don't even eat dinner by then! When will I drink your delicious coffee now, huh?

Well I'll tell you: NEVER!

And the justification for said change of hours? Profits. It's not "profitable" to stay open past 6. Don't give me that free-market bullshit. I hate you for being a for-profit establishment. It's so over between us.

coffeeshopmania

2005-05-18T20:39:00.000-07:00

I tried quitting coffee. Oh yes, I did. It made me more tired (ironic, I know, still haven't figured that one out). It made me very hungry and whenever I was stranded without food my blood sugar (and mood) dropped precipitously.

I tried giving up the dark demon. The delicious, enticing smell. The warm, bitter taste (no sugar, of course). The habit of carrying a drink, a warm distraction, to class with me every morning. To my desk every night.

But these attractive qualities could not compare to that sidekick, the Ethel to the Lucy, the uh... bald guy to David Letterman (okay...still working on the similie thing) the Coffee Shop.

Coffee shops are my haven. I have trouble working anywhere else. The library is too damn quiet, unless it's 2 in the morning and every coffee shop is closed. But the coffee shop, in all its incarnations, never disappoints.

I love my locals, Coffeetopia and Lulu Carpenters, the indie coffeshops, with free wireless internet and alternative individuals sipping espressos. I love the playlists, which vary from weird experimental shit I've never heard, to the barista's sentimental mix from high school (which happens to coincide with my high school years, making me all the more inspired to crank out that paper).

I love my Border's, where the cafe is like a balcony. I love to look down at a million colorful books, contemplating the incredible literary endeavor that is the modern chain bookstore. Not to mention spying on people as they weave about, picking up various titles.

I even love my Starbucks, because I feel satisfied knowing they give health insurance to all of their employees who work even part time. That and they have excellent coffee and the New York Times.

So I tried quitting coffee, I honestly did, but damned if you can't keep a girl out of a great coffeeshop.

Sugarmania

2005-05-17T23:05:00.000-07:00

As Ezra will warn you, I am a notoriously awful storyteller. Absolutely horrible. I can take the most fascinating, life-and-death, seat gripping tale and turn it into C-SPAN.

So, in my attempts to rectify this unfortunate tendency, I'm practicing by recounting my morning at Peet's.

In case you don't live on the West Coast, Peet's are a fabulous chain of coffeeshops. Peet's are warm, earthy establishments, with interior colors like olive, chestnut, and slate. Their coffee is incredible, rich and dark, and the smell, the smell , is enough to make the most ardent tea lover a coffee convert (though their tea is incredible as well). Their to-go cups have bright Indigenous art patterns around the bottom. They're also fantastically bougie places (yes, that Latte drinking, Volvo driving type place). Considering the above wonderful qualities, and my complete obsession with coffee, Peet's is favorite morning hang out.

On this particular morning Ezra and I were getting our usuals (genmaicha for him, double espresso with a bit of steamed milk for me). Drinks in hand, we were at the milk/sugar station, adding creamer and such, when a small hand reaches up to grab the sugar.

The hand belongs to a five year old girl, with gold hair in a mushroom type cut, and big round blue eyes. As she reaches for the sugar, Ezra and I stare at her, amused.

"And what are you doing?"

The little girl looks up in surprise, hand around the sugar, clearly worried us big kids might out her.

"Okay, well I won't tell your mom," I say, and, relieved that we won't be tattlers, she replies, "Oh, I won't tell my mom," and quickly pours a gigantic mound of sugar in her palm, probably the contents of at least 4 individual sugar packets. She takes a quick gulp, and scampers off, almost falling, before she stops to hide behind a display of teapots and mugs, throws back her head and inhales the rest of the two inch high mound of sugar.

Ezra and I begin to laugh hysterically, watching as the mom looks at her daughter with absolutely no clue of what just passed. We finish up with the cream and sugar, and walk out. As we leave, I look back and see the girl take a flying leap out the door, clearly enjoying her sugar high.

Kids are so awesome.

It's preventable.

2005-02-05T21:27:00.000-08:00

The NY Times has a heartbreaking peice about methamphetamines. It's really worth a read, if only to get perspective on what some people are going through. A good friend of mine, one of the most kind, intelligent people I know, was addicted to meth at 14. Thank God she was young enough to be committed (in juvy), she's totally sober today and getting her degree from a UC. My friend's brother wasn't so lucky -- he stole money from his wife and was in jail for threatening to kill her and kidnap their children.

Meth isn't one of those drugs that most kids are educated about (really, why all the emphasis on pot?! It's 1/1000 as harmful as this shit). I always learned that heroin is the worst drug out there. As far as I can tell, meth is much worse. It's the hardest to get off, its effects the most drastic. Kids aren't educated about the extreme dangers of meth -- like never being able to be happy again because it rewires your brain. They must be, God help us that this never happens to someone we love.

Am I classist?

2005-02-04T21:34:00.000-08:00

Wow, I didn't realize it'd been so long since I posted. I honestly don't understand how "real bloggers" do it...it takes me forever to write a post...it takes even longer to get inspired to do so.

But tonight I've got some inspiration.

I'm struggling with a frightening possibility: I am classist.

I want to flush out the reasons I believe this to be true, what it means, and if it's necessarily a bad thing (I'm not so sure).

I never understood the idea that America is a classless society, probably because I was raised in the upperclass. My grandparents had three homes and gave all of the grandchildren trust funds. Manners were enforced early on (hand-written thank you notes an absolute must). I was a debutante. Attending college was the only post-high school option in my family; even the black sheep of our clan went. To me, it was obvious that many (the vast majority, in fact) people did not live like my family. Never that they were any less or worse than us, but that they didn't have money like us.

So why the classist meandering? My choice in men.

I have had four boyfriends. Three of them are the some of the most intelligent people I have ever met. They go to prestigious schools -- UCLA, Northwestern, and the University of Chicago. The other worked at a fish market and had no school or career aspirations. I was (and am with one) very emotionally involved and attached with the first three. I cheated on the fourth. I lost interest, and when he wanted to get back together, the reason that kept me from doing so was this one memory I couldn't shake. We were driving around and I was saying how such and such was so phallic, and he said, "what does that mean?". Okay, I know this seems ridiculous from the outside, but it really bothered me that he didn't know what phallic meant. Other words too, like pensive...I don't know. I know that pensive isn't a particularly common word, but these things really bothered me.

I've always been interested in current events, and I spend a good chunk of time reading up on them. I've really started savoring the label of intellectual. Tieing or beating Ezra in argument is no small accomplishment, but it comes often these days, and I LOVE it. But bringing out my intellectual self has led to some sober reflection; remembering the phallic moment, and how that relationship could never work for me now. I don't think I could ever again date someone who isn't politically aware and passionate, who doesn't engage their mind (and mine as well). There's this guy who works at a local coffeeshop who flirts with me a lot. But when he does, I can't help thinking, "This guy is always here working at this coffeeshop. Did he follow the election? Does he know why SS privatization is bullshit? Did he listen to the state of the union last night? Does he know why we desperately need nationalized health care? "

But I am worried. I am worried that these thoughts make me classist.

I'm taking a class right now about the history of racism in the US, along with eugenics and other traumatizing topics. We talk a lot about class, specifically how pseudoscience was used to establish some as "feebleminded", biologically less intelligent than whites, and used to justify sterilization. I know these are extreme examples, obviously not wanting to date someone without my education level doesn't equate to sterilization, but I worry that feelings like mine reinforce the stratification of our society. Most people from the working class can't afford and aren't encouraged to go to college. Thus it's unlikely that they'll fulfill the requirements listed above. This isn't because they're not intelligent, or don't want to learn, it's just hard to spend your time reading up on the intricacies of SS privitazation if you're working two jobs, or if you've got no one to discuss the ideas at length with.

I know I'm making assumptions here, but you get the equation: my not wanting to date someone without my education level reinforces stratification because it denies people the chance to move up in society.

Then again -- I'm not sure that's true. I'm part of an educated elite, but I chose that title. Most of the people I go to school with do not feel this passionately about knowledge and would probably not have these qualms about education levels. Really, the most essential social movement is from working to middle class, not working to upper or middle to upper. I'm not requiring money (I want to work in public health or a nonprofit) -- I'm not closed off to someone from a different class when they share my intellectual desires.

I think the question here is one of stereotyping. Maybe I'm being too judgmental of the guy from the coffeeshop. (Not that I'll give him a chance, I've got a better boyfriend than I could ever dream of) But surely there are people who didn't go to college that care about these things and are really intelligent. What it really comes down to is personal preference: I want someone like me. Which is what we all want. Who's to say my stereotyped working class man wants to hear me rattle on about politics for hours anyways?

You and me...

2005-01-16T15:42:00.000-08:00

Furthering recent attempts to bring out my inner audiophile, last night I went to The Catalyst to see the local band Devil Makes Three (you can read about them here). They're a three person band, featuring a female acoustic bass player, which makes them even cooler. Great fun songs with good vocals and simple instrumentals. Although this is my first time hearing of them, they're obviously quite popular as a good portion of the crowd was singing along. It was a great time, and not just because the band was amazing. The catalyst is such a great venue because it's semi intimate with lots of space for dancing. (Particularly hippie dancing, it's Santa Cruz after all) The whole spatial layout is just really comfortable and pleasing. Anyway, I would describe their style as bluegrass and thanks to the buzzed and smiling crowd, it was the most fun I've had a show in a long time. Which I guess isn't saying much because I never go to shows. But I'm rethinking that habit.

On a related note, I've given The Shin's Oh, inverted world another listen, and I LOVE it. So if you did the same as me, and wrote it off, I beg you, give it another try. You'll be pleasantly surprised.

Revisting tortured acceptance

2005-01-15T11:18:00.000-08:00

NY Times (I promise I will cite other sources on my next post) reports that Specialst Charles Graner was found guilty on the torture charges.

My imagination runs wild with this quote:

"The jury heard from 23 witnesses, but not from Specialist Graner, despite early statements from his lawyers that he would testify because he was the best person to explain the acts seen in the photographs."

Yeah. I can just picture the arguments over whether he should testify and "explain" the photographs. Graner's lawyers are sitting in front of him, while he stands next to a projection screen, pointer in hand, with the photographs coming up, slide show style.

"Well, here I positioned him like this, just to get him real embarrassed. And the hood was just a, a little extra, you know, and I think it just, well it gives it that oomph to finally get 'im to talk. He looks damn uncomfortable, doesn't he?"

I'm sorry. I know it's not funny. I'm bad. I'll go back in my hole now, to repost in another week.

Tortured acceptance

2005-01-08T13:38:00.000-08:00

Dahlia Withlick over at Slate has an excellent piece on Gonzales and torture, but her critique of the Bush Administration is particularly eloquent:

"The Bush administration's party line on every smudge and tear it has inflicted upon the Constitution has been: "Trust us—we know what we're doing." But it's hard to trust a government that either won't disclose what it's doing or denies what we know it to be doing behind closed doors. From the Patriot Act, to its treatment of aliens, to its indefinite detainment of citizens, and the sham of its military tribunals, we have been advised at every turn that the administration has only the national interest at heart. And even that argument might have been defensible were the government honest about what it deemed our best interests to be. Many, if not most, Americans were once willing to trust the Bush administration to protect them in wartime. But when government officials cannot publicly stand behind the extreme positions they have staked out in private; when they espouse one view in secret and irreconcilable politically correct versions before the cameras; when not a single individual is ever held to account for genuine government screw ups—such as those at Guantanamo and Abu Ghraib—one is left only to wonder which individuals and ideas we were meant to trust in the first place. "

I just love this. She put so many of my worries and feelings into an exponentially better paragraph than I ever could.

More importantly, we're left with the question of torture, one that I'm extremely uncomfortable with. Other parts of her article argue that Gonzales' position is defensible, that torture is defensible in some ways. Ezra has made similar arguments on Pandagon. I'm just not so sure.

The very idea of torture signifies horrid things in my mind, as it does in most I'm sure. I can't bring myself to overcome the symbolic weight of torture in order to mull it over as a legitimate strategy. Parts of me simply resort to the old Golden Rule, even though it's unsophisticated. I try to breach that hurdle by accepting the realities of our world: there will always be torture (probably), so if it can prevent loss of lives, shouldn't it be used? Still, even when I force myself to try and see the possible situations where it should be legitimate, I can't. I am unable to do so internally. Which is why I point others to articles like these, I can read the arguments, but never make them myself.

I guess my other discomfort comes from the fact that the prisoners tortured in Iraq most likely knew nothing. Any evidence gleaned was minimal, it was all for nothing, and tarnished our presence irreparably. So if I can't ever support torture, regardless of current political realities, how could I ever condone it with this administration?

I guess I'll just await the invention of the truth serum.

SARC

2005-01-04T15:59:00.000-08:00

As this article from the New York Times notes, the Pentagon has finally ordered a post named "Sexual Assault Response Coordinator" created at every US Military base in the world, as a means to deal effectively with the high rates of sexual assault within the military. I am trying to evoke more positive associations with feminist gains, rather than the "it's-2004-we-should-have-had-this-20-years-ago" type feelings. The coordinator, also called a SARC, appears to be a realistic and effective way of punishing assaulters, in the least, and perhaps discouraging them, at best. In the past women rarely had a superior they felt comfortable discussing sexual assault with, so hopefully incidents will decrease.

This really is an important step for women in an institution known for lagging behind cultural practices.

At the University, we have the Title IX Coordinator, who investigates sexual harrassment and assault, as well as RA's, Provosts, and others who can serve as non-threatening resources for women who have been assaulted. Yet most community police stations lack this. Wouldn't it be amazing this kind of post could, some day, be created in most police stations in the country? So women (and men) who have been assaulted feel there is a safe person to talk to, and we could come close to knowing the true rates of sexual assault.

Selling coffeemakers

2004-12-18T20:35:00.000-08:00

This is a poem I wrote when I was working for a construction company two summers ago, which is the same time I started this blog, and left it untouched till now. I'm scrapping everything else I wrote, but wanted to keep this. I like it.

An elderly man just came in.
His presence brought me to tears.
Not that it’s my business to decide that he needs tears
But his old frame
His stomach pooch
And thin comb-over
The fact that he was here to check and see if our coffee machine was working
An elderly salesman.
A job of frustration
Day after day, needing to make a sale to feed his family
Each day, desperation to sell.
Through the booming and the bust“please, sir, buy my coffeemaker, it’s top of the line”
I am labeling him with pity
But his eyes, his sad eyes
His posture speaks of these things

The Holiday Spirit

2004-12-18T20:03:00.000-08:00

The Holiday Spirit has officially taken over me. I have been possessed, my sanity has left, and my worst attributes are shining through with megawattage.

That word, that nasty word has crept into the recesses of my brain and taken up residence. It's whispering, gollum-like, "I want, I want". We all know the word well at this time of year: materialism.

It all started with Old Navy. My family has a rule: you don't buy yourself anything new right before Christmas. I received an Old Navy gift card, found several items I liked and threw caution to the wind. I spent $67 including my gift card. Granted, they were great purchases...See?! There I go, justifying it. But the worse case definitely came when I was talking to Ezra, who returned some unwanted books today, one of which was a cookbook. (We will both use cookbooks next year) He didn't buy another cookbook, and I griped at him for it. Which is utterly ridiculous because a) It's his money b) He doesn't have a kitchen to cook in until June c) One of the books he did end up buying he intended to pass on to me. So, not only was I completely selfish, but quite embarrassed because he did buy something we could share after all. Foot in mouth, and I deserve it.

My other problem is this: I come home and become like a three year old in front of the television. It's not that my family watches particularly excessive amounts of tv (though we watch our share, for sure), it's that the home environment lends my glue-age to the tv. This is a worrisome trend. Not only am I boring, and bored, and my brain is being sucked out etc, but it's my break! I have all this free time to read great books, but I spend it in front of the television. This must stop.

So, in light of the above, I am making resolutions.

1. Limit my tv watching to 2.5 hours a day (I know that still seems like a lot, but I'm not kidding when I say I'm like a 3 year old in this matter)
2. I will not buy myself anything*, any gadget, shoes, jewelry, and especially no clothing for at least 2 months. This is a big step, and it must happen. I am committing myself to only buying books.
3. And lots of them.

Let's hope I can stick to it, and thus be filled with incredible ideas for this blog! My intellect depends on it.

*movies and food excluded. and concerts. and coffee. But definitely no clothes.

The Time Bind

2004-12-16T11:44:00.000-08:00

Maybe it’s because I’m entering the workforce next year. Maybe it’s because I’m a sociologist at heart. Maybe it’s because my life is so leisurely now. Or because I’m in a serious relationship and have visions in my head of a collective future. I don’t know which of these factors is the culprit, but Arlie Hochschild’s work captivates me more than anything I’ve read in years. In all honesty, I can’t remember the last time I’ve been so enthralled by a book. Or an author. I couldn’t tell you the last thing I’ve read that truly inspired me, started the wheels spinning in my brain at overdrive. Granted, all this may only reveal a poor memory. But to me, it represents the discovery of an intellectual gold-mine.

Hochschild’s work focuses on families, and my current obsession-du-choix is Time Bind. It’s basically a detailed study of fictitiously-named Amerco, a large American company with plants across the nation and world. My inkling is that Amerco is Ford, but the company’s true identity is immaterial. It’s the families Hochschild follows that peak my curiosity. Her present inquiries deal with why parents are working so many hours. She examines the usual arguments: fear of being fired, lack of knowledge of company’s family policies, obstructive management, fear of “backlash” (in terms of women preserving their image/place in male dominated departments). Yet the evidence from her research finds that none of these theories holds under scrutiny, and there are two more pernicious forces at work: materialism (my idea) and change in how Americans view work (her idea). I think materialism and the famed “Spirit of Capitalism” are to blame, in part, because of our insatiable lust for more stuff. (Trust me, I’m an expert on the never ending lust for clothing) But I think this drive is different than always wanting to buy new shirts, it’s being further reified in a general sense of constant saving. We’re saving for X vacation, for X car, gadget, for college, for retirement – there’s an endless well to put money in, and that pressure is causing families to feel that they can’t work less, because how will they afford these things?

Hochschild’s argument is, of course, much more sophisticated than mine, and centers on the notion that the equation home = haven no longer exists for many families. Now bear in mind I’ve only read 40 pages, so my conclusions thus far can hold only partially true. Through extensive observation and interview, Hochschild finds that many workers, particularly women (I’ll get to this observation in a minute) feel the most stable at work, not home. They enjoy work, not the overwhelming responsibilities of home. I can only describe my first reaction to these findings as shock. Why would people enjoy working more than being home?! Yet the more I mull the theory over in my head, and the more of the book I read, the pieces just fall into place. At work there are fixed responsibilities, schedules, expectations. Much of the stressful emotional situations we experience in the home are absent. At work you don’t have whining, tantrum-throwing children, although you might have difficult employees. At work you don’t have a resentful partner or children, you have sympathetic colleagues. Work doesn’t involve a constant list of items to be cleaned. Now, I’m not suggesting work is stressless, but rather attempting to give light to reasons why work might become a haven. It makes sense that women would give into this feeling more, because for many of them (especially those in the work force at the time Hochschild wrote the book, in the mid 1990’s) work is a blessing. These women were able to pursue a career, something that many of their mothers could not do. They might enjoy work more because they feel they’ve earned their position, and we should see this sentiment displayed strongly among women in male-dominated fields. Yet the converse is true at home; many women of this generation still do the majority of the housework (find stat). They come home to a second shift; after working an 8, 9, 10 hour day, they are responsible for most of the housework as well. It’s no wonder that women, in particular, would find work to be that place of sanctuary.

To me, this theory gracefully connects to many other contemporary problems: the number of children we have in day care (and number of hours they are there), divorce rates, the so-called “cultural cooling”. Traditionally women have done the care taking, but if they are preferring to spend most of their time at work, we can only assume the above trends will worsen. I don’t mean to be dour, but these changes are frightening.

The principle reason I’m so intrigued by Hochschild’s theories is because I am so fearful that my future family will become one of those in the book. How can we prevent this? There’s no doubt that raising children can be stressful, what are some ways to lessen that stress? Escaping to work when home gets overwhelming would be quite tempting. How can you avoid that? Verbal contracts? I know that’s such a ridiculous phrase, but would doing something like simply promising to each other to always be open, to always discuss when things are bothering you prevent giving in to temptation?

I guess what this also comes down to is the $64,000 question for young couples: how do you avoid divorce? With the rate at 50% (higher in some regions), it seems almost inevitable. When you read books like Time Bind, seeds of your fears appear to grow into a jungle before your eyes. The pain and guilt associated with being a workaholic family forms a canopy above you, endless expectations like roots on the ground just waiting to trip you. I guess you have to keep open eyes. Read books like Time Bind, Second Shift. Be aware of these contemporary issues facing families, and talk about how you would deal with these things. I guess the bottom line is that you can never be completely sure (how to avoid divorce, that is). And that I’m way too young to be worrying this much now.