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Javier E

To Live Past 100, Mangia a Lot Less: Italian Expert's Ideas on Aging - The New York Times - 0 views

www.nytimes.com/...italy-aging-valter-longo.html

aging longevity italy research researcher diet genetics

shared by Javier E on 26 Mar 24 - No Cached
  • Valter Longo, a nutrition-obsessed Italian Ph.D. student, wrestled with a lifelong addiction to longevity.
  • “For studying aging, Italy is just incredible,
  • Italy has one of the world’s oldest populations, including multiple pockets of centenarians who tantalize researchers searching for the fountain of youth. “It’s nirvana.”
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  • Dr. Longo, who is also a professor of gerontology and director of the U.S.C. Longevity Institute in California, has long advocated longer and better living through eating Lite Italian, one of a global explosion of Road to Perpetual Wellville theories about how to stay young in a field that is itself still in its adolescence.
  • In addition to identifying genes that regulate aging, he has created a plant and nut-based diet with supplements and kale crackers that mimics fasting to, he argues, allow cells to shed harmful baggage and rejuvenate, without the down side of actually starving.
  • He has patented and sold his ProLon diet kits; published best-selling books (“The Longevity Diet”); and been called an influential “Fasting Evangelist” by Time magazine.
  • Last month, he published a new study based on clinical trials of hundreds of older people — including in the Calabria town from which his family hails — that he said suggests that periodic cycles of his own faux-fasting approach could reduce biological age and stave off illnesses associated with aging.
  • “It’s very similar to the original Mediterranean diet, not the present one,” she said, pointing at photographs on the wall of a bowl of ancient legumes similar to the chickpe
  • “Almost nobody in Italy eats the Mediterranean diet,”
  • He added that many Italian children, especially in the country’s south, are obese, bloated on what he calls the poisonous five Ps — pizza, pasta, protein, potatoes and pane (or bread).
  • in recent years, Silicon Valley billionaires who hope to be forever young have funded secretive labs. Wellness articles have conquered newspaper home pages and Fountains-of-Youth workout and diet ads featuring insanely fit middle-aged people teem on the social media feeds of not insanely fit middle-aged people.
  • he said Italy’s lack of investment in research was a disgrace.
  • even as concepts like longevity, intermittent fasting and biological age — you’re only as old as your cells feel! — have gained momentum, governments like Italy’s are fretting over a creakier future in which booming populations of old people drain resources from the dwindling young.
  • many scientists, nutritionists and longevity fanatics the world over continue to stare longingly toward Italy, seeking in its deep pockets of centenarians a secret ingredient to long life.
  • “Probably they kept breeding between cousins and relatives,” Dr. Longo offered, referring to the sometimes close relations in little Italian hill towns. “At some point, we suspect it sort of generated the super-longevity genome.”
  • The genetic drawbacks of incest, he hypothesized, slowly vanished because those mutations either killed their carriers before they could reproduce or because the town noticed a monstrous ailment — like early onset Alzheimer’s — in a particular family line and steered clear.
  • Dr. Longo wonders whether Italy’s centenarians had been protected from later disease by a starvation period and old-fashioned Mediterranean diet early in life, during rural Italy’s abject war-era poverty. Then a boost of proteins and fats and modern medicine after Italy’s postwar economic miracle protected them from frailty as they got older and kept them alive.
  • At age 16, he moved to Chicago to live with relatives and couldn’t help notice that his middle-aged aunts and uncles fed on the “Chicago diet” of sausages and sugary drinks suffered diabetes and cardiovascular disease that their relatives back in Calabria did not.
  • He eventually earned his Ph.D in biochemistry at U.C.L.A. and did his postdoctoral training in the neurobiology of aging at U.S.C. He overcame early skepticism about the field to publish in top journals and became a zealous evangelizer for the age-reversing effects of his diet. About 10 years ago, eager to be closer to his aging parents in Genoa, he took a second job at the IFOM oncology institute in Milan.
  • He found a fount of inspiration in the pescatarian-heavy diet around Genoa and all the legumes down in Calabria.
  • he also found the modern Italian diet — the cured meats, layers of lasagna and fried vegetables the world hungered for — horrendous and a source of disease.
  • His private foundation, also based in Milan, tailors diets for cancer patients, but also consults for Italian companies and schools, promoting a Mediterranean diet that is actually foreign to most Italians today.
  • “Italy’s got such incredible history and a wealth of information about aging,” he said. “But spends virtually nothing.”
  • He talked about how he and others had identified an important regulator of aging in yeast, and how he has investigated whether the same pathway was at work in all organisms.
  • Dr. Longo said he thinks of his mission as extending youth and health, not simply putting more years on the clock, a goal he said could lead to a “scary world,” in which only the rich could afford to live for centuries, potentially forcing caps on having children
  • A more likely short-term scenario, he said, was division between two populations. The first would live as we do now and reach about 80 or longer through medical advancements. But Italians would be saddled with long — and, given the drop in the birthrate, potentially lonely — years burdened by horrible diseases.
  • The other population would follow fasting diets and scientific breakthroughs and live to 100 and perhaps 110 in relative good health.
Javier E

Robert W. Fogel Investigates Human Evolution - NYTimes.com - 0 views

www.nytimes.com/...estigates-human-evolution.html

evolution health physical history measurement body statistics

shared by Javier E on 09 Aug 13 - No Cached
  • “in most if not quite all parts of the world, the size, shape and longevity of the human body have changed more substantially, and much more rapidly, during the past three centuries than over many previous millennia.”
  • This “technophysio evolution,” powered by advances in food production and public health, has so outpaced traditional evolution, the authors argue, that people today stand apart not just from every other species, but from all previous generations of Homo sapiens as well.
  • “I don’t know that there is a bigger story in human history than the improvements in health, which include height, weight, disability and longevity,”
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  • the average adult man in 1850 in America stood about 5 feet 7 inches and weighed about 146 pounds; someone born then was expected to live until about 45. In the 1980s the typical man in his early 30s was about 5 feet 10 inches tall, weighed about 174 pounds and was likely to pass his 75th birthday. Across the Atlantic, at the time of the French Revolution, a 30-something Frenchman weighed about 110 pounds, compared with 170 pounds now. And in Norway an average 22-year-old man was about 5 ½ inches taller at the end of the 20th century (5 feet 10.7 inches) than in the middle of the 18th century (5 feet 5.2 inches).
  • Mr. Fogel and his colleagues’ great achievement was to figure out a way to measure some of that gain in body size, Mr. Preston said. Much of the evidence — childhood growth, mortality, adult living standards, labor productivity, food and manufacturing output — was available, but no one had put it all together in this way before.
Javier E

Robert W. Fogel Investigates Human Evolution - NYTimes.com - 0 views

www.nytimes.com/...estigates-human-evolution.html

nutrition health economic longevity econometrics cleometrics Fogel human evolution research world history

shared by Javier E on 27 Apr 11 - No Cached
  • the basic argument is rather simple: that the health and nutrition of pregnant mothers and their children contribute to the strength and longevity of the next generation. If babies are deprived of sufficient nutrition in the womb and early in life, they will be more fragile and more vulnerable to diseases later on. These weakened adults will, in turn, produce weaker offspring in a self-reinforcing spiral.
  • Technology rescued humankind from centuries of physical maladies and malnutrition, Mr. Fogel argues. Before the 19th century, most people were caught in an endless cycle of subsistence farming. A colonial-era farmer, for example, worked about 78 hours during a five-and-a-half-day week. People needed more food to grow and gain strength, but they were unable to produce more food without being stronger.
  • “In many parts of the world, including the United States in the 20th century, medical advances appear to be at least as important as improvements in nutritional intake,”
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  • the Harvard School of Public Health published a paper that used the height of women in 54 low- and middle-income countries to indicate how children in Africa, Latin America, Asia and the Middle East were faring. (The answer was not good: height had stayed the same or declined, particularly in Africa, suggesting that living conditions and disease controls for children have deteriorated.)
  • If food production is the most important factor, then focusing on economic growth might be the best policy, but if infectious disease is a major reason for chronic illness and premature death, then more aggressive public health measures might also be needed.
  • historians have not paid enough attention to changes in height (as a useful measure of nutrition and disease) or in lifespan. History textbooks, she complained, almost completely ignore the topic.
aleija

Exercise 11 Minutes a Day for a Longer Life - The New York Times - 0 views

www.nytimes.com/...xercise-sitting-longevity.html

pandemic culture health

shared by aleija on 03 Dec 20 - No Cached
  • The sweet spot for physical activity and longevity seemed to arrive at about 35 minutes a day of brisk walking or other moderate activities.
  • Walking for at least 11 minutes a day could lessen the undesirable health consequences of sitting for hours and hours, according to a helpful new study of the ways in which both inactivity and exercise influence how long we live. The study, which relied on objective data from tens of thousands of people about how they spent their days, found that those who were the most sedentary faced a high risk of dying young, but if people got up and moved, they slashed that threat substantially, even if they did not move much.
  • Recent surveys of people’s behavior since the start of the pandemic indicate that a majority of us are exercising less and sitting more than we were a year ago.
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  • Not surprisingly, there could be long-term health consequences from this physical quietude.
  • Dividing people into thirds, based on how much they moved and sat, the researchers found, to no one’s surprise, that being extremely sedentary was hazardous, with people in the top third for sitting and bottom third for activity having about 260 percent more likelihood of premature death than the men and women who moved the most and sat the least. (The researchers controlled for smoking, body mass and other factors that might have influenced the results.)
  • The scientists wound up gathering results from nine recent studies in which almost 50,000 men and women wore accelerometers. These studies’ volunteers were middle-aged or older and lived in Europe or the United States.
  • If you sit for eight hours at work, for instance, then stroll for half an hour in the evening — meaning you comply with the standard exercise recommendation of about 30 minutes of exercise most days — is that enough movement to undo most of the health risks of too much sitting?
  • Of course, this study was observational and does not prove that exercise caused people to live longer, only that physical activity, sitting and mortality were linked.
Javier E

Medical Mystery: Something Happened to U.S. Health Spending After 1980 - The New York T... - 0 views

www.nytimes.com/...tery-health-spending-1980.html

health care Spending Medical history politics economics

shared by Javier E on 26 Jul 20 - No Cached
  • The United States devotes a lot more of its economic resources to health care than any other nation, and yet its health care outcomes aren’t better for it.
  • That hasn’t always been the case. America was in the realm of other countries in per-capita health spending through about 1980. Then it diverged.
  • It’s the same story with health spending as a fraction of gross domestic product. Likewise, life expectancy. In 1980, the U.S. was right in the middle of the pack of peer nations in life expectancy at birth. But by the mid-2000s, we were at the bottom of the pack.
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  • “Medical care is one of the less important determinants of life expectancy,” said Joseph Newhouse, a health economist at Harvard. “Socioeconomic status and other social factors exert larger influences on longevity.”
  • The United States has relied more on market forces, which have been less effective.
  • For spending, many experts point to differences in public policy on health care financing. “Other countries have been able to put limits on health care prices and spending” with government policies
  • One result: Prices for health care goods and services are much higher in the United States.
  • “The differential between what the U.S. and other industrialized countries pay for prescriptions and for hospital and physician services continues to widen over time,”
  • The degree of competition, or lack thereof, in the American health system plays a role
  • periods of rapid growth in U.S. health care spending coincide with rapid growth in markups of health care prices. This is what one would expect in markets with low levels of competition.
  • Although American health care markets are highly consolidated, which contributes to higher prices, there are also enough players to impose administrative drag. Rising administrative costs — like billing and price negotiations across many insurers — may also explain part of the problem.
  • The additional costs associated with many insurers, each requiring different billing documentation, adds inefficiency
  • “We have big pharma vs. big insurance vs. big hospital networks, and the patient and employers and also the government end up paying the bills,”
  • Though we have some large public health care programs, they are not able to keep a lid on prices. Medicare, for example, is forbidden to negotiate as a whole for drug prices,
  • once those spending constraints eased, “suppliers of medical inputs marketed very costly technological innovations with gusto,”
  • , all across the world, one sees constraints on payment, technology, etc., in the 1970s and 1980s,” he said. The United States is not different in kind, only degree; our constraints were weaker.
  • Mr. Starr suggests that the high inflation of the late 1970s contributed to growth in health care spending, which other countries had more systems in place to control
  • These are all highly valuable, but they came at very high prices. This willingness to pay more has in turn made the United States an attractive market for innovation in health care.
  • The last third of the 20th century or so was a fertile time for expensive health care innovation
  • being an engine for innovation doesn’t necessarily translate into better outcomes.
  • international differences in rates of smoking, obesity, traffic accidents and homicides cannot explain why Americans tend to die younger.
  • Some have speculated that slower American life expectancy improvements are a result of a more diverse population
  • But Ms. Glied and Mr. Muennig found that life expectancy growth has been higher in minority groups in the United States
  • even accounting for motor vehicle traffic crashes, firearm-related injuries and drug poisonings, the United States has higher mortality rates than comparably wealthy countries.
  • The lack of universal health coverage and less safety net support for low-income populations could have something to do with it
  • “The most efficient way to improve population health is to focus on those at the bottom,” she said. “But we don’t do as much for them as other countries.”
  • The effectiveness of focusing on low-income populations is evident from large expansions of public health insurance for pregnant women and children in the 1980s. There were large reductions in child mortality associated with these expansions.
  • A report by RAND shows that in 1980 the United States spent 11 percent of its G.D.P. on social programs, excluding health care, while members of the European Union spent an average of about 15 percent. In 2011 the gap had widened to 16 percent versus 22 percent.
  • “Social underfunding probably has more long-term implications than underinvestment in medical care,” he said. For example, “if the underspending is on early childhood education — one of the key socioeconomic determinants of health — then there are long-term implications.”
  • Slow income growth could also play a role because poorer health is associated with lower incomes. “It’s notable that, apart from the richest of Americans, income growth stagnated starting in the late 1970s,”
  • History demonstrates that it is possible for the U.S. health system to perform on par with other wealthy countries
  • That doesn’t mean it’s a simple matter to return to international parity. A lot has changed in 40 years. What began as small gaps in performance are now yawning chasms
  • “For starters, we could have a lot more competition in health care. And government programs should often pay less than they do.” He added that if savings could be reaped from these approaches, and others — and reinvested in improving the welfare of lower-income Americans — we might close both the spending and longevity gaps.
Javier E

AI scientist Ray Kurzweil: 'We are going to expand intelligence a millionfold by 2045' ... - 0 views

www.theguardian.com/...e-ai-the-singularity-is-nearer

ai kurzweil predictions evaluation 2024

shared by Javier E on 29 Jun 24 - No Cached
  • American computer scientist and techno-optimist Ray Kurzweil is a long-serving authority on artificial intelligence (AI). His bestselling 2005 book, The Singularity Is Near, sparked imaginations with sci-fi like predictions that computers would reach human-level intelligence by 2029 and that we would merge with computers and become superhuman around 2045, which he called “the Singularity”. Now, nearly 20 years on, Kurzweil, 76, has a sequel, The Singularity Is Nearer
  • no longer seem so wacky.
  • Your 2029 and 2045 projections haven’t changed…I have stayed consistent. So 2029, both for human-level intelligence and for artificial general intelligence (AGI) – which is a little bit different. Human-level intelligence generally means AI that has reached the ability of the most skilled humans in a particular domain and by 2029 that will be achieved in most respects. (There may be a few years of transition beyond 2029 where AI has not surpassed the top humans in a few key skills like writing Oscar-winning screenplays or generating deep new philosophical insights, though it will.) AGI means AI that can do everything that any human can do, but to a superior level. AGI sounds more difficult, but it’s coming at the same time.
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  • Why write this book? The Singularity Is Near talked about the future, but 20 years ago, when people didn’t know what AI was. It was clear to me what would happen, but it wasn’t clear to everybody. Now AI is dominating the conversation. It is time to take a look again both at the progress we’ve made – large language models (LLMs) are quite delightful to use – and the coming breakthroughs.
  • It is hard to imagine what this would be like, but it doesn’t sound very appealing… Think of it like having your phone, but in your brain. If you ask a question your brain will be able to go out to the cloud for an answer similar to the way you do on your phone now – only it will be instant, there won’t be any input or output issues, and you won’t realise it has been done (the answer will just appear). People do say “I don’t want that”: they thought they didn’t want phones either!
  • The most important driver is the exponential growth in the amount of computing power for the price in constant dollars. We are doubling price-performance every 15 months. LLMs just began to work two years ago because of the increase in computation.
  • What’s missing currently to bring AI to where you are predicting it will be in 2029? One is more computing power – and that’s coming. That will enable improvements in contextual memory, common sense reasoning and social interaction, which are all areas where deficiencies remain
  • LLM hallucinations [where they create nonsensical or inaccurate outputs] will become much less of a problem, certainly by 2029 – they already happen much less than they did two years ago. The issue occurs because they don’t have the answer, and they don’t know that. They look for the best thing, which might be wrong or not appropriate. As AI gets smarter, it will be able to understand its own knowledge more precisely and accurately report to humans when it doesn’t know.
  • What exactly is the Singularity? Today, we have one brain size which we can’t go beyond to get smarter. But the cloud is getting smarter and it is growing really without bounds. The Singularity, which is a metaphor borrowed from physics, will occur when we merge our brain with the cloud. We’re going to be a combination of our natural intelligence and our cybernetic intelligence and it’s all going to be rolled into one. Making it possible will be brain-computer interfaces which ultimately will be nanobots – robots the size of molecules – that will go noninvasively into our brains through the capillaries. We are going to expand intelligence a millionfold by 2045 and it is going to deepen our awareness and consciousness.
  • Why should we believe your dates? I’m really the only person that predicted the tremendous AI interest that we’re seeing today. In 1999 people thought that would take a century or more. I said 30 years and look what we have.
  • I have a chapter on perils. I’ve been involved with trying to find the best way to move forward and I helped to develop the Asilomar AI Principles [a 2017 non-legally binding set of guidelines for responsible AI development]
  • All the major companies are putting more effort into making sure their systems are safe and align with human values than they are into creating new advances, which is positive.
  • Not everyone is likely to be able to afford the technology of the future you envisage. Does technological inequality worry you? Being wealthy allows you to afford these technologies at an early point, but also one where they don’t work very well. When [mobile] phones were new they were very expensive and also did a terrible job. They had access to very little information and didn’t talk to the cloud. Now they are very affordable and extremely useful. About three quarters of people in the world have one. So it’s going to be the same thing here: this issue goes away over time.
  • The book looks in detail at AI’s job-killing potential. Should we be worried? Yes, and no. Certain types of jobs will be automated and people will be affected. But new capabilities also create new jobs. A job like “social media influencer” didn’t make sense, even 10 years ago. Today we have more jobs than we’ve ever had and US average personal income per hours worked is 10 times what it was 100 years ago adjusted to today’s dollars. Universal basic income will start in the 2030s, which will help cushion the harms of job disruptions. It won’t be adequate at that point but over time it will become so.
  • Everything is progressing exponentially: not only computing power but our understanding of biology and our ability to engineer at far smaller scales. In the early 2030s we can expect to reach longevity escape velocity where every year of life we lose through ageing we get back from scientific progress. And as we move past that we’ll actually get back more years.
  • What is your own plan for immortality? My first plan is to stay alive, therefore reaching longevity escape velocity. I take about 80 pills a day to help keep me healthy. Cryogenic freezing is the fallback. I’m also intending to create a replicant of myself [an afterlife AI avatar], which is an option I think we’ll all have in the late 2020s
  • I did something like that with my father, collecting everything that he had written in his life, and it was a little bit like talking to him. [My replicant] will be able to draw on more material and so represent my personality more faithfully.
  • What should we be doing now to best prepare for the future? It is not going to be us versus AI: AI is going inside ourselves. It will allow us to create new things that weren’t feasible before. It’ll be a pretty fantastic future.
Javier E

The American Scholar: Those Other Ancestors - Priscilla Long - 0 views

theamericanscholar.org/those-other-ancestors

neanderthal human evolution

shared by Javier E on 15 May 13 - No Cached
  • The human species Homo erectus evolved out of earlier human forms 1.8 million years ago and survived until 143,000 years ago. He and she walked on two feet and used tools and gradually spread over Africa and western and eastern Asia. Out of Homo erectus evolved, it is thought, Homo heidelbergensis. This common ancestor of both Homo neanderthalensis and Homo sapiens existed from 400,000 to 350,000 years ago. Homo heidelbergensis used fire and was the first to build shelters as opposed to just finding shelter, although they did that too. The European branch of Homo heidelbergensis evolved into the Neandertals 300,000 or more years ago. The Neandertals were big-bodied, light-skinned, cold-adapted humans. Some, at least, were redheads. The African branch of Homo heidelbergensis evolved into Homo sapiens—us—200,000 years ago. We were slighter-bodied. We had narrower hips and darker skin
  • Homo sapiens began moving out of Africa to the Near East 40,000 years ago. There they encountered a southern remnant of Neandertals. Most of that species had long since gone extinct. But we shared the region for 15,000 years, until the Neandertals disappeared.
  • Contrary to previous suppositions and speculations, Neandertals ate a varied diet including not only large mammals like mammoths but also birds, rabbits, and seafood. They possessed the “language gene,” just as we do, and likely communicated in some sort of language. They manufactured tools, although not in as great a variety as we did. They decorated their bodies and wore jewelry—an index of symbolic cognition. They likely adorned themselves with feathers.
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  • Because they had bigger bodies, they required more calories to survive than we do. They may have lacked sewing skills. Neither Neandertals nor Homo sapiens lived long (the rare 30-year-old Neandertal was old), but at some point, for reasons not really understood, the life spans of Homo sapiens began to increase. More longevity provided a grandparent generation to impart knowledge, skills, and more resources to the group.
  • Another discovery bearing on the subject are the extreme climate fluctuations that occurred between 65,000 and 25,000 years ago. The Neandertals had bodies and cultures adapted to ice and snow. This time of fluctuation involved such rapid climate change that in one lifetime “all the plants and animals that a person had grown up with could vanish and be replaced with unfamiliar flora and fauna,” writes Wong. The environmental stress may have decimated their ranks to below zero population growth.
Javier E

Americans Under 50 Fare Poorly on Health Measures, New Report Says - NYTimes.com - 0 views

www.nytimes.com/...-measures-new-report-says.html

health US comparative international report

shared by Javier E on 11 Jan 13 - No Cached
  • Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.
  • The panel called the pattern of higher rates of disease and shorter lives “the U.S. health disadvantage,” and said it was responsible for dragging the country to the bottom in terms of life expectancy over the past 30 years. American men ranked last in life expectancy among the 17 countries in the study, and American women ranked second to last.
  • “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it’s getting worse.”
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  • The rate of firearm homicides was 20 times higher in the United States than in the other countries, according to the report, which cited a 2011 study of 23 countries. And though suicide rates were lower in the United States, firearm suicide rates were six times higher.
  • Panelists were surprised at just how consistently Americans ended up at the bottom of the rankings. The United States had the second-highest death rate from the most common form of heart disease, the kind that causes heart attacks, and the second-highest death rate from lung disease, a legacy of high smoking rates in past decades. American adults also have the highest diabetes rates.
  • Youths fared no better. The United States has the highest infant mortality rate among these countries, and its young people have the highest rates of sexually transmitted diseases, teen pregnancy and deaths from car crashes. Americans lose more years of life before age 50 to alcohol and drug abuse than people in any of the other countries.
  • The United States is a bigger, more heterogeneous society with greater levels of economic inequality, and comparing its health outcomes to those in countries like Sweden or France may seem lopsided. B
  • the U.S. ranked near and at the bottom in almost every heath indicator. That stunned us.”
  • The panel sought to explain the poor performance. It noted the United States has a highly fragmented health care system, with limited primary care resources and a large uninsured population. It has the highest rates of poverty among the countries studied.
  • In the other countries, more generous social safety nets buffer families from the health consequences of poverty, the report said.
  • Could cultural factors like individualism and dislike of government interference play a role? Americans are less likely to wear seat belts and more likely to ride motorcycles without helmets.  
  • Americans also had the lowest probability over all of surviving to the age of 50. The report’s second chapter details health indicators for youths where the United States ranks near or at the bottom. There are so many that the list takes up four pages.
  • the panelists point out that this country spends more on health care than any other in the survey. And as recently as the 1950s, Americans scored better in life expectancy and disease than many of the other countries in the current study.
Javier E

What sort of Toryism will emerge from this fractious upheaval? | Eliza Filby | Opinion ... - 0 views

www.theguardian.com/...ious-upheaval-thatcherism-dead

conservatives UK brexit crisis politics History

shared by Javier E on 03 Jul 16 - No Cached
  • . A new Conservative government will soon emerge, one that has a parliamentary majority and will be faced with a Labour party that is either in the process of disintegrating or reeling from the shockwaves of internal turmoil
  • The Conservative government will charge forward with reform concurrent with the European negotiations so as to avoid the next election being simply a referendum on the Brexit settlement.
  • The key question is whether anything has happened in the last seven days to rupture the Osborne-Cameron consensus? Is there still a one-nation will existing within the party?
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  • Under David Cameron, the Tories came to rediscover what Labour seems to have forgotten, namely that elections are fought and won on the centre ground. It is possible to nudge the dial a little, but victory can only be achieved by straddling the centre while appeasing your core.
  • this is a lesson that is deep rooted within the party. One of Cameron’s greatest strengths was his longevity; as leader for over a decade, he was able to make significant progress in reshaping the parliamentary party in his own image
  • One of the outcomes of the referendum has been to prompt a new realignment within the party. The old Thatcherite v one-nation split, which admittedly has long been on the wane, has now firmly recrystallised around the new labels of Remainer and Leaver. So the present leadership contest is essentially a battle between one-nation Conservatives with only Liam Fox, the stand-alone candidate from the old school.
  • It will be one-nation Tories who will be in charge of making Brexit a reality.
  • Brexit can only be part of the solution. An agenda of social reform, which addresses some of the frustrations and divisions that the vote unmasked, is politically necessar
  • the referendum debate has provided the rationale and opportunity (given Labour’s dire state) for Cameron Conservatism to be fully realised.
  • First, it requires a more robust one-nation vision. One that moves away from offering cosy reassurances to metropolitan liberals that the Conservatives are no longer the “nasty party” (which was essentially what legalising gay marriage did) to one that addresses the concerns of those in Britain’s deindustralised heartlands
  • , a one-nation Conservative agenda cannot be seen to enact a divide, as much of Thatcher’s social reform did, between the deserving and undeserving poor or, worse, heed the Ukip agenda, creating a division between immigrants and the indigenous population.
  • When Conservatives such as Gove talk about social reform, they tend to centre on the individual, policies that help people realise their potential through opportunity. But surely, if the referendum has revealed anything, political capital needs to be realised at a community rather than individual level.
  • Second, the fate of whoever wins the leadership will depend almost entirely on how he or she negotiates Brexit and specifically, what is crucially the central plank of the deal – the balancing of freedom of movement with the freedom to trade. This will not be easy
  • If people start feeling that Brexit has not worked for them and do not soon see increases in wages, improved access to social services and a restriction on immigration then the political backlash will begin in earnest
  • If the public gets any whiff of a whitewash or if the government is seen to have sold Britain short in any way, the narrative of the “Great Betrayal” will be scripted long before the election.
  • Third, the fortunes of one-nation Conservatism will depend largely on the fortunes of the Labour party.
  • if under new leadership, Labour was somehow able to resuscitate itself and make a direct charge for the centre ground, a credible revival is still possible.
  • Cameron inadvertently has achieved his chief goal: to stop the Tories banging on about Europe.
abbykleman

Africa is young. Why are its leaders so old? - 0 views

www.cnn.com/...index.html

shared by abbykleman on 21 Feb 17 - No Cached
  • abbykleman on 21 Feb 17
     
    Its five longest presidencies stretch between 29 and 36 years, adding to a cumulative 169 years. Their longevity in office is matched by their old age, ranging from 71 to 91 years, and a combined 390 years. Gabon's Omar Bongo had been president for a whopping 41 years when he died in office at the age of 73 in 2011.
Javier E

Everyone likes the idea of equal opportunity. This economist thinks it's a fantasy. - 0 views

www.washingtonpost.com/...economist-thinks-its-a-fantasy

social mobility equal opportunity economics culture biology success

shared by Javier E on 01 Feb 14 - No Cached
  • His new book, "The Son Also Rises" (Clark is a big fan of Hemingway puns), traces families with particular surnames to measure social mobility over the course of hundreds of years in England, the United States, Sweden, India, China and more. He finds that there's much less mobility than we often assume, and that government interventions to promote it more often than not fail.
  • What gave you the idea to look at surname data? Initially I was interested just in extending conventional social mobility estimates into the distant past. Estimating social mobility is very data intensive. You need to link individual parents and children. There are thus no such estimates for any society before 1850. Tracking surname status was a convenient shortcut. In most societies, all the people with a surname such as Goodhart descended from the earlier set of Goodharts. We do not know the individual linkages, but we can ask what is happening to their status as a group across generations.
  • I found that you get radically slower estimated mobility rates for all societies when you switch to surnames.
  • ...18 more annotations...
  • The effect is dramatic in some countries. Modern Sweden has some of the most rapid social mobility rates estimated in the world. Yet surnames in modern Sweden show status persistence exactly in this 0.7-0.8 range. This result was completely unexpected. Understanding why that is the case is a key puzzle the book tackles.
  • The book mainly concentrates on measures such as education, occupational status, wealth and longevity as indicators of status. Another surprising puzzle that emerged is that with surnames, the persistence of status was the same for all these measures. We might expect wealth to persist in a different way, since it can be transmitted across generations in a different way than education. You do not need any talent to inherit wealth. This is another regularity the book tries to account for.
  • Another remarkable feature of the surname data is how seemingly impervious social mobility rates are to government interventions. In all societies, what seems to matter is just who your parents are. At the extreme, we see in modern Sweden an extensive system of public education and social support. Yet underlying mobility rates are no higher in modern Sweden than in pre-industrial Sweden or medieval England.
  • Interestingly, in China, the extreme social intervention represented by the Communist Revolution of 1949, which included executing large numbers of members of the old upper class, has not resulted in much of an increase in social mobility. Surnames of high status in the Imperial and Republican era continue to be overrepresented among modern elites, including Communist Party officials.
  • families that have high social competence, whatever the social system is, typically find their way to the top of the social ladder.
  •  It is clear that families are very powerful determinants of children’s outcomes. But what do parents transmit to their children? Is it mainly some type of culture? Or is it mainly genetics?
  • The data does not exist to provide any conclusive answer to this question. But even if this is cultural transmission, it looks in all respects just the same as biological inheritance. The book performs a series of tests to see if biological transmission can be ruled out as the important link, and the empirical patterns never rule this out.
  • A recent book, "The Triple Package"  [by Amy Chua and Jed Rubenfeld], argues the extreme opposite of biology in explaining social status, with the claim that successful cultural groups in the U.S. have three key features leading to success, one being impulse control. But what is remarkable is how disparate the culturally successful groups they identify are – Jews, Chinese, Indians, Mormons, Iranians, Lebanese, Nigerians, Cubans. And it is demonstrable that most of the successful groups identified here were elites selected from the parent populations as a combined result of politics at home and immigration policy in the U.S.
  • All this information on social mobility within societies unfortunately does not offer much insight into why societies as a whole succeed or fail in economic terms.
  • The surname data suggests that you will not be able to do much to increase social mobility through social policies of any type.  We already live in societies of massive social intervention in terms of the provision of education and health care. Yet we have not been able to raise social mobility rates above those of the pre-industrial era.
  • But if we're learning that we can predict the majority of people's outcomes at conception, that should lead us to reexamine our assumption that whatever income distribution comes out in society is fine. Because if it's the case that a lot of this is determined before someone enters the game, it weakens the case for letting the market determine the distribution. You'd be much more likely to favor a society with much less inequality.
  • And that's where Sweden's system does provide advantages over the U.S.'s. They haven't changed mobility rates, but they've changed the consequences, strongly, of ending up at various points in the distribution. It's a much better place for people who end up at the bottom of the distribution.
  • One piece of news that most people will find encouraging in these various studies is that eventually all elites become average in their characteristics, even if that takes 300 years
  • Accounts that emphasize cultural transmission all have a hard time explaining why successful groups, and successful families in general, all experience regression to the mean. There is nothing to stop a cultural trait being inherited unchanged
  • Only biological inheritance has an inbuilt mechanism to explain observed regression to the mean. It also has predictions about when this regression to the mean will not be observed (complete endogamy). It further implies that the rate of regression to the mean will be the same at the top of the status distribution as at the bottom. So the biological pathway has two advantages over the cultural. It produces a mechanism to explain the regression of all elites and underclasses that we observe, and it has testable implications about the speed and character of that mobility.
  • The final surprise in conducting this study was to find a seeming simple physics that underlies social mobility.
  • When we observe an elite group in 1800 in England, we can predict to seven generations in the future what their relative social position will be, despite the arrival of the Industrial Revolution and the rise of the modern welfare state in the interval.
  • Two very simple equations are sufficient to describe a major feature of the social world, and a feature that you would think impossible to model in any such manner.
Javier E

The Dark Power of Fraternities - The Atlantic - 0 views

www.theatlantic.com/...357580

fraternity university

shared by Javier E on 22 Feb 14 - No Cached
  • College fraternities—by which term of art I refer to the formerly all-white, now nominally integrated men’s “general” or “social” fraternities, and not the several other types of fraternities on American campuses (religious, ethnic, academic)—are as old, almost, as the republic.
  • While the system has produced its share of poets, aesthetes, and Henry James scholars, it is far more famous for its success in the powerhouse fraternity fields of business, law, and politics. An astonishing number of CEOs of Fortune 500 companies, congressmen and male senators, and American presidents have belonged to fraternities
  • They also have a long, dark history of violence against their own members and visitors to their houses, which makes them in many respects at odds with the core mission of college itself.
  • ...62 more annotations...
  • A recent series of articles on fraternities by Bloomberg News’s David Glovin and John Hechinger notes that since 2005, more than 60 people—the majority of them students—have died in incidents linked to fraternities, a sobering number in itself, but one that is dwarfed by the numbers of serious injuries, assaults, and sexual crimes that regularly take place in these houses.
  • I have spent most of the past year looking deeply into the questions posed by these lawsuits, and more generally into the particular nature of fraternity life on the modern American campus
  • to answer the vexing question “why don’t colleges just get rid of their bad fraternities?”—the system, and its individual frats, have only grown in power and influence. Indeed, in many substantive ways, fraternities are now mightier than the colleges and universities that host them.
  • The entire multibillion-dollar, 2,000-campus American college system
  • the Kappa Alpha Society. Word of the group spread, and a new kind of college institution was founded, and with it a brand-new notion: that going to college could include some pleasure. It was the American age of societies, and this new type fit right in.
  • every moment of the experience is sweetened by the general understanding that with each kegger and rager, each lazy afternoon spent snoozing on the quad (a forgotten highlighter slowly drying out on the open pages of Introduction to Economics, a Coke Zero sweating beside it), they are actively engaged in the most significant act of self-improvement available to an American young person: college!
  • There are many thousands of American undergraduates whose economic futures (and those of their parents) would be far brighter if they knocked off some of their general-education requirements online, or at the local community college—for pennies on the dollar—before entering the Weimar Republic of traditional-college pricing. But college education, like weddings and funerals, tends to prompt irrational financial decision making,
  • depends overwhelmingly for its very existence on one resource: an ever-renewing supply of fee-paying undergraduates. It could never attract hundreds of thousands of them each year—many of them woefully unprepared for the experience, a staggering number (some 40 percent) destined never to get a degree, more than 60 percent of them saddled with student loans that they very well may carry with them to their deathbeds—if the experience were not accurately marketed as a blast.
  • When colleges tried to shut them down, fraternities asserted that any threat to men’s membership in the clubs constituted an infringement of their right to freedom of association. It was, at best, a legally delicate argument, but it was a symbolically potent one, and it has withstood through the years. The powerful and well-funded political-action committee that represents fraternities in Washington has fought successfully to ensure that freedom-of-association language is included in all higher-education reauthorization legislation, thus “disallowing public Universities the ability to ban fraternities.”
  • While the fraternities continued to exert their independence from the colleges with which they were affiliated, these same colleges started to develop an increasingly bedeviling kind of interdependence with the accursed societies
  • the fraternities involved themselves very deeply in the business of student housing, which provided tremendous financial savings to their host institutions, and allowed them to expand the number of students they could admit. Today, one in eight American students at four-year colleges lives in a Greek house
  • fraternities tie alumni to their colleges in a powerful and lucrative way. At least one study has affirmed what had long been assumed: that fraternity men tend to be generous to their alma maters. Furthermore, fraternities provide colleges with unlimited social programming of a kind that is highly attractive to legions of potential students
  • It is true that fraternity lawsuits tend to involve at least one, and often more, of the four horsemen of the student-life apocalypse, a set of factors that exist far beyond frat row
  • the binge-drinking epidemic, which anyone outside the problem has a hard time grasping as serious (everyone drinks in college!) and which anyone with knowledge of the current situation understands as a lurid and complicated disaster
  • The second is the issue of sexual assault of female undergraduates by their male peers, a subject of urgent importance but one that remains stubbornly difficult even to quantify
  • The third is the growing pervasiveness of violent hazing on campus
  • But it’s impossible to examine particular types of campus calamity and not find that a large number of them cluster at fraternity houses
  • the fourth is the fact that Boomers, who in their own days destroyed the doctrine of in loco parentis so that they could party in blissful, unsupervised freedom, have grown up into the helicopter parents of today
  • during the period of time under consideration, serious falls from fraternity houses on the two Palouse campuses far outnumbered those from other types of student residences, including privately owned apartments occupied by students. I began to view Amanda Andaverde’s situation in a new light.
  • Why are so many colleges allowing students to live and party in such unsafe locations? And why do the lawsuits against fraternities for this kind of serious injury and death—so predictable and so preventable—have such a hard time getting traction? The answers lie in the recent history of fraternities and the colleges and universities that host them.
  • This question is perhaps most elegantly expressed in the subtitle of Robert D. Bickel and Peter F. Lake’s authoritative 1999 book on the subject, The Rights and Responsibilities of the Modern University: Who Assumes the Risks of College Life?
  • The answer to this question has been steadily evolving ever since the 1960s, when dramatic changes took place on American campuses, changes that affected both a university’s ability to control student behavior and the status of fraternities in the undergraduate firmament. During this period of student unrest, the fraternities—long the unquestioned leaders in the area of sabotaging or ignoring the patriarchal control of school administrators—became the exact opposite: representatives of the very status quo the new activists sought to overthrow. Suddenly their beer bashes and sorority mixers, their panty raids and obsession with the big game, seemed impossibly reactionary when compared with the mind-altering drugs being sampled in off-campus apartments where sexual liberation was being born and the Little Red Book proved, if nothing else, a fantastic coaster for a leaky bong.
  • American colleges began to regard their students not as dependents whose private lives they must shape and monitor, but as adult consumers whose contract was solely for an education, not an upbringing. The doctrine of in loco parentis was abolished at school after school.
  • Through it all, fraternities—for so long the repositories of the most outrageous behavior—moldered, all but forgotten.
  • Animal House, released in 1978, at once predicted and to no small extent occasioned the roaring return of fraternity life that began in the early ’80s and that gave birth to today’s vital Greek scene
  • In this newly forming culture, the drugs and personal liberation of the ’60s would be paired with the self-serving materialism of the ’80s, all of which made partying for its own sake—and not as a philosophical adjunct to solving some complicated problem in Southeast Asia—a righteous activity for the pampered young collegian. Fraternity life was reborn with a vengeance.
  • These new members and their countless guests brought with them hard drugs, new and ever-developing sexual attitudes, and a stunningly high tolerance for squalor
  • Adult supervision was nowhere to be found. Colleges had little authority to intervene in what took place in the personal lives of its students visiting private property. Fraternities, eager to provide their members with the independence that is at the heart of the system—and responsive to members’ wish for the same level of freedom that non-Greek students enjoyed—had largely gotten rid of the live-in resident advisers who had once provided some sort of check on the brothers
  • , in 1984 Congress passed the National Minimum Drinking Age Act, with the ultimate result of raising the legal drinking age to 21 in all 50 states. This change moved college partying away from bars and college-sponsored events and toward private houses—an ideal situation for fraternities
  • lawsuits began to pour in.
  • Liability insurance became both ruinously expensive and increasingly difficult to obtain. The insurance industry ranked American fraternities as the sixth-worst insurance risk in the country—just ahead of toxic-waste-removal companies.
  • For fraternities to survive, they needed to do four separate but related things: take the task of acquiring insurance out of the hands of the local chapters and place it in the hands of the vast national organizations; develop procedures and policies that would transfer as much of their liability as possible to outside parties; find new and creative means of protecting their massive assets from juries; and—perhaps most important of all—find a way of indemnifying the national and local organizations from the dangerous and illegal behavior of some of their undergraduate members.
  • comprising a set of realities you should absolutely understand in detail if your son ever decides to join a fraternity.
  • you may think you belong to Tau Kappa Epsilon or Sigma Nu or Delta Tau Delta—but if you find yourself a part of life-changing litigation involving one of those outfits, what you really belong to is FIPG, because its risk-management policy (and your adherence to or violation of it) will determine your fate far more than the vows you made during your initiation ritual
  • the need to manage or transfer risk presented by alcohol is perhaps the most important factor in protecting the system’s longevity. Any plaintiff’s attorney worth his salt knows how to use relevant social-host and dramshop laws against a fraternity; to avoid this kind of liability, the fraternity needs to establish that the young men being charged were not acting within the scope of their status as fraternity members. Once they violated their frat’s alcohol policy, they parted company with the frat.
  • there are actually only two FIPG-approved means of serving drinks at a frat party. The first is to hire a third-party vendor who will sell drinks and to whom some liability—most significant, that of checking whether drinkers are of legal age—will be transferred. The second and far more common is to have a BYO event, in which the liability for each bottle of alcohol resides solely in the person who brought it.
  • these policies make it possible for fraternities to be the one industry in the country in which every aspect of serving alcohol can be monitored and managed by people who are legally too young to drink it.
  • But when the inevitable catastrophes do happen, that policy can come to seem more like a cynical hoax than a real-world solution to a serious problem.
  • Thanks in part to the guest/witness list, Larry can be cut loose, both from the expensive insurance he was required to help pay for (by dint of his dues) as a precondition of membership, and from any legal defense paid for by the organization. What will happen to Larry now?
  • “I’ve recovered millions and millions of dollars from homeowners’ policies,” a top fraternal plaintiff’s attorney told me. For that is how many of the claims against boys who violate the strict policies are paid: from their parents’ homeowners’ insurance
  • , the Fraternal Information and Programming Group’s chillingly comprehensive crisis-management plan was included in its manual for many years
  • the plan serves a dual purpose, at once benevolent and mercenary. The benevolent part is accomplished by the clear directive that injured parties are to receive immediate medical attention, and that all fraternity brothers who come into contact with the relevant emergency workers are to be completely forthright
  • “Until proven otherwise,” Fierberg told me in April of fraternities, “they all are very risky organizations for young people to be involved in.” He maintains that fraternities “are part of an industry that has tremendous risk and a tremendous history of rape, serious injury, and death, and the vast majority share common risk-management policies that are fundamentally flawed. Most of them are awash in alcohol. And most if not all of them are bereft of any meaningful adult supervision.”
  • the interests of the national organization and the individual members cleave sharply as this crisis-management plan is followed. Those questionnaires and honest accounts—submitted gratefully to the grown-ups who have arrived, the brothers believe, to help them—may return to haunt many of the brothers, providing possible cause for separating them from the fraternity, dropping them from the fraternity’s insurance, laying the blame on them as individuals and not on the fraternity as the sponsoring organization.
  • So here is the essential question: In the matter of these disasters, are fraternities acting in an ethical manner, requiring good behavior from their members and punishing them soundly for bad or even horrific decisions? Or are they keeping a cool distance from the mayhem, knowing full well that misbehavior occurs with regularity (“most events take place at night”) and doing nothing about it until the inevitable tragedy occurs, at which point they cajole members into incriminating themselves via a crisis-management plan presented as being in their favor?
  • I have had long and wide-ranging conversations with both men, in which each put forth his perspective on the situation.
  • the young men who typically rush so gratefully into the open arms of the representatives from their beloved national—an outfit to which they have pledged eternal allegiance—would be far better served by not talking to them at all, by walking away from the chapter house as quickly as possible and calling a lawyer.
  • The fraternity system, he argues, is “the largest industry in this country directly involved in the provision of alcohol to underage people.” The crisis-management plans reveal that in “the foreseeable future” there may be “the death or serious injury” of a healthy young person at a fraternity function.
  • His belief is that what’s tarnishing the reputation of the fraternities is the bad behavior of a very few members, who ignore all the risk-management training that is requisite for membership, who flout policies that could not be any more clear, and who are shocked when the response from the home office is not to help them cover their asses but to ensure that—perhaps for the first time in their lives—they are held 100 percent accountable for their actions.
  • The fraternity system, he argues, is “the largest industry in this country directly involved in the provision of alcohol to underage people.” The crisis-management plans reveal that in “the foreseeable future” there may be “the death or serious injury” of a healthy young person at a fraternity function.
  • His belief is that what’s tarnishing the reputation of the fraternities is the bad behavior of a very few members, who ignore all the risk-management training that is requisite for membership, who flout policies that could not be any more clear, and who are shocked when the response from the home office is not to help them cover their asses but to ensure that—perhaps for the first time in their lives—they are held 100 percent accountable for their actions.
  • Unspoken but inherent in this larger philosophy is the idea that it is in a young man’s nature to court danger and to behave in a foolhardy manner; the fraternity experience is intended to help tame the baser passions, to channel protean energies into productive endeavors such as service, sport, and career preparation.
  • In a sense, Fierberg, Smithhisler, and the powerful forces they each represent operate as a check and balance on the system. Personal-injury lawsuits bring the hated media attention and potential financial losses that motivate fraternities to improve. It would be a neat, almost a perfect, system, if the people wandering into it were not young, healthy college students with everything to lose.
  • In a sense, Fierberg, Smithhisler, and the powerful forces they each represent operate as a check and balance on the system. Personal-injury lawsuits bring the hated media attention and potential financial losses that motivate fraternities to improve. It would be a neat, almost a perfect, system, if the people wandering into it were not young, healthy college students with everything to lose.
  • Wesleyan is one of those places that has by now become so hard to get into that the mere fact of attendance is testament, in most cases, to a level of high-school preparation—combined with sheer academic ability—that exists among students at only a handful of top colleges in this country and that is almost without historical precedent.
  • Wesleyan is one of those places that has by now become so hard to get into that the mere fact of attendance is testament, in most cases, to a level of high-school preparation—combined with sheer academic ability—that exists among students at only a handful of top colleges in this country and that is almost without historical precedent.
  • This January, after publishing a withering series of reports on fraternity malfeasance, the editors of Bloomberg.com published an editorial with a surprising headline: “Abolish Fraternities.” It compared colleges and universities to companies, and fraternities to units that “don’t fit into their business model, fail to yield an adequate return or cause reputational harm.”
  • A college or university can choose, as Wesleyan did, to end its formal relationship with a troublesome fraternity, but—if that fiasco proves anything—keeping a fraternity at arm’s length can be more devastating to a university and its students than keeping it in the fold.
  • A college or university can choose, as Wesleyan did, to end its formal relationship with a troublesome fraternity, but—if that fiasco proves anything—keeping a fraternity at arm’s length can be more devastating to a university and its students than keeping it in the fold.
  • there is a Grand Canyon–size chasm between the official risk-management policies of the fraternities and the way life is actually lived in countless dangerous chapters.
  • When there is a common denominator among hundreds of such injuries and deaths, one that exists across all kinds of campuses, from private to public, prestigious to obscure, then it is more than newsworthy: it begins to approach a national scandal.
  • When there is a common denominator among hundreds of such injuries and deaths, one that exists across all kinds of campuses, from private to public, prestigious to obscure, then it is more than newsworthy: it begins to approach a national scandal.
Javier E

What American Healthcare Can Learn From Germany - Olga Khazan - The Atlantic - 0 views

www.theatlantic.com/...360133

germany health-care system us comparative

shared by Javier E on 09 Apr 14 - No Cached
  • Every German resident must belong to a sickness fund, and in turn the funds must insure all comers. They’re also mandated to cover a standard set of benefits, which includes most procedures and medications. Workers pay half the cost of their sickness fund insurance, and employers pay the rest. The German government foots the bill for the unemployed and for children. There are also limits on out-of-pocket expenses, so it’s rare for a German to go into debt because of medical bills.
  • this is very similar to the health-insurance regime that Americans are now living under, now that the Affordable Care Act is four years old and a few days past its first enrollment deadline.
  • There are, of course, a few key differences. Co-pays in the German system are minuscule, about 10 euros per visit. Even those for hospital stays are laughably small by American standards: Sam payed 40 euro for a three-day stay for a minor operation a few years ago
  • ...24 more annotations...
  • nearly five million Americans fall into what’s called the “Medicaid gap”
  • In Germany, employees' premiums are a percentage of their incomes, so low-wage workers simply pay rock-bottom insurance rates.
  • You can think of this setup as the Goldilocks option among all of the possible ways governments can insure health. It's not as radical as single-payer models like the U.K.’s, where the government covers everyone. And it's also not as brutal as the less-regulated version of the insurance market we had before the ACA.
  • Germany actually pioneered this type of insurance—it all started when Otto von Bismarck signed his Health Insurance Bill of 1883 into law. (It’s still known as the “Bismarck model” because of his legacy, and other parts of Europe and Asia have adopted it over the years.)
  • Since there are no provider networks in Germany, doctors don’t know what other providers patients have seen, so there are few ways to limit repeat procedures.
  • All things considered, it’s good to be a sick German. There are no network limitations, so people can see any doctor they want. There are no deductibles, so Germans have no fear of spending hundreds before their insurance ever kicks in.
  • There’s also no money that changes hands during a medical appointment. Patients show their insurance card at the doctor’s office, and the doctors' association pays the doctor using money from the sickness funds. "You don’t have to sit at home and sort through invoices or wonder if you overlooked fine print,”
  • That insurance card, by the way, is good for hospital visits anywhere in Europe.
  • of all of the countries studied, Germans were the most likely to be able to get a same-day or next-day appointment and to hear back from a doctor quickly if they had a question. They rarely use emergency rooms, and they can access doctors after-hours with ease.
  • And Germany manages to put its health-care dollars to relatively good use: For each $100 it spends on healthcare, it extends life by about four months, according to a recent analysis in the American Journal of Public Health. In the U.S., one of the worst-performing nations in the ranking, each $100 spent on healthcare resulted in only a couple of extra weeks of longevity.
  • those differences aside, it’s fair to say the U.S. is moving in the direction of systems like Germany’s—multi-payer, compulsory, employer-based, highly regulated, and fee-for-service.
  • The German government is similarly trying to push more people into “family physician” programs, in which just one doctor would serve as a gatekeeper.
  • like the U.S., Germany may see a shortage of primary-care doctors in the near future, both because primary-care doctors there don’t get paid as much as specialists, and because entrenched norms have prevented physician assistants from shouldering more responsibility
  • With limitations on how much they can charge, German doctors and hospitals instead try to pump up their earnings by performing as many procedures as possible, just like American providers do.
  • With few resource constraints, healthcare systems like America's and Germany's tend to go with the most expensive treatment option possible. An American might find himself in an MRI machine for a headache that a British doctor would have treated with an aspirin and a smile.
  • Similarly, “In Germany, it will always be an operation,” Göpffarth said. “Meanwhile, France and the U.K. tend to try drugs first and operations later.”
  • Perhaps the biggest difference between our two approaches is the extent to which Germany has managed to rein in the cost of healthcare for consumers. Prices for procedures there are lower and more uniform because doctors’ associations negotiate their fees directly with all of the sickness funds in each state. That's part of the reason why an appendectomy costs $3,093 in Germany, but $13,000 in the U.S.
  • “In Germany, there is a uniform fee schedule for all physicians that work under the social code,” Schlette said. “There’s a huge catalogue where they determine meticulously how much is billed for each procedure. That’s like the Bible.”
  • certain U.S. states have tried a more German strategy, attempting to keep costs low by setting prices across the board. Maryland, for example, has been regulating how much all of the state’s hospitals can charge since 1977. A 2009 study published in Health Affairs found that we would have saved $2 trillion if the entire country’s health costs had grown at the same rate as Maryland’s over the past three decades.
  • Now, Maryland is going a step further still, having just launched a plan to cap the amount each hospital can spend, total, each year. The state's hospital spending growth will be limited to 3.58 percent for the next five years. “We know that right now, the more [doctors] do, the more they get paid,” John Colmers, executive director of Maryland’s Health Services Cost Review Commission, told me. “We want to say, ‘The better you do, the better you get paid.’”
  • “The red states are unlikely to follow their lead. The notion that government may be a big part of the solution, instead of the problem, is anathema, and Republican controlled legislatures, and their governors, would find it too substantial a conflict to pursue with any vigor.”
  • no other state has Maryland’s uniform, German-style payment system in place, “so Maryland starts the race nine paces ahead of the other 46 states,” McDonough said.
  • the unique spirit of each country is what ultimately gets in its way. Germany’s more orderly system can be too rigid for experimentation. And America’s free-for-all, where hospitals and doctors all charge different amounts, is great for innovation but too chaotic to make payment reforms stick.
  • rising health costs will continue to be the main problem for Americans as we launch into our more Bismarckian system. “The main challenge you’ll have is price control,” he said. “You have subsidies in health exchanges now, so for the first time, the federal budget is really involved in health expenditure increases in the commercial market. In order to keep your federal budget under control, you’ll have to control prices.”
Javier E

Happiness--Part 7: Why Americans These Days Are the Most Anxious People Ever | Rightly ... - 0 views

bigthink.com/31708

anxiety US cultural values control comparative

shared by Javier E on 28 Mar 11 - No Cached
  • Perhaps the most puzzling statistics are the ones that reveal that we're significantly more anxious than countries in the developing world, many of which report only a fraction of the diagnosable cases of anxiety that we do. One of the reasons for this is that the people in many of these third-world nations are more accustomed to dealing with uncertainty and unpredictability.
  • people in "less developed" nations have lives which are actually more uncertain and unpredictable;  what happens to them is actually beyond their rational control.  But they're used to it. 
  • Our lives actually are more predictable and secure than lives have ever been; we have less reason than ever, for example, to be anxious about a child dying. But it seems parents are more nervous than ever.
  • ...5 more annotations...
  • it's not so much the actual lack of control--but obsessing over lack of control--that's the cause of anxiety.
  • We're the people least likely to relax and let God or nature take its course.  That fact, like most facts about social transformation, is both good and bad.  But who can deny that it does anxiously rob us of the happiness or contentment we can enjoy right now. Is it harder than ever to be happily in love with or in the moment? 
  • Is it true that more "rational control" we have, the more anxious we are?  Maybe that's because each of us is stuck with knowing how much the very future of one's own being is in one's own hands.  We're stuck with being control freaks, always calculating--nervously or anxiously--about our personal security. 
  • We might be looking forward to a future with people blessed by technology with indefinite longevity obsessing over their lack of immortality.
  • The economists are right that there are certain advantages to deferred gratification and having a really expanded time horizon. But probably happiness isn’t one of them.
Javier E

Shunya's Notes: Ian Morris on Why the West Rules-For Now - 0 views

blog.shunya.net/...ian-morris.html

Morris western civilization china world history

shared by Javier E on 28 Mar 11 - No Cached
  • Morris takes on theories which "suggest that there is something unique about western culture". His argument is simple: "from the Mediterranean to the Yellow Sea," there were philosophers wrestling with the same questions "and finding similar answers" as Socrates. "Socrates was part of a huge pattern, not a unique giant who sent the West down a superior path". What can I say? Does Morris, a specialized Professor of Classics, seriously believe that Indian and Chinese thinkers were reasoning in ways similar to Europeans? First of all, one of the exceptional qualities about the West is the continuous sequence of original thinkers in ancient Greece, in Rome, in Christian and in Modern Europe. The mere appearance of a Socrates at one point in time is not the issue. Find me in ancient Asia a continuous line of original thinkers
  • Morris brings up the Renaissance only to tell us that there were renaissances everywhere. The revivals ones sees in Asia history were always revivals of the same traditional ways of thinking; imagine Europeans for ever writing textual studies of Plato
  • Christianity? -- well, Morris says that all religions are the same. Christianity and Islam are fundamentally different religious traditions, and not only because the former has exhibited a far richer scholarly tradition, which is rather visible in the immediate fusion of Greek philosophy, Roman Law, and Christian theology in the first centuries AD, not to mention the Middle Ages, but because in Islam the idea that Allah has limits to his own powers, by making an everlasting covenant, with human beings, is unthinkable, in that Allah is viewed as absolutely transcendent; whereas for Christianity the authority of the earthly rulers is limited by God's law, which both grants rights to every person and holds that God is conterminous with Reason. There is no self-limitation to the sovereignty of Islamic rulers, and for this reason Islam has faced great difficulties producing a secular political order subject to constitutional checks and balances.
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  • If one is to dismiss the role of Chritianity, one should at least take on the extremely rich literature associated with such names as Edward Grant, Toby Huff, James Hannam, and others, of which Morris shows not even a minimal awareness.
  • Morris's emphasis on a common cultural humanity is consistent with the officially established academic ideology of "diversity" (see Peter Wood's book, Diversity: The Invention of a Concept), which is intended precisely to do away with the notion that Western nations have a distinctive, particular identity.
  • The argument that the Scientific Revolution was made possible by the "requirements" for new knowledge occasioned by travel and exploration across the Atlantic is true only in the sense that this was part of a much wider set of institutional and intellectual developments with a long background history. Geography always matters; it is always there, but there is no way one can draw a neat line of causation from geographical mobility and colonization to Newtonian physics. For a far better line of argumentation, see the newly release, and more intelligently argued _Intellectual Curiosity and the Scientific Revolution_ (2010), by Toby Huff.
  • geography has shaped the development and the distribution of power and wealth in the world over the last 15,000 years, but at the same time the development of societies has changed what the geography means across this period. This is the core thing in the book."
  • next it is the British who are passively required to become inventive: "As the 18th century goes on, the British, in particular, find that the new wealth coming in from the new market economy is pushing up wages, making it rather difficult for the British to compete with some other European countries in their manufactures. The British, in particular, start facing the need to mechanize production and, ideally, to tap into new energy sources."
  • My view is the opposite; the Europeans who colonized the Americas and made revolutions in all spheres of life, in ancient, medieval, and modern times, were the most active, restless humans on earth. (And I might add that this disposition was nurtured by the geographical landscape of the European landmass which runs from the Pontic steppes all the way to the Atlantic). Morris's argument on British good luck in the possession of coal and colonies comes from A. G. Frank and Pomeranz; this is how Morris, apparently, integrates the long term and the short term, and, in this respect, goes beyond Diamond.
  • He finds it a bit alarming that Americans speak of decline as if it were a terrible thing; after all, "if you just substitute America and China, you get really remarkably similar kinds of things." It makes no difference if the US or China is the dominant power in the world.
  • This way of thinking is conterminous with Morris's geographical determinism and his claim that humans are all the same regardless of cultural background, religious beliefs and intellectual life. Americans and the Chinese are practically (in terms of what matters, economic growth and biological longevity) the same, or at least similarly enough that their difference don't really make much of a difference.
jlessner

Republican Takeover of Senate Pushes Women Out of Powerful Committee Posts - NYTimes.com - 0 views

www.nytimes.com/...-powerful-committee-posts.html

republican takeover senate committee US politics

shared by jlessner on 02 Feb 15 - No Cached
  • “But I did think that was somewhat telling. We are not thinking about the women.”
  • The November elections brought a record number of female lawmakers to Washington. With 20 in the Senate and 84 in the House, women for the first time in history hold more than 100 seats in Congress. But the Republican takeover of the Senate has also cost women powerful committee leadership posts and presented new challenges to their wielding of power.
  • Last year, when Democrats controlled the Senate, women led a record nine committees, including male bastions like the Appropriations Committee, which dispenses billions in federal dollars, and Intelligence, which oversees the government’s secret national security apparatus. Now there are only two female committee chairs: Ms. Murkowski and Senator Susan Collins, Republican of Maine.
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  • The reason is largely because Congress is a culture where power is tied tightly with seniority, and committee chairmanships do not go to junior members. More than two-thirds of female lawmakers are Democrats, and Democratic women, who overall were elected earlier and in larger numbers than their Republican counterparts, have more longevity. When Democrats lost control, women lost top jobs.Continue reading the main story
  • “You cannot deny that women were in a more powerful position in the United States Senate when the Democrats were in control,
  • It’s not to say that women can’t and won’t exert leadership, but we do know that titles matter, those formal positions of leadership matter.”
Javier E

Why Won't Blackface Go Away? It's Part of America's Troubled Cultural Legacy - The New ... - 0 views

www.nytimes.com/...face-american-pop-culture.html

racism stereotypes history culture

shared by Javier E on 08 Feb 19 - No Cached
  • the persistence of blackface is unsurprising. It has been a part of American popular culture since what we recognize as popular culture emerged — roughly round 1832, when Thomas Dartmouth Rice, in blackface, performed his song “Jump Jim Crow” to thunderous applause at the Bowery Theatre in New York.
  • minstrel shows and blackface performances, both reinforced and popularized the “stereotype of the dimwitted slave who was happy to be in the South.”
  • “Its longevity is because it’s been institutionalized into every aspect of American life,” Dr. Barnes said. “People have perpetuated blackface because we don’t teach minstrel history. If these people had ever been exposed to it in a safe classroom environment, they would know better.”
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  • A partial list of people who have appeared in blackface on screen and stage in the 186 years since Rice’s performance on the Bowery includes: Desi Arnaz, Fred Astaire, Dan Aykroyd, Freeman Gosden and Charles Correll (from “Amos ‘n’ Andy”), Ethel Barrymore, Milton Berle, Jimmy Cagney, Joan Crawford, Bing Crosby, Billy Crystal, Ted Danson, Marion Davies, Robert Downey Jr., Judy Garland, Alec Guinness, Stan Laurel, Oliver Hardy, Benny Hill, Bob Hope, Boris Karloff, Buster Keaton, Hedy Lamarr, Janet Leigh, Harold Lloyd, Sophia Loren, Myrna Loy, the Marx Brothers, David Niven, Laurence Olivier, Will Rogers, Mickey Rooney, Frank Sinatra, Grace Slick, Spencer Tracy, Shirley Temple, John Wayne, Mae West, Gene Wilder and the Three Stooges.
  • For showbusiness impresarios, there was money to be made in perpetuating such stereotypes.
  • blackface was such an ingrained part of popular American culture — enacted so widely across entertainment media — that it had passed from the stage and screen to everyday life for many. A joke that could be made, a costume that could be worn.
  • If one were looking for a historical case study in celebrating blackface, well, one could proceed straight to the White House of Woodrow Wilson
  • President Wilson showed the movie at the White House; it may have been the first movie ever screened there. “It is like writing history with lightning,” Wilson was quoted as saying about the film. “And my only regret is that it is all so terribly true.”
  • The popularity of blackface was at its height in the early 20th century and has waned sharply since the ’50s, but it certainly hasn’t disappeared. Rather, it has taken on different forms, perhaps more palatable to modern audiences.
  • As the 19th century wore on, the country swooned over minstrel and vaudeville productions, which often used burnt cork or shoe polish to darken performers’ faces. And over Al Jolson, in particular. It was around 1904 when Jolson, a Jewish man born in what is now Lithuania, began performing in blackface.
manhefnawi

Sergaent, Marshal and King: Jean Baptiste Bernadotte, 1763-1844, Part I | History Today - 0 views

www.historytoday.com/...te-bernadotte-1763-1844-part-i

Napoleonic Era France Sweden Military

shared by manhefnawi on 17 May 18 - No Cached
  • Bernadotte, alone among the marshals of the Empire, was a man of independent political means. He survived Napoleon’s abdication and fall as his own master, which again distinguishes him from his former colleagues
  • Only Bernadotte, elected Crown Prince of Sweden in 1810—he became King in 1818—was spared the dilemma that faced the Marshals when in 1814 the French Senate decreed Napoleon’s overthrow and the Allied Sovereigns coupled promises of further employment with demands for immediate public submission to the brothers of Louis XVI
  • Allied backing of the Bourbons, quite content to devote his governmental talents to the prosperity of his adoptive country, which, by his alliance with Tsar Alexander I and an understanding with England, he had already launched on the road to political and economic recovery
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  • But even before 1814, when Napoleon’s defeats in Spain, Russia and Germany presented the Marshals with besetting and complex conflicts between their duty as Frenchmen, their loyalty to the Emperor and their self-respect as professional soldiers, Bernadotte had been able to rely on what might be called his excellent political health which he had preserved in sixteen years of successful evasive action against encroachments by his Chief’s all-devouring authority
  • His independence as a Swedish Prince reflected and expressed an inner independence of mind and outlook
  • The other relevant item is that twice during those ten years Bernadotte fell dangerously ill, and that during his second illness he was given up for dead. He recovered and lived to be eighty. His father and brother had died at an early age, as had his sister; yet after him the Kings of Sweden became famous for longevity
  • The future Marshal and King was born at Pau in Navarre in January 1763
  • under the shadow of the historic castle of Henri IV.” When the restored Bourbon Kings poured ridicule and contempt on his origins, Bernadotte might have reminded them that at least he was from Navarre
  • It was not until 1788 that he was promoted sergeant-major, the highest rank normally open to a man of his background during the reign of Henri IV’s great-great- great-great-great-grandson Louis XVI
  • I can accuse Bernadotte of ingratitude, but not of treachery.” In his heart, le roi Jean, as he preferred calling himself after his coronation as Charles XIV John of Sweden and Norway, remained a son of the Revolution and the Empire. “What misfortunes,” he said nostalgically, “Napoleon would have avoided, if he had only listened to me
  • Louis XVIII may be on the throne before a fortnight is up
  • The army of reinforcement, commanded by Bernadotte, Is composed of an efficient corps of fine young troops. The soldiers march gaily, without any appearance of fatigue... without causing any trouble or making any depradation. Everything is done with a good discipline, which is very surprising
  • These events mark the point at which the paths of Bonaparte and Bernadotte begin to separate
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