SiCKO, Part Three

So how is it that we have a health care "system" here in the U.S. that provides such mediocre care, on average, but costs so much more money per capita than other nations' systems? First, there are the problems that are specific to the health care industry; you may have heard some of these before, and some of them are actually true:

• The health insurance bureaucracy eats over 30 percent of all health care costs.
• Blame the lawyers! Medical malpractice insurance stemming from huge lawsuit awards drive up costs. Not really: malpractice premiums are less than 1% of total health care costs, according to the AMA. "Defensive medicine" administered to help guard against malpractice claims is estimated to be 2% of total costs.
• Too many doctors! You've probably heard that the opposite will be the problem as the Baby Boom generation ages, but it may just be that there are too many specialists and not enough primary care physicians.
  

Then there are the institutionalized behaviors and legal/political issues that are at the root of the problem, the breakdowns in how "our" government operates and how our political system works [this is where I start the real opionatin', so feel free to disagree and refute]. One scene in SiCKO that really struck me was of an American in France (in Paris?) commenting that in the U.S., people are afraid of the government, while in France, the government is afraid of the people. Then Moore showed footage of French protesters, footage that would probably elicit a "lazy French" - or worse - response from your average American. But joke all you want about white flags, surrender monkeys and the like, but when was the last time there were huge protests in this country? At least the French are fighting, even if they are sometimes fighting for rights that we might see as extravagances (then again, maybe we're just jealous of all their vacation time).

Meanwhile, back home we're stuck with an inept, corrupt government that few people trust. We have an entrenched two-party political system, strengthened by ridiculous congressional redistricting that protects incumbents. We have spectacularly expensive legislative and presidential campaigns that are almost entirely privately funded by corporations and trade groups. We have a Supreme Court that equates political donations with free speech, which serves to legalize this corruption. We have lobbyists that write legislation. We have ludicrous taxpayer-funded projects. We not only have private health care, but an increasingly privatized military. We have out-of-control educational expenses, expenses that are unheard of in other industrialized countries that provide free higher education to citizens. When that's the government that most Americans see, how could they ever be convinced to let it be in charge of their health? Looks like I am gonna need a Part Four....

SiCKO, Part Two

Michael Moore's website has a nice page that provides references to many of the assertions in SiCKO, it's definitely worth a look. I did take notice of a few of the film's facts that didn't sound quite right, however, that I wanted to check out myself. This also led me to seek out other bits of data:

• France has more productive workers than the U.S.? I could have sworn that the U.S. was at or near the top of the latest OECD statistics in this category, but I could be wrong. Alas, the link on Moore's website that leads to the specific OECD page is broken, so I had to look around a bit. I also kept in mind that whatever OECD numbers Moore was using were 2005 numbers; current stats may tell a different story, but one would think that these types of metrics wouldn't change all that much in a two-year period. I found my way to the OECD database portal, which as productivity data as of October 2006. For some reason the sort function didn't work, so I pulled the numbers offline, but this is what I found:
• surprisingly, the U.S. ranks 18th in hours worked per person - I assumed that this would be higher! We're waaaay behind the #1 country, South Korea, which has us beat by over 600 hours per year (2357 vs. 1708). Good for us! France, by the way, weighs in with 1555 hrs/yr/person, good if you can get it!
• When it comes to GDP per hour worked, we're #6 at $50.4 per, which is well behind leaders Luxembourg and Norway, which are at $72.2 and $71 respectively. Why is Norway's number so high, oil money? Ikea? Wait, that's Sweden. Anyway, France is right behind the U.S. at $49.9. Close enough that it could very well be that it was slightly different in 2005, and France was ahead that year.
  
• Searching for this data led me to what looks to be a pretty neat blog, The Big Picture, that I'm going to check out in greater detail a bit later. The particular entry that popped up as I was searching for productivity stats was this one, which is worth a quick read. It makes some fantastic - and succinct! - points about the future of America's economic might, and how current policies could cause problems for our economic engine going forward. One of my favorite questions also pops up in that post; who would/could sacrifice money-based wealth for time-based wealth? I know where I stand, which is why at some point in this SiCKO informational odyssey, I'll be looking up immigration policies of other countries...just for fun ;)
• Looking up OECD statistics in one's spare time ranks in the top five of most pathetic uses of free time for non-retired persons.
• The most recent United Nations Human Development Report (link to pdf) ranks the U.S. at #12, ahead of #14 U.K. but behind #10 France and well behind #4 Canada (the countries Moore visits in SiCKO). Our high per capita GDP boosts us up the list, while we take a hit for slightly lower life expectancy and eduction stats. Cuba ranks #51, with its low GDP number dragging it down but with life expectancy 0.2 years higher than the U.S. and its education score higher as well. All sorts of neat stats are available in this U.N. report! A few favorites that I picked out:
  
• Our use of coal has remained steady from 1990 to 2005, while it has dropped, sometimes precipitously, in Europe. The U.K. dropped from 29.7% to 16.1%; that's impressive. While in Japan, Israel, and Australia, coal use has actually increased. Yuck.
• Electricity consumption per capita - the U.S. isn't quite as bad as I thought, although when one considers the latitudes of the nations that consume more than us, then the U.S. numbers seem awful. Too bad we're so averse to paying more for efficient, long-lasting appliances.
• Hmmm, I don't think we're nearly as generous, as a nation, as we think we are.
• Finally, a metric that the U.S. leads the world in, health expenditures per capita!
  
• We also kick ass in homicide rate, although plenty of South and Central American and Eastern European countries have us beat. We'll have to work on that....
  
• How do these countries that provide universal health care do it? It's hard to find reliable tax data - the rates tend to be all over the place, depending on which site one visits - plus there are ranges due to tax brackets, and then VAT taxes and local/state taxes also throw wrenches into any objective comparison. But here goes:
• The World Taxpayers Associations indicate that the U.S. has it pretty good when it comes to tax rates.
• Wikipedia's numbers seem to indicate that, when one factors in state taxes and sales taxes, maybe the average U.S. citizen is being taxed like Europe and Canada.
• None of these sites provide a comparison of effective tax rate - how do I know if France gets all the deductions and credits that an America provides? Do they get more deductions? Fewer? This is almost impossible to figure out.
• Back to the OECD - Table 0.2, near the bottom of the page, indicates that the U.S. worker pays less than most other OECD nations in terms of income tax and social security contributions. That's actually quite reassuring - we're not paying too much for all those government services that we don't receive!
  

SiCKO, Part One

We watched SiCKO last night; maybe not the best film to watch during the holiday season, as it doesn't exactly leave one feeling warm and cuddly afterwards, but it was next on the Netflix queue.

How was it? Well, I would definitely give it 4 out of 5 stars, but there are caveats. I happen to be a Michael Moore fan - he's a great entertainer, he's provocative, and for better or worse, he gets people talking about the issues that his films present. No, he's not a journalist, he's not fair and balanced, but that's not his job, he obviously has an agenda and he's not trying to hide it. If you watch one of his movies thinking that you're going to get both sides of the story, you're going to be just as disappointed as if you were to approach Fox News or Salon.com with the same expectations. Not gonna happen. If you're looking for a documentary that presents facts without emotion, again, good luck. One of his most effective tools is giving a human face to the given issue, something that the evening news does all the time, albeit much more subtly and less effectively. One perfectly valid criticism of his past movies is that he's on screen too much, pulling dumb stunts that likely hurt his cause as much as help it. OK, I'll buy that, even if the stunts are usually entertaining. SiCKO, fortunately, moves away from the Fahrenheit 9/11 in-your-face style; Moore doesn't even make an on-screen appearance until the film's half over, and the publicity stunts are limited to a silly trip to Cuba at the end of the film that unfortunately isn't entertaining or effective (you want a good Cuba documentary, try Buena Vista Social Club, awesome movie).

It might be his best movie since Roger and Me in terms of content, but it's also the most frustrating film he's made. I think you would need three or four sequels to do this problem - health care in the U.S. - any justice, but even so there aren't enough Whys being asked in SiCKO. It doesn't take a genius to figure out that health care in the U.S. is fucked up, but why? It's helpful to point out countries such as Canada, Britain, and France where universal government-run care seems to be working, since I'm sure there are plenty of Americans that are ignorant that there are these kinds of systems in place that people are happy with, but how do they make it work? At one point, Moore asks a French doctor whether the national model that's in place in France would work in the U.S. He says "No", then walks away...what, no follow up? Just 'No'?!? I'm not expecting that this doctor would have all the answers, but I was waiting for someone on screen to at least attempt to explain this mess. It's easy to tag Richard Nixon with the blame, as Moore does at one point, but there is no possible way that it's that simple. I have my own theories and suspicions about who and what is to blame, but in the interest of brevity I'll save those for another post. There are also zero suggestions on how to fix the obviously broken American system.

I'll be spending at least one more entry on this topic, picking out scenes and themes from the film, delving into fact vs. fiction, checking some numbers, and searching for any practical ideas for fixing the system. Universal health care is also a great jumping-off point for discussions about the role of government in our lives, so who knows what tangential topics might end up being put in play - taxes, education, infrastructure, libertarians?

All you need to know about the Mitchell Report

You know you've fucked up ("you" being the commish, players, GMs, etc.) when Pete Rose accuses you of making a mockery of the sport.

[full disclosure: I'm a Pete Rose fan, even though he's a liar, jerk, and probably an all-around not-so-great human, who still belongs in the HOF]

Questions for the Terrapins

In light of last night's home loss to BC:

1. Is Greivis Vasquez one crazy-ass Venezuelan, or what? I'm not talking Hugo Chavez, "I hate you, but I'll sell you oil anyway, you capitalist pigs" crazy-bad, but crazy-good, for the most part. But the dude (Vasquez) needs to chill out, although if he did that he'd probably be diminished as a basketball player.
2. Is the backcourt incapable of playing well in the first half of a game?
3. Why do the Terps only seem to hit three-pointers with any regularity during the last two or three minutes of a game? [0-6 in the first half, 5-7 in the last 2 minutes of the game, 6-19 overall]
   
4. Gary, please explain, why is Dupree starting and Osby coming off the bench?
   

A few positives that I saw - no it wasn't all bad -

• Landon Milbourne's all-around play, especially that incredible dunk midway through the second half
• MD forwards actually setting screens for shooters; where's that been for the past few seasons?
• Cliff Tucker, who looked pretty damn good in the second half after Vasquez fouled out.
  
• In an attempt to make the officiating look marginally balanced, the officials actually called 13 fouls on BC! (versus the Terps' 25) Way to go, guys!
  

Ravens Get Close...

...but their sad season continues. Ah well, at least there's Washington to root for! [that was a joke, kinda like Joe Gibbs' second stint as head coach].

As I was watching last night's game, I was thinking that it was just a matter of time before Kyle Boller gave it away. Now his interception wasn't the sole reason they lost (the ill-timed timeout when the defense had stopped the Ravens on 4th-and-1 and the galacticly stupid final possession and clock mismanagement were also culprits), but the offense and the play calling have to be more demoralizing to that defense than Tom Brady or Randy Moss.

After all these years of the defense carrying the team, who does Ray Lewis have to stab in a dark alley to get a decent QB and offense in Baltimore?

Terps v. UCLA: 30s Review

Terps lost to #1-ranked UCLA last night. First half was terrible - UCLA is a great defensive team, but the Terps were awful. Too many turnovers. Vasquez needs to calm the hell down. Hayes needs to shoot more, a lot more, or else Gist and Osby will face double and triple-teams all year. One of the freshmen and/or Landon Milbourne - who looked good in brief stretches - need to step up to provide additional offense.

The Spree, Live!

On Saturday night, we ventured out to Ram's Head Live (our first time catching a show there) to see the Polyphonic Spree. While the acoustics were hard to judge - with 23 people on stage, the sheer cacophony can be a bit overwhelming - Ram's Head is a cool venue. As for the Spree, well it's seriously a performance that you have to experience. Any description won't do it justice, so I'm just not going to write one. We did wonder if we were seeing the energy level of a typical show, considering that it was the last night of this particular tour (and also founder and lead singer Tim DeLaughter's birthday), so I guess that means that we'll just have to see them some other time, to put that question to rest.

Not a problem at all though; they definitely go on my short list of acts that I've already seen, but that I would go see again and again, whenever opportunity presented [others on the list: the Police, Elvis Costello, Garbage, Harry Connick].

Strange Trips

Soon after our trip to Tanzania earlier in the year, Jenny and I started thinking about where to go next. We haven't really made any decisions, although we think we've 'narrowed it down' to Eastern Europe or South America. But something on TV last week got me thinking about less conventional destinations.

The TV piece was on Greenland, and how it received 30,000 visitors in the past year. Yeah, Greenland! Strange. But what caught my attention was that this report mentioned that direct flights on Air Greenland were available from...Baltimore! Their website isn't that easy to use; no flexible-date option, so it took a bit of trial-and-error before I figured out that there aren't any flights available during the winter months. I was finally able to get some results from a search for July 2008 flights from BWI to their hub in Kangerlussuaq. I'm not sure whether that's the best time to visit Greenland, but it still isn't cheap - 2,790 Denmark Kroner, each way! That works out to about $550 each way, so not too bad considering the lack of competition on the route. But from there, many locations are only accessible via helicopter, so transport costs are bound to be be significant.

How about something a bit closer to home, like the Creation Museum in Kentucky! It takes visitors back in time thousands of years, when dinosaurs and man coexisted. This review contrasts the Creation Museum with the Smithsonian's Natural History Museum in D.C.

Finally, what globe-trotting adventurer wouldn't relish the opportunity to take a spin on the Axis of Evil? That's right, North Korea!!! This guy hit the entire Axis, but I'll assume that most people are on a budget and don't enjoy getting shot at or blown up, so North Korea seems like the safest choice. This trip can be a tough ticket if you're an American though, so plan ahead; I actually couldn't find any current travel packages that allowed U.S. citizens. I'll keep looking though - in case Greenland has melted before we make our way there for a visit, the Democratic People's Republic of Korea is an excellent fall-back destination. Besides, who wants to go to Kentucky for vacation?!?

UPDATE: After some additional searching, I found a North Korea tours operator that is currently in operation, and that takes U.S. travelers (whether those travelers' Visas get approved is out of the company's control, though).

One-Question Pop Quiz

OK, what's scarier:

a) the apparent need for this sign in Korean toilets

b) the fact that Larry Craig is still a U.S. Senator

United, They Fall

I cheered on the home side, D.C. United, at what turned out to be their final game of the season, a 2-2 draw with Chicago in round one of the MLS playoffs. Since they lost the first game of the home-and-home series 0-1, they lost on aggregate and the Fire advance. It was a game that United deserved to lose after what can only be described as lackluster play over the first sixty-plus minutes. The last twenty-five minutes were another story entirely, with United seemingly finding themselves, and playing at a much faster pace and with great urgency. The crowd was delirious when Christian Gomez put one in during added time to make it 3-2, comeback complete! But the goal was waved off because of a marginal handball by Gomez that was pretty clear on replays. D.C. just didn't get it going in time, period. Still, a thrilling and entertaining end to the season for United, even if they didn't get the desired result.

Black Hole of Sports

Unless you're a basketball fan, the Baltimore-Washington area has been tough going for area sports fans over the past five years. In football land, the Redskins still have an offensive name, a greedy and inept owner, and just got demolished yesterday. Up I-95, the Ravens offense just had their most productive week; they had a bye. On the college level, Maryland's injuries to its linemen indicate that its players may be taking health-maintenance advice from their coach. Navy just lost to a I-AA school (albeit one of the better I-AA football schools). Baseball is no prettier - the Nationals will get their new stadium next year but are still quite a way from contending. The AngelO's may be even farther away; I love the Oriole Bird, but a more appropriate (if not quite family-oriented) team mascot would be a guy in a business suit with his head planted permanently in his own ass. The only bright spots are in roundball, and that's due mainly to major and minor resurgences by the Hoyas and Terps, respectively, and the exploits of the oddest guy in the NBA, #0 for the Wizards (strange time when the Wizards are the area's best pro team, yes?). Oh yeah, I almost forgot D.C. United, but they've been pretty damn good for years and the vast majority of the sporting public hasn't noticed yet.

Contrast that with New England, where a new Evil Empire is rising. Epstein, Belichick, and Ainge are sending their well-compensated minions swarming into stadiums and arenas throughout the land, destroying, or planning to destroy (see: Celtics trades) everything in their path. Belichick even deployed his own personal Eye of Sauron in service of his dastardly plans, keeping an ever-watchful eye on enemy sidelines until the commissioner mercifully vanquished that threat. And then there are the fans - Red Sox caps are the new sporting gear du jour for fans in this area, replacing NYY caps: "So you're from Boston/New England?" "Nah, I grew up in Maryland, I couldn't even find Boston on a map! I just like the team". Fantastic! It's also difficult to account for all the local Pats fans that are now sporting their teams' gear, which had been mysteriously absent from public spaces for most of the 90's.

Candidate Picks Up a Crucial Endorsement

This must mean that Mike Huckabee is now practically a lock for the Republican nomination, right?

Things That May Only Interest Me

Forget some people's concern over a Bush-Clinton-Bush-Clinton White House; are all of these candidates related?

In India, match-making web sites are referred to as matrimonial sites.

Stephen Colbert did grow up in Charleston, SC (hence his run for president in that state only as a 'native son' candidate), but was born in Washington, D.C. Also, he's a huge Lord of the Rings fan, which might explain Viggo Mortensen mysteriously appearing on the Colbert Report recently to offer him a sword, a la Excalibur, as a sign that he should run for president.

Newsworthy?

Maybe I'm just being cynical, but does the WP front page "revelation", that Verizon turned over phone records without a court order, really matter much? The government is going to get this information one way or another, since not cooperating can tend to hurt the bottom line. Corporations will continue to roll over for the Feds, to protect themselves and their shareholders. How shocking!

October Sand

I spent last week on the beaches of the Outer Banks in NC, where the surfing conditions were unseasonably bad (no weather systems to stir things up) but the weather was awesome. My dad and I also tried out some beginner's hang gliding on Jockey's Ridge, which was interesting but also frustrating (it was really too windy for a beginner's lesson). And Marty is a dog who pretty much refuses to get into the water at all - she just laid on the beach for most of the week. I think she still had a good time though.

One piece of unsettling news - the Weeping Radish Brewery and Restaurant has moved from its sound-side location in Manteo to a mainland location along Route 158, in Jarvisburg. Dumb move - please explain the brilliant business plan that advocates relocating to an area the most people simply drive past? I wish them luck, if only because their beer is so tasty and the Eco Farm idea sounds interesting, but I just don't know whether I'll ever visit them at the new location.

Meanwhile, 200 Miles Overhead....

The ISS (International Space Station) may be visible tonight around 8. Wonder if we have a good shot at actually seeing it in the city, considering all the light pollution.

Half-Assed MLB Playoff Predictions

In 2007 I've seen less baseball than in any year since I started seriously following the sport (in high school), so take these "predicitons" as seriously as that warrants:

Indians v. NYY: I can't claim impartiality on this one, the Yanks remain public enemy #2 in my baseball universe (after Angelos). Cleveland in four.

Red Sox v. Angels: This one's a toss-up in my book. While I certainly have no love for the Sox either (public enemy #3, mainly due to their obnoxious fans at Camden Yards the past few years - hey we won one title in the last 80 years, we must be the greatest franchise ever!!!), I think they have the slight edge due to home field and pitching, but it would hardly be surprising to see the Angels advance. Sox in five.

Diamondbacks v. Cubs: Wow, could there be a trendier pick than the Cubs? Maybe I'm just being contrary, but they're still the Cubs, and even though they're clearly the better team on paper...Arizona in five.

Rockies v. Phillies: Two hottest teams, blah blah blah. Two killer offenses, but the Phils have better pitching (I think). Phillies in four.

ALCS: Cleveland over Red Sox. Don't ask me why, it's probably not the smartest pick. Too bad!

NLCS: Phillies over Arizona. Because Arizona's pitching isn't good enough to hold down that lineup.

WS: Indians over Phillies. Because Cleveland has two very good SP, and since there are seemingly four days between each World Series game, this allows them to go with a two-man rotation.

Tasering for Everyone!

OK, this Florida student may have been acting like an idiot as he tried to ask John Kerry a question, but what was wrong with cutting off his mic and just ending the forum? No, the thugs in the police uniforms decide to forcibly escort him away, then end up tasering him.

Living in Baltimore, I know the value of a good police force, but terrible decision-making on the part of police, like this incident and many more like it, just end up doing damage to law-enforcement. These incidents may be rare, but they almost always make the news, like D.C. Metro cops arresting a 12-year old years ago (crime: eating French fries on the subway). Then there are the popular zero-tolerance, quality-of-life arrests, as popularized by Rudy in New York. Do those approaches work? Hard to say. They likely tamp down some of the petty crime, but the suspicions of police that they engender probably contribute to fewer jury convictions, even for the most serious crimes. Throw in witness intimidation, the stop snitching "code" that so many fine Baltimorons honor, underfunding of police, lowering standards to attract new recruits, and law-enforcement is a big mess.

And what's with tasers, anyway? They've at least contributed to quite a few deaths since they were adopted by police; can't the geniuses employed by the military-industrial complex come up with something better?

Sweet Tail

Here are a few photos from our whale-watching excursion while we were in Boston a few weeks ago. We were up there seeing the sights and visiting Lis and John, who graciously put us up for a few nights and showed us around.

This past weekend was another crazy-busy weekend filled with Matt & Amy wedding stuff. A fun time, but it took us a few days to recover from all the activity and all the people.

And now Mr. Grau is a father. And the apocalypse is not upon us! Weird.