Maybe they are all from Chelm

Now would be a good time to have a charitable thought for pundits, bloggers, opinion columnists – yes, and policy professors – for whom the last month has been incredibly challenging, harder than any time in the last decade. When the world behaves like a parody of grownup affairs, and people with positional authority are one-upping each other with insanity suited to an especially shark-jumping Simpsons episode, the spectacle is immune to both ridicule and analysis. What is there to say when Michelle Bachmann, an actual live paid professional elected US Representative, claims S&P downgraded US credit because the debt limit was increased [ht: Steve Benen] and she isn’t laughed out of the room?
Here’s a conjecture worth exploring: there has been a hitherto unnoticed inexplicable emigration from the city of Chelm, perhaps over decades, and the Chelmniks have suddenly found each other in places like Iowa, formed clubs, and over tea (in glasses, of course), organized to enrich American culture with theirs. Chelm, if you haven’t heard of it, is a town of fools in old Jewish Russia, or maybe Poland, that hosts innumerable jokes like the following:

A farmer of Chelm was constantly confusing his horses, and would feed one twice and not feed the other, or work the same horse two days in a row rather than alternating them. His wife said, “why not go to the rabbi and see if he can help you?”
“Rebbe, I’m at my wits’ end. Look at my horses; they are so alike I keep mixing them up. Can you see a way to tell them apart?”
“Yitzhak, I’m not an expert in horses, but I do see your problem; those horses are very much alike!” The rabbi walks around and around the horses, looking at them from every angle. “Wait a minute, I think I see something! If you stand right here and look straight across them when they’re standing still, you can see that the black mare is just an inch taller than the white stallion!”

It’s hard to take Rick Perry or Grover Norquist as holy Jewish fools from the shtetl, but try saying the following in a heavy stage Jewish accent, and I think you’ll agree I’m onto something:

“So it’s unemployment you’re worried about suddenly? Tax cuts for the rich! Take two, and some chicken soup, and everyone will have a good job. [rimshot]”

I’m not sure why the current lunacy is being wrapped up in Christian fundamentalist stuff; maybe it’s letting out the string on the goyim, maybe it has something to do with the reactionary Christians’ politics about Israel. I know, the theory needs work, not least because what the Rethugs are about is infused with an insouciant, deaf-and-dumb, cruelty to victims and the innocent that is unknown in Jewish humor. Maybe readers can help make this hang together, because I have no theory B or C that survives a straight-face test any better.

On Wisconsin!

On Tuesday I’ll drive from Chicago up to Sauk City, Wisconsin, to do voter protection, that is, pollwatching while holding a law degree.  Wisconsin historically has offered exceptionally inclusive voter access, including in-precinct same-day registration.  But one of the many delightful consequences of the Republican takeover of the state is a photo-i.d. law which isn’t supposed to take effect til the first of the year but is unclear enough to make for messy election days–precisely what the sponsors intended.  So I’ll go up there and do what I can to make sure everybody can vote, and hope that the selfsame “everybody” will throw the anti-collective-bargaining rascals out.

(Last weekend at the Bughouse Square debates–the Newberry Library’s annual effort to restore the fine art of soapbox speaking–the central topic was public-sector collective bargaining.   The young man speaking in opposition wore a Solidarity t-shirt as he argued that “public employee collective bargaining inserts needless conflict between citizen and citizen.”  Does he realize that Solidarity was a public-sector union?)

I’m going to Wisconsin because it’s a political situation about which I can do something–contra the whole debt-ceiling mess, about which I can do absolutely nothing.  I disagree with my colleagues on the left who think the President got backed into a corner on the debt ceiling because he’s weak.  He got backed into a corner because he’s actually trying to govern and the people he’s dealing with are not.

When the President was awarded the Nobel Peace Prize, skeptics wondered what he could possibly have done to deserve it.  It seemed pretty straightforward to me: his election meant the restoration of constitutional government in the world’s only superpower.  What could be more essential to peace?

Unfortunately, the Constitution had been damaged more than most of us realized, and merely electing a President didn’t guarantee its restoration–not when anti-government idealogues control the legislature and the judiciary.   All the finger-pointing on the left ignores the extent to which the right is engaging in the deliberate destruction of our governmental system.

The idea that people who hate government are controlling ours is actually more frightening than the notion that the President somehow betrayed us by averting a default.  The scary thing is, he did as much as he could.

Blackberry Means Never Fully Being Where You Are

The APA Monitor has an interview with Dr. Sherry Turkle who has documented how iphones, blackberries and other mobile devices have reduced the amount of attention users pay to people who are physically present. I love the technology as much as the next person, but there is something sad in reading that fathers are emailing during Sunday football game breaks during which they used to talk to their sons and some moms are texting while breastfeeding instead of focusing on their infant (which many mothers tell me was one of the most intimate experiences of their lives).

In my first week working at the Executive Office of the President, I was shocked when I saw someone was clearly sending email during a face to face meeting of only 4 people, but I soon adjusted to the norm. In the West Wing there is a photo of an oval office meeting of President Obama and some of his key advisors, and David Axelrod is Blackberrying away.

The technology is here to stay but I wonder if we can’t develop better social norms around it. Few of us are getting emails along the lines of “Doctor the patient has lost 2 pints of blood — get to the hospital now!”. Are we so narcissistic that we can’t admit that most of our email is spam or real but trivial, and certainly not something that can’t wait long enough for us to interact with people we care about who are sitting right next to us?

I have a friend who, every time we get together for lunch, puts his iphone next to his fork and reads it every time it buzzes. This behavior bothers me enough that I tend to arrange shared meals in places that do not allow cell phone use. Why I haven’t said “Would you shut that off?” I am not sure, but I think it’s because I think I shouldn’t have to anymore that I have to tell my dining companions not to pick their nose in front of me or chew with their mouth open. My social norm preference would place the burden of asking on the person who wants to disconnect from face to face interaction through technology rather than making that the default expectation. But I am not sure if my wishes are widely shared enough for that to ever become the social norm of how we use these new technologies.

Are Hospital Readmissions Really a Bad Thing?

Consider four psychiatric patients, all discharged from an inpatient unit on the same day following stabilization of an acute psychotic episode. A week later, the following events takes place:

Arnold’s symptoms return and in despair he commits suicide.

Barbara’s symptoms return and she goes on a cocaine binge, fueling her aggressive tendencies to the point where she punches a cop, landing herself in jail.

Carlos’s symptoms return and he becomes convinced that his apartment is full of listening devices. He moves to living under a bridge far from town.

Derrick’s symptoms return, and, having learned about his illness in the hospital, he recognizes the problem and returns to his site of care. He is admitted for 24 hours, re-stabilizes, and is then maintained as an outpatient in the community.

So, why would some powerful players in our health care system consider Derrick to have had the worst outcome? Because he and not the others was re-admitted to care within 30 days of discharge.

This situation is not unique to psychiatry. Last week, I went to a meeting of cardiologists who are grappling with the same reality. Medicare ratings, consumer groups and an increasing number of insurers are pressuring cardiologists to have shorter lengths of stay and fewer rapid (i.e., within 30 days) readmissions. The desired outcome has become a measure of health care utilization rather than health. As this tail increasingly wags the dog, hospitals face some perverse incentives. If you aggressively monitor your patients after discharge, you are more likely to catch a symptom that warrants re-admission (Presuming you have this funny idea in your head that the health care system should try to save people’s lives). Likewise, if the hospital is in a location that provides easy access and its admission procedure poses minimal burearaucratic barriers — normally things we would cherish — re-admission is more likely and the hospital’s rating and level of reimbursement may go down.

If you follow the logic of the anti-readmission crowd out, you arrive at the conclusion that the best hospitals are those that close and those that kill every patient on the surgical table, because both types of facilities have a re-admission rate of zero.

Why I Could Never Be An Entrepreneur

A Saturday Night Live sketch from the late 1970’s featured a store that only sold Scotch tape.  Not tape — only Scotch tape.  Then, when the economy went bad, the sketch said that the store did well because everyone needed Scotch tape for their “Going Out Of Business” signs.

It was a pretty funny sketch; how ridiculous to only have a Scotch tape store! 

Well, the last laugh’s on me: around the corner from my house is a franchise of a hair salon chain that proudly announces that it does not cut hair.  It does not style hair.  It does not wash hair.  It dries hair.  That’s it: it blow-dries your hair.  For $35.

I’m suppose that there is something deeply non-ridiculous about this, although I can’t imagine what it is.  Maybe I’m not sufficiently in touch with my feminine side.  Or, as the post’s title suggests, I just have no entrepreneurial sense because I can’t understand why anyone would pay $35 for someone to blow dry their hair.

Or maybe it’s just that some people have too much money.

Play for its Own Sake

My wife and I greatly admire the parenting of some friends of ours who live in Palo Alto, land of compulsive overachievment. After school, the other parents in their neighborhood chaffeur their kids to Hebrew lessons, dance classes, debate societies, baseball coaching (not Little League mind you, but private instructors in hitting, fielding etc.) and a million other activities that will allegedly “get them into Harvard someday.” Our friends in contrast do something radical with their children once the school day has ended: They let them play. Sometimes their kids run around aimlessly, sometimes they invent games, sometimes they read books, sometimes they make big constructions from rocks and blocks and then knock them over, sometimes they stare at the sky.

Our friends don’t feel defensive about their decision: Like my wife and me, they love to see their children playing and have no worries about dire consequences. Other such parents are apparently not so secure, and have formed a “play movement” to defend children’s playtime, by emphasizing that in fact play is great preparation for adult life. It stimulates the mind, encourages creativity and hones social skills. In short, “Ha ha who laughs last? The play-promoting parent-cum-activists whose kids will get the slots at Harvard that your little gradgrinds think are going to them!”

In the Atlantic this month, Christina Schwarz nails how both the achievement-obsessed and the “play movement” are buying into the same b.s. Both assume that play is not a good in itself, but is only of value if it promotes adult achievement. Indeed, childhood itself seems to have no inherent worth either, except to the extent it gets you into Harvard someday, which some people consider the ultimate sign that a child has been launched as a successful adult.

When I lived in Champaign, Illinois, there was a little area of town called Mahomet, where a lot of strivers lived. I knew a retired music teacher there who still took on private pupils (She didn’t need the money, she just loved kids and music). She said that a number of her young students simply cried at the piano, because they felt such constant pressure to be doing something to please their parents or get into Harvard or both all the time. When the anxious looking parents would pick their kids up, she would lie to them: “He’s another Mozart, a genius”, “She plays better than my college pupils” etc. And her students adored her, because she was the only person in their lives who accepted that no one can perform for others or “be productive” all the time, and sometimes kids just want to have fun and trust that adults will accept them the way they are.

Unbelievable.

Student refuses to stop surfing the web during class. Professor shuts her laptop. Result: professor sued, arrested, suspended.

A Valdosta State University student refused, after repeated requests, to stop surfing the web during class.  The professor shut her laptop.  As a reward for noticing when a student wasn’t learning, and caring that she wasn’t, the professor has been sued, arrested for battery, and—the least forgivable, since completely under the administration’s control—suspended from teaching.

Commentary fails. The only silver lining is that other students have apparently supported the professor.

I have an opinion about this. If you do too, I think a certain university president ought to hear it.

(via my brilliant ex-roommate Larry Saul at Lawrence of Academia)

Glenn Beck, minion of the great conspiracy

Glenn Beck has revealed himself, finally, as a covert agent of the communist/socialist left-Islamic-fanatic-Code Pink-Obama-fluoridation-currency-abasing-job-killing conspiracy.  While ill-informed and unqualified naïfs like Jon Stewart and Rachel Maddow give him the cover of ridicule, Beck advances his masters’ designs  by  describing just enough of the plotters’ workings (and for credibility, sticking assiduously to facts) to conceal the key coordinating element that would allow us to defend ourselves.

What keystone is missing from Beck’s carefully crafted deception? What central coordinating power, preparing across centuries for a simultaneous world coup, has he absolutely refused to recognize or even name? Think back to the small ads with pyramids on the inside covers of comic books and Popular Mechanics, and to matchbooks before these insidious little propaganda messages were blanked out to preserve security: who was secretly recruiting members with these harmless-sounding promises of ancient wisdom?

The Rosicrucians! Alchemists (think it’s an accident that wingers are trying to put us on a gold standard?), Freemasons (the Shriners have a crescent right in their trademark, for Pete’s sake!),  international (what more do you need to know?).  Code Pink? It’s a code alright, but it’s code for Rosae Crucis!

Beck has never once named this central organizing fraternity of menace obviously pulling the strings, and if you think it’s an oversight, you don’t understand what an agent of disinformation is. Why has he never identified a single Rosicrucian agent? Have you even studied Beck’s hand gesture signals when he tells you to look at the chart? How many Rosicrucians are already in place in your company, or the Congress, or planning havoc at Davos,  or blogging to each other in the cipher only they understand?

You don’t know any, right; you’re not supposed to! Do I need a blackboard to explain this? America, wake up!

How the DMV Undermines Democracy, Part II

My late August rant about my terrible experiences at the Virginia and California Department of Motor Vehicles generated comments from RBC readers, from Mark, as well as from Kevin Drum, Matthew Yglesias and their flocks. Some resonated with my trauma; others defended the high quality of DMVs. In light of all the comments here and elsewhere, as well as my subsequent experiences at the California DMV, I wish to expand and amend my initial remarks. I was too hard on the DMV in one respect, but too easy on it in all others.

After spending a year in Washington D.C., I have been trying to move my car registration back to California. As I recorded in my initial post, after being exposed to abuse and incompetence, I left the California DMV office in late August with a 30-day temporary license plate and the mandate to get a smog check. I was told to mail proof of said smog check and my other paperwork to the DMV. I accomplished this within a week and waited for my permanent license plates to arrive.

Thirty days passed and my permanent plates never arrived, making my car illegal to drive. I went online to the DMV website to get a new appointment so that I could find out what happened. The first available appointment was three weeks away, meaning I could not legally drive my car for 21 days. It’s our only car so this was more than a minor problem. We use our car for extravagances such as buying the food that we eat, taking our children to the doctor when they are ill, etc. I am just lucky that I can walk to work. Most people would struggle to get to work in the San Francisco Bay area with no car unless they had several extra hours a day available to navigate public transportation.

When the appointed day finally came, in mid-October, I broke the law and drove my car to the DMV office. Again, there was a long line of people extending out of the front door. Many had appointments but because the sign tells everyone to stand in the same line, those with appointments were needlessly wasting their time doing so. Having endured this farce on my first visit, I knew that there was an “appointment line” parallel to the end of the huge line (from the back, it looks like a rightward bulge near the front of the huge line). Confusion is furthered by the fact that both “separate lines” go to exactly the same place: A tired-looking clerk who tries to manage both lines simultaneously with a minimum of violence.

The only aspect of my initial splenetic post that I wish I could take back was my failure to acknowledge that the employees of the DMV are among its victims; I apologize to them unreservedly for that oversight. Yes, a few of them are surly by nature, but for the most part they are well-meaning, hapless innocents trapped in a world of hurt they never made. To wit, the customer in front of me in the rightward bulge of the huge line (henceforth “the appointments line”) stepped to the desk smartly and said “I have my confirmation number!”. The clerk sighed audibly and said “Those don’t work”. She asked his name, time of appointment and type of appointment. She then thumbed through about 5 separate stapled stacks of paper, one apparently for each appointment type. She put on her reading glasses and scanned the small type line by line until she found his name, which she crossed off with a pen.

Yes, that’s right: Even though appointments are made on-line and half the acne-ridden junior high school kids in Silicon Valley could download that information into a searchable, large print Excel chart for this poor clerk, she is instead stuck with a bic pen and a system that is slower than a Sperry Univac. Continue reading “How the DMV Undermines Democracy, Part II”