Thursday, March 30, 2006
So, even though I Ain't Lileks, I hied my tender self down the block to Zeitgeist Coffee and am mooching free WiFi. They are playing some kind of very weird alt-techno music and there is the sound of grinders and barristas pounding espresso baskets. Very different from the office, provocative. Zeitgeist is the very model for Cafe Nervosa on the old TV show Frasier. Lots of exposed brick and attitude. Very Seattle.
I'm gonna hang here until my vanpool meets at 5 pm.
"Give me your tired, your poor,I posted the entire sonnet:
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-toss'd to me,
I lift my lamp beside the golden door!"
Not like the brazen giant of Greek fame,Anyway, go read my response there, if you wish. But in the synchronicity of things, the very next page I looked at was Peggy Noonan's column, Patriots, Then and Now.
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.
"Keep ancient lands, your storied pomp!" cries she
With silent lips. "Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-toss'd to me,
I lift my lamp beside the golden door!"
What this all got me thinking about, the next day, was . . . immigration. I know that seems a lurch, but there's a part of the debate that isn't sufficiently noted. There are a variety of things driving American anxiety about illegal immigration and we all know them--economic arguments, the danger of porous borders in the age of terrorism, with anyone able to come in.Which is exactly my point. When immigrants come to America today, are they imparted spirit?
But there's another thing. And it's not fear about "them." It's anxiety about us.
It's the broad public knowledge, or intuition, in America, that we are not assimilating our immigrants patriotically. And if you don't do that, you'll lose it all.
We used to do it. We loved our country with full-throated love, we had no ambivalence. We had pride and appreciation. We were a free country. We communicated our pride and delight in this in a million ways--in our schools, our movies, our popular songs, our newspapers. It was just there, in the air. Immigrants breathed it in. That's how the last great wave of immigrants, the European wave of 1880-1920, was turned into a great wave of Americans.We are not assimilating our immigrants patriotically now. We are assimilating them culturally.
Whether their parents are from Trinidad, Bosnia, Lebanon or Chile, their children, once Americans, know the same music, the same references, watch the same shows...And to a degree and in a way it will hold them together. But not forever and not in a crunch.What is the legend, the myth? That God made this a special place. That they're joining something special. That the streets are paved with more than gold--they're paved with the greatest thoughts man ever had, the greatest decisions he ever made, about how to live. We have free thought, free speech, freedom of worship. Look at the literature of the Republic: the Constitution, the Bill of Rights, the Federalist papers. Look at the great rich history, the courage and sacrifice, the house-raisings, the stubbornness. The Puritans, the Indians, the City on a Hill.
So far we are assimilating our immigrants economically, too. They come here and work. Good.
But we are not communicating love of country. We are not giving them the great legend of our country. We are losing that great legend.
The genius cluster--Jefferson, Hamilton, Adams, Madison, Franklin, all the rest--that came along at the exact same moment to lead us. And then Washington, a great man in the greatest way, not in unearned gifts well used (i.e., a high IQ followed by high attainment) but in character, in moral nature effortfully developed. How did that happen? How did we get so lucky? (I once asked a great historian if he had thoughts on this, and he nodded. He said he had come to believe it was "providential.")
We fought a war to free slaves. We sent millions of white men to battle and destroyed a portion of our nation to free millions of black men. What kind of nation does this? We went to Europe, fought, died and won, and then taxed ourselves to save our enemies with the Marshall Plan. What kind of nation does this? Soviet communism stalked the world and we were the ones who steeled ourselves and taxed ourselves to stop it. Again: What kind of nation does this?
Only a very great one. Maybe the greatest of all.
Do we teach our immigrants that this is what they're joining? That this is the tradition they will now continue, and uphold?
Do we, today, act as if this is such a special place? No, not always, not even often. American exceptionalism is so yesterday. We don't want to be impolite. We don't want to offend. We don't want to seem narrow. In the age of globalism, honest patriotism seems like a faux pas.Because we do not communicate to our immigrants, legal and illegal, that they have joined something special, some of them, understandably, get the impression they've joined not a great enterprise but a big box store. A big box store on the highway where you can get anything cheap. It's a good place. But it has no legends, no meaning, and it imparts no spirit.
The latest cat-calls from some on both sides of the aisle are that their opponents aren't patriotic. This is more than just unfortunate--this erodes the framework upon which we carry out or national conversation.
I don't pretend that my country's actions have always been without spot or blemish, but I love my country with full-throated love, and I have no ambivalence.
Wednesday, March 29, 2006
I am going to advocate her approach to my congresscritters.
A few weeks back, I noted that national health care seemed to be the only major policy programme that the left could basically agree upon. Now, I hear the stirrings of a push for national health care rippling through the liberal blogosphere like a rising storm wind.
If this movement actually takes off, I expect that we'll see a great deal of vehement argument between conservatives screaming that the liberals are going to screw up our health care system, and liberals arguing that conservative people are hardhearted bastards who want the poor to die. So before that happens, I thought I'd set down some quasi-reasonable thoughts about what we want from our health care system, what a single-payer US system would probably look like, and what the pro's and con's of such a system would be.
The first point to make is that our health care system is already screwed up. The practice of having your employer pay for your health insurance is lunatic. We should not be surprised at what we get when the person who pays for your health insurance is not the person who consumes it....
Let's think about where the money actually goes:
- 30% of all healthcare expenditures occur in the last six months of life
- 31% of expenditures are on hospital care
- 9% of spending is on nursing homes
- 22% of spending is on physician and clinical services
- 10% of spending is on prescription drugs
- 10% of spending is on dental/other professional care
- 10% of spending is on medical equipment, supplies, and construction
- 7% of spending is on administrative expenses
So how likely are either Health Savings Accounts, which encourage consumers to shop around because they're spending their own money, or single payer, to reduce any of these categories significantly?
In theory, either HSAs or single payer could cut down on many of these expenses. In practice, colour me unconvinced...
It is possible, even likely, that a government-run health care system would be able to batter cost savings out of suppliers of medical equipment, supplies, and pharmaceuticals. But that doesn't strike me as a good thing. The high returns on medical equipment and drugs are what encourage people to invent more such. Get rid of the return, and you get rid of the innovation. Generating cost savings on new technology in order to cover today's uninsured simply privileges one small group of unfortunates over the very much larger group of people, living now or in the future, who have diseases which we can't currently cure. The lucrative American market is currently the only incentive left for medical innovation; I am very much against destroying it.
Single payer advocates retort that pharmaceutical companies spend a lot of money on marketing, which is true, but irrelevant--forcing pharmaceutical companies to price at cost-plus will kill the research along with the marketing. Actually, if I were running a pharma company, and something torched my profits, I'd kill the highly speculative research before the lucrative marketing campaigns. If we want to stop pharmaceutical companies from advertising, or selling directly to doctors, surely outlawing those things is a much more effective way to manage it than slashing their profit margins and hoping that they cut only the things you want them to.
Others argue that the government can take over the research. Perhaps the government is necessary to fund basic research; I haven't studied the question. But looking at the defense industry, where the government is the sole purchaser and major funder of new technology, it's very, very hard to believe that applying a similar model to health care would result in greater value for money. Rather, it seems very likely to me that politically popular diseases would get an even more disproportionate share of funds than they do now. Pharmaceutical companies have to pay attention to things like the size of the market, and the strength of demand. Politicians pay attention to how loud the lobby is, which is why breast cancer and AIDS get research funding all out of proportion to the number of people they kill...
Here is my suggestion. It is simple and elegant enough to be explained in a single sentence, yet powerful enough to meet all the criteria above:
Have the government pay for all health care expenditures above 15% of adjusted gross income, and cover 100% of health care expenditures by people living under 200% of the poverty line.
This preserves the market in most health care services--happy [Health Savings Account] advocates! It is progressive, and provides universal coverage--happy single-payer advocates! It directs coverage to those who really need it--the very sick--without a middle class subsidy--happy Jane! And it preserves market prices for almost everything from hospital beds to surgical procedures, since a significant fraction of the market will be paying their own way. That keeps the government from having to set prices, which as Soviet Russia showed us, is generally a bad idea. Most importantly (from my perspective) it preserves the market for innovations in drugs and medical equipment.
It is certainly not perfect. For one thing, I make no promises that it will control costs; I only allege that it will improve quality.
But you know what? We're rich. We're really, really rich. We're the richest country in the entire history of the world.
We're so rich that we have stores full of nothing but beautifully sculpted plumbing. What do we want to spend our money on that's better than health care?
One of the things I don’t do on this blog is blog about work.
A few days ago though, I had an experience that took my breath away. I stood in an warm, overcrowded conference room, leaning around the people standing in front of me to see the slides and hear the speaker. What I heard were people laying the groundwork for the next five, ten, or one hundred revolutions in the biological sciences. Yesterday I wasn’t just glad to have a job, I was proud to be associated with my company, Teranode.
The speaker was John Wilbanks, Executive Director of the Science Commons. He had come to our company, Teranode Corporation, to brief us on what was happening in the NeuroCommons project. I almost hesitate to try to recap what he said, because I know that I cannot recapture the jaw-dropping, "Eureka!" sensation I felt.
Creative Commons began as an attempt to create “open source” copyright law. The Creative Commons website allows users to point and click to create a usage license that they can then associate with their creative work. Creators can decide how many and what kind of rights to grant users of their creations.
But what begins as a simple, easily-used tool can create unintended results. The obvious parallel to draw is with TCP/IP and HTTP, the simple, unpatented tools that created the current global network. With the Creative Commons licenses, creative people can allow other creative people to draw from their work, incorporating existing work into new works. If that usage is tracked (as at sites such as ccMixter), it becomes easy to see whose creative work is the most used, the most influential, and the most "important" to subsequent works.
What is interesting and cool in the music community becomes earth-shaking in the science community. Kids, If you thought that the RIAA was jealous of easy access to the product of artists, you haven't seen what science and medical journals do to protect the data contained in their published articles. ScienceCommons is a project to allow scientists and univestities to allow freeer access to their work, so that their work can inform and influence other scientists and labs working in related areas. NeruoCommons is the proving ground for the technologies of the ScienceCommons
Right now academics live by the rule, "publish or perish." Scientists are measured by how many peer-reviewed articles they can get published and how often those articles are cited by other published papers. But cites are a second-order measure of importance. Measuring the actual use the of information from a discovery to enable a further discovery would be a direct measure of the first discovery's importance. The ScienceCommons project makes this measurement possible.
One of the mantra repeated by Mr. Wilbanks was, "We aren't making new discoveries; we are laying "cable" for a new network."
Well, it's been six years and no remake.
During this morning's commute, the topic of a Forbidden Planet remake or sequel came up. We quickly realized that you couldn't use the "monster from the id." That's been done.
If I wrote a sequel to Forbidden Planet it would have a "monster from the superego." It would have the voice of John Lithgow and it would be constantly nagging the United Planets officers about how they were falling short in thier duties and what would all the other spacemen think?
...And Peter Jackson sleeps easily.
Tuesday, March 07, 2006
Part of the problem is bloat. The Academy Awards show is now competing with new award shows the spring up, mushroomlike, on basic cable and the weblets every week. So every year it tries to distinguish itself by becoming more and more long-winded, more and more pretentious and self-congratulatory.
Pretty soon all this self-importance and political "awareness" and "courage" will fuse and they Academy will declare itself the third branch of the US legislature. Or, perhaps some new UN Council on Eating Your (Political) Vegetables.
Once again, it's not fair to John Stewart, but look back at the times Johnny Carson hosted the awards. Carson's shtick as the bemused midwesterner surrounded by Hollywood glamour worked. Perhaps because it wasn't based on condescension to mid-America and uber-hippness.
Or, for a crushing comparison, go back to Bob Hope's hosting. Bob, a show business insider from the days of vaudeville, still adopted the stance of an outsider, bemoaning his lack of an Oscar as he skewered those who received them.
Oh, well. Stewart won't be asked back. Maybe next year it will be Kanye West and Snoop Dogg co-emceeing. Bet that would make 'em tune in...
UPDATE: Peggy Noonan agrees with me!
But viewership of the Oscars continues to decline, even in the great movie-loving nation. Why? Here's one practical reason.
What happened to the Oscars is what happened to the Olympics. They became common. They made themselves common. When the Olympics were held every four years, they were a real event. It was something to look forward to and be surprised by: The Olympics are on this year. Four years was enough time for a whole new cast of athletes, what felt like a whole new generation, to come up. Enough time for history to have passed, to have yielded up new geopolitical realities, new reasons to applaud and hope for this nation or that one.
Everyone watched. It was a success. So they decided to get even more success by making the Olympics every two years. It's not an event now, it's an expected thing, part of the usual tapestry. It's more common, less special. Viewership is down.
In the same way, the Oscars used to be the big awards show. Then another came by, and another: Golden Globes, People's Choice, Independent Spirit, Foreign Press.
Movie stars put on their gowns and tuxes all the time now. It must be embarrassing--I mean this seriously--to spend half your year accepting awards on TV, and for what is already highly compensated work.
It's like what happened a few years ago, when network programmers found that "Who Wants to Be a Millionaire" was an overnight sensation. So they put it on four nights a week. And it stopped being a sensation.
Hollywood should stop diminishing its own mystique. It should discourage the proliferation of awards shows. They're getting embarrassing for everybody.
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