George Packer in the New Yorker is the latest to chronicle (and it really is an excellent piece) the hive of obstruction and special interest money that is the Senate.
Excellent Links
Great Headlines
Sullivan points to the following as the headline of the year:
Is this a lucrative field? Is this one of those green jobs we keep hearing so much about?
This sentence kills me: “The research could pave the way for advanced methods of enraging monkeys.” All I can think of is this:
Get In On The Ground Floor
Fear Is the Mind Killer
Dr. Atul Gawande has a typically thoughtful article on hospice care in the August 2 issue of the New Yorker:
… When there is no way of knowing exactly how long our skeins will run—and when we imagine ourselves to have much more time than we do—our every impulse is to fight, to die with chemo in our veins or a tube in our throats or fresh sutures in our flesh. The fact that we may be shortening or worsening the time we have left hardly seems to register. We imagine that we can wait until the doctors tell us that there is nothing more they can do. But rarely is there nothing more that doctors can do. They can give toxic drugs of unknown efficacy, operate to try to remove part of the tumor, put in a feeding tube if a person can’t eat: there’s always something. We want these choices. We don’t want anyone—certainly not bureaucrats or the marketplace—to limit them. But that doesn’t mean we are eager to make the choices ourselves. Instead, most often, we make no choice at all. We fall back on the default, and the default is: Do Something. Is there any way out of this?
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In late 2004, executives at Aetna, the insurance company, started an experiment. They knew that only a small percentage of the terminally ill ever halted efforts at curative treatment and enrolled in hospice, and that, when they did, it was usually not until the very end. So Aetna decided to let a group of policyholders with a life expectancy of less than a year receive hospice services without forgoing other treatments… A two-year study of this “concurrent care” program found that enrolled patients were much more likely to use hospice: the figure leaped from twenty-six per cent to seventy per cent. That was no surprise, since they weren’t forced to give up anything. The surprising result was that they did give up things. They visited the emergency room almost half as often as the control patients did. Their use of hospitals and I.C.U.s dropped by more than two-thirds. Over-all costs fell by almost a quarter.
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This was stunning, and puzzling: it wasn’t obvious what made the approach work. Aetna ran a more modest concurrent-care program for a broader group of terminally ill patients. For these patients, the traditional hospice rules applied—in order to qualify for home hospice, they had to give up attempts at curative treatment. But, either way, they received phone calls from palliative-care nurses who offered to check in regularly and help them find services for anything from pain control to making out a living will. For these patients, too, hospice enrollment jumped to seventy per cent, and their use of hospital services dropped sharply. Among elderly patients, use of intensive-care units fell by more than eighty-five per cent. Satisfaction scores went way up. What was going on here? The program’s leaders had the impression that they had simply given patients someone experienced and knowledgeable to talk to about their daily needs. And somehow that was enough—just talking.
How’s That Crackerjack Peter King Whip Organization Working Out?
Apparently the video that Mistermix posted of Anthony Weiner going mental on the House floor was not the end of things, as Weiner went on Fox news this morning, whipped out his ginormous penis, and proceeded to repeatedly slap Peter King in the face with it:
If more Dems acted like this, they would be gaining seats in November.
How’s That Crackerjack Peter King Whip Organization Working Out?Post + Comments (148)
Barack & Hamid’s Excellent Adventure
Everybody should run out and buy a copy of the August Harper’s Magazine. I want to write a separate post about Dan Baum’s “Happiness Is A Worn Gun: My Concealed Weapon and Me”, but I can’t resist pimping the positively Menckenian David Samuels:
… The reporters practice their questions, as if this were still the old days and raising their hands meant that there was even a slight chance they might be called upon. In fact, Obama hasn’t had a real press conference in almost a year, which is the longest period of such abstinence since anyone began keeping track. The reporters who get to ask questions are selected weeks in advance by the White House. Still, pretending is helpful for morale.
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“How about negotiating with the Taliban? You still good with that?”
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“Is your brother a CIA agent?”
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The question refers to Hamid Karzai’s half brother, Ahmed Wali Karzai, who is regularly portrayed in the American press as a corrupt drug lord who charges huge fees for allowing trucks full of opium to cross the bridges over the Helmand River to Kandahar. Last fall, President Obama duly warned that he expected Karzai to establish tough new anti-corruption laws and remove his brother from the government of a country into which the United States would soon be sending 30,000 additional troops. Never mind that Afghanistan produces an estimated 90 percent of the world’s supply of opium; and that the Taliban pays Wali Karzai to ship opium through the territories he governs; and that the U.S. Army, under the ill-fated General Stanley McChrystal, relies on Wali Karzai for logistical support and subcontracts special tasks, which include killing people, to gunmen under his direct control; and that as a courtesy we no longer destroy the poppy crop; and that Wali Karzai happens to be the CIA’s landlord in Kandahar, renting them Taliban leader Mullah Omar’s old villa. After a few months of back-and-forth, the message got through, and on March 30 the New York Times reported that “Afghan and American officials have decided that the president’s brother will be allowed to stay in place,” quoting a senior NATO official as saying that Wali Karzai could be a big help to the ongoing American reconstruction effort. “One thing, he is a successful businessman,” the official said. “He can create jobs.”
Tucker’s Fate
Is now to be openly mocked by an actual journalist, James Fallows.