Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Development & Density?

No thanks. By failing to approve a new mixed use, high density urban development, the "preservationists" would rather keep Canal Street's "historical character" of boarded up buildings, shut down hotels, shoe shops, and faux-voodoo tourist kitsch.

That's a shame for a streetscape that should be one of the bustling, dynamic, walkable commerical avenues of the Southeastern United States.

Wide streets can be fronted by tall buildings, that's one of the way urban design is supposed to work. I find the complaints of this building's height to be baseless. There are plenty of other buildings on that streetscape of that height, and they work because they front Canal.

Historical character? The building design does look "modern" in the aspect that it appears to use state of the art building design and materials. While this may not fit perfectly with the rest of the street towards the river, it isn't like this is some concrete-block monstrosity or post-modern experiment going in on that street.

As for the building it is replacing, it is a ramshackle low rise with a boarded up first floor covered in graffiti and posters. There is a need here to balance historical character with needed economic expansion. You'll be more able to preserve the historical character of other buildings and this part of the city as a whole if it is part of a working, dynamic downtown economy.

In other words, the Saenger Theatre, the Lowe's Theatre, and the Broadway South concept for that intersection isn't going to work if the theatres have no economic support nearby. If the University Medical Center ever does get built, people who work there could live in this building and walk to work, increasing the value of properties between this location going up Canal Street - an area that desperately needs commerical dollars.

And the folks making these decisions need to look up the definition of "leverage." They have some leverage in that a location like this on Canal Street should be quite valuable. But that knowledge needs to temptered with the reality that a location like this on Canal Street currently isn't as valuable as it could be, because of a lack of developers willing to take a risk of locating there.

Because, while the location has the potential to be very valuable based on the proximity of planned theatres and hospitals, those planned theatres and hospitals aren't yet done deals. Going ahead with developments of this nature assist the critical mass required for those projects to be successful. Otherwise, you'll end up stuck with the street the way it is now.

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Rationing

OH NOES! TEH DEATH PANELIZMS BE RATIONING MAH HEALTH CARES!!!

It sure doesn't take long to manufacture a dog-whistle, does it? Of course, Representative Gingrey phrases it like this:

Well, here are the facts: the only proposal to reform Medicare that President Obama has advanced is to employ a bureaucratic panel to ration health care. These 15 unelected individuals comprise a board called the Independent Payment Advisory Board (IPAB), which was first created in Obamacare. It’s empowered to make decisions about critical coverage and payment policies regarding Medicare — without having to answer to the American people.


Wow, those are pretty words. The long form of "TEH DEATH PANELIZMS!" And yet,

These distracting gimmicks have allowed Democrats to avoid discussing the dangers of IPAB and unfairly rendered many Americans ill-informed.


Which brings me to another point regarding political communication. When Democrats, progressives, and liberals lose elections because they don't think they have to convince people to agree with them, their answer is "The American People are Stupid" or "Why Do People Vote Against Their Own Interests" or "WHHAAA! Politics is Hard!!"

On the other hands, the GOP blames Americans' status as "ill-informed" due to "distracting gimmicks" from the Democrats.

Guess who wins more credibility just through phrasing? (HINT: Who controls the US House of Representatives?)

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$64,000 Question

So you're telling me a couple that makes $64,000 a year, including Social Security benefits, might qualify for Medicare and that's a bad thing?

I'll admit that might be a little bit high. Median household income in the United States is around $45K a year, so I guess folks who earn around that number might consider themselves "middle class." But with the price of food and gasoline going up, the value of homes decreasing, and the astronomical costs of medicine in this country, maintaining a household of two + individuals at $64,000 a year isn't a walk in the park.

Hit with almost any major medical emergency, that $64,000 can vanish quickly.

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Why We Can't Have Nice Things

Mayor Landrieu makes the case for building the University Medical Center in New Olreans. This is a response to those who would seek to take the knees out from under the project and benefit their special interests under the cloak of "fiscal conservatism." All at the last minute, once an entire neighborhood has been destroyed and families have been uprooted.

In the larger context, Landrieu's rebuttal exposes the way individuals who play "conservative" on television willingly misrepresent tax figures as a means of providing for their own pork projects and protecting their own clients' subsidies.

For those of you who live in more progress-prone parts of the nation, you may be scratching your head wondering why this has been so difficult for New Orleans. Jeffery puts it in local context:

Ever content to remain the richest club in a poor and shrinking city, New Orleans' socialites resist any and every effort to grow the economy. They dress this conservative agenda up as "preservation" but it's better described as ossification. What gets "preserved" are old buildings, staid pageantry, anything that might make easy packaging for a hotelier or a filmmaker to sell.


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How Not to Build Stuff

Maybe they should have thought of this, or something like it BEFORE they declared imminent domain and bulldozed the neighborhood that existed there before. You want to talk about government waste?

Step 1: Your city has a teaching hospital run by the public state university that treats a high volume of at-risk patients. The system has big problems, but the building is solid and would be viable given some serious renovations.

Step 2: Man-made disaster seriously damages the teaching hospital.

Step 3: Agents of the government attempt to repair the teaching hospital. It is a hospital in the middle of a disaster area. Such facilities tend to be useful.

Step 4: Agents of the public state university allegedly stop repairs and close the teaching hospital. They want to declare the old hospital a loss, collect insurance money, collect national disaster money and build a new teaching hospital.

Step 5A: Powers that be know where they would put a new hospital. Friends, family, and connections begin buying cheap land in and around that area. These properties are left to moulder because they'll all get torn down when the new teaching hospital gets built.

Step 5B: Regular citizens who live in that area move back into their homes, and use what little insurance and government disaster aid they can apply for to renovate their homes. They aren't informed by the powers that be that all of their properties will be seized by imminent domain and torn down to make way for a new teaching hospital.

Step 6: Argue in public over the option to renovate the old teaching hospital (for $600 million) or build a new teaching hospital (for $1.2 billion). Ignore homeowners and businesses and other government agencies who have sunk money into properties that will be demolished. Let several years go by without much action, because who really needs a public hospital in the middle of a disaster area to serve at-risk populations?

Step 7: Convince the US Department of Veterans Affairs that the new teaching hospital is a done deal, and that they should start building their new hospital nearby.

Step 8: Convince developers and investors that the new teaching hospital is a done deal, and that they should start building new retail and residential use facilities as if the new hospital is guaranteed to be built.

(Seriously, I have a friend in another city, and some NOLA booster organization gave them a sales pitch that this hospital would be ready to open this fall or winter, with 5,000 new professional jobs coming to town.)

Step 9: Win the argument despite divisive local opionion and viable, cheaper alternatives. A Shiny New Hospital Will Be Built! Begin declaring eminent domain and bulldozing buildings. Move a few historical buildings to shut up the most agitating homeowners and preservationists. Clear dozens of city blocks of structures.

Step 10: Have state and federal officials representing competing intereststs attempt to derail the project at the last minute under the name of hostage taking fiscal conservatism.

Because if you think anything above describes fiscal conservatism (or fiscal liberalism, for that matter) you watch too much cable network news and don't understand the definition.

As a whole, words just fail.

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I'mma Do Me

More GOP elected officials sounding like gangsta rappers.

What happens in the Paul Ryan End Medicare Plan when your private employer does not offer retirees medical benefits? Here's what GOP Representative Rob Woodall of Georgia's 7th Congressional District had to say:

"You want the government to take care of you, because your employer decided not to take care of you. My question is, 'When do I decide I'm going to take care of me?'"


As if the woman hadn't been paying into Medicare and Social Security and Medicaid through her years of work at a private company. Someone needs to explain to these fools that the woman did take care of herself by working and paying into the program. A program enacted through popular legislation, executive signature, and supported over judicial challenges since the 1930's.

And that GOP representative has the temerity to call her a freeloader in front of a town hall meeting. Because that's what he did. And the "handout" narrative is so deep at this point, he gets applause for saying it. As if Social Security, Medicare, and Medicaid are all programs forced upon the middle class by a government controlled by a bunch of laughing, lazy, good for nothing layabouts in their Welfare Cadillacs.

Every place I have worked professionally has employed some measure of custodial staff (mostly through contractors) that show up to work at crappy times, work long hours on their feet, pitch in to help other members of their working families, and still have to recieve some sort of food stamp benefit to make ends meet. I can guaran-damn-tee you that the "private company" they work for doesn't offer them retirement benefits. And they're going to be shit out of luck and a burden on their families once they aren't able to work anymore - because they're going to work until their health gives out. They have no real recourse for retirement or medical care once retired, after all.

Somebody needs to explain to me how, exactly, they haven't been taking care of themselves after paying into their Social Security, Medicare and Medicaid benefits their whole working lives. Somebody needs to explain to me how the Ryan plan deals with those people. Because I haven't heard a good explanation so far.

I've been trying not to drink too deeply of the "Ending Medicare Forever to Pay for Our Newly Minted Feudal System of Subsidizing the Already Uber Wealthy" Demagougery flavored Kool-Aid, but at what point should I start taking this more seriously? At what point do I have to listen to the very words of the GOP Congressmen themselves when they say "Ending Medicare Forever" and question the morality or philosophy or work ethics of people who are depending on the system they've paid into like they were supposed to.

At what point can I begin to accept that Ending Medicare Forever to pay for tax breaks is not a demogouging fear tactic to win elections, but the GOP's stated philosophical and legislative goal.

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Mo' Money Mo' Choices

This.

Think of all the ideas put forth during the health care "debate" about how everybody should try to get the best "deal" on their care. That presumes that people (who are sick, by the way) have time to call doctor after doctor and hassle office manager after office manager for prices on stuff, and I don't know about you, but my doctor's office generally acts like money doesn't exist, so trying to get them to show me the price tag is an all-day endeavor.


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A Non-Frivolous Lawsuit

One thing I want to start doing is highlighting lawsuits that matter. I want to do so to counter a popular and dangerous cultural narrative that exists in our society.

I've heard a lot about "frivolous" lawsuits recently, both on talk radio and through chain emails. I'm sure it has to do with the Taco-Bell-Not-Serving-Beef litigation (a suit I do not consider frivolous), which came about the same time some woman who walked into a water fountain while texting attempted to sue the mall she was in for her accident (which I do consider silly).

But the "frivolous lawsuit" comes from a longstanding cultural narrative that America is a too-quick-to-sue culture. The narrative continues that these lawsuits are the fault of trial lawyers (who, we are constantly reminded, robustly support Democratic Pary with donations) and drive up costs for all services and goods, especially in the field of medicine. Every time you see a warning label on a product, we are told to remember that such a warning exists because someone filed a ridiculous lawsuit sometime somewhere someway. The focus driving this narrative is always the initial filing, or initial finding - I do not believe a cultural understaning exists to check on whether any of those cases get dismissed or have an outrageous award reduced on appeal.

Thing is, you rarely hear about the necessary lawsuits. You rarely hear about those lawsuits constantly required to keep big business or government overreach in check. You rarely hear about those lawsuits that fall under the guise of a "redress of grievances" that take years to come to a conclusion, that take hundreds of thousands, if not millions of dollars from filing to final verdict. You would be hard pressed to find widespread circulation of how damaging a "loser pays" system would be for those individuals who attempt to right some wrong.

Part of that is because following legal minutiae is boring, part of it is because of the cultural narrative that leads us to believe most lawsuits are frivolous.

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