04 November 2010

Book Review - The Fountainhead

[This is the first in what will hopefully become a series of book reviews. I have a huge list of things I want to read, and I figure taking notes and writing reviews will be a good way to refine my thoughts. If other folks get something out of the reviews, too... well, that's just bonus!]

Title: The Fountainhead (Amazon) (Wikipedia)
Author: Ayn Rand
First Published: 1943

Summary

Howard Roark, Architect. The book opens with Roark being expelled from the architecture program at the fictitious Stanton Institute of Technology, shortly before he would have graduated. Instead of fighting to stay, he steps away without looking back. This act represents the first of many instances where Roark, with characteristically few words, sails forward on the course he, and he alone, charts – learning that which he needs from those around him and taking advantage of the opportunities presented to him, but otherwise never relying for a moment on the kindness or altruism of others.

It is tempting to say that Roark has to fight the system around him: in a time when duplication of classical architectural styles is held up as the only acceptable mode, his style is strikingly modern. His work always represents a seamless merging of material, landscape, and space that, for those with an eye to see, brooks no modification and admits no possible improvement. Yet, it invariably is panned by reviewers appalled by the departure from the 'accepted' classical forms. Despite this, Roark pays little attention to those who do not appreciate his designs, and refuses to engage them. He cares only for those few who recognize his genius and makes his living off of their occasional commissions.

While much of the book follows Roark's principled pursuit of his creative purpose, the rest addresses other aspects of this idea of individualistic creative integrity as personified by three main characters:
  • Ellsworth Toohey, the 'nemesis,' whose sole purpose is promulgation of a comprehensively collectivist social order
  • Dominique Francon, the 'pessimist,' whose values closely mirror Roark's but whose response to the world's collectivist challenge is retreat into cynical frivolity instead of assertive pursuit of her desires
  • Gail Wynand, the 'inversion,' who shares the core of Roark's values, drive and motivation—but whose chosen purpose is to publicly compromise and corrupt the individualistic integrity of others

Notes

I found the book to be a ringing indictment of collectivism, both via the narrative device and via the interspersed philosophical arguments. The glimpses of what I believe would later be developed into Objectivism, however, are harsh and distastefully un- (or even anti-) sentimental. I note this not to argue that more genuine rationality in public discourse would be undesirable, but to point out that Objectivism's wholesale rejection of emotion and sentimentality in favor of rationality rather tosses the baby out with the bathwater.

As a Christian, it struck me that Rand labeled Christianity as one of the pantheon of collectivist ideologies to be reviled. On the one hand, I agree that many of the historical and modern doctrines/denominations have focused greatly on abasing oneself whilst serving others. On the other hand, I would dispute that these are proper interpretations of the commands of Jesus. In Matthew 22:39 it is written, "You shall love your neighbor as yourself;" not, "You shall love your neighbor, but not yourself." I would characterize this philosophical aspect of Christianity as 'other-conscious individualism.' From this perspective, I disagree with the book's categorical characterization of altruism as vile, though I agree with the disparagement of the idea that worth is only found in serving or thinking only of others.

A few quotes that I found noteworthy, with commentary following each [page references from original Signet paperback edition, 12th printing, (c)1943]:

Ellsworth Toohey, p293 – "Kindness, Peter," said the voice softly, "kindness. That is the first commandment, perhaps the only one. That is why I had to pan that new play, in my column yesterday. That play lacked essential kindness. We must be kind Peter, to everybody around us. We must accept and forgive—there is so much to be forgiven in each one of us. If you learn to love everything, the humblest, the least, the meanest, then the meanest in you will be loved. Then we’ll find the sense of universal equality, the great peace of brotherhood, a new world, Peter, a beautiful new world…."

This philosophy implicitly posits that every sphere contains only different variants of (moral) 'good' - and, by implication, rejects consideration of the 'wrongness' of things. Philosophies that reject a dual-pole (good/evil) morality are toxic in a reality governed by a dual-pole morality—but now's not the time for that discussion.

p491 – Wynand and Dominique sat in the center of the fourth row, not looking at each other, listening to the play. The things being done on the stage were merely trite and crass; but the undercurrent made them frightening. There was an air about the ponderous inanities spoken, which the actors had absorbed like an infection; it was in their smirking faces, in the slyness of their voices; in their untidy gestures. It was an air of inanities uttered as revelations and insolently demanding acceptance as such; an air, not of innocent presumption, but of conscious effrontery; as if the author knew the nature of his work and boasted of his power to make it appear sublime in the minds of his audience and thus destroy the capacity for the sublime within them. The work justified the verdict of its sponsors: it brought laughs, it was amusing; it was an indecent joke, acted out not on the stage but in the audience. It was a pedestal from which a god had been torn, and in his place there stood, not Satan with a sword, but a corner lout sipping a bottle of Coca-Cola.

This reminds me so strongly of most advertising today. In general, commercials pretty much just make me want to retch.

Ellsworth Toohey, p639 – "I have no private purpose. I want power. I want my world of the future. Let all live for all. Let all sacrifice and none profit. Let all suffer and none enjoy. Let progress stop. Let all stagnate. There’s equality in stagnation. All subjugated to the will of all. Universal slavery—without even the dignity of a master. Slavery to slavery. A great circle—and a total equality. The world of the future."

"Let all sacrifice and none profit. Let all suffer and none enjoy. Let progress stop. Let all stagnate. There's equality in stagnation." I was revolted, reading the monologue from which this came.

Howard Roark, p680 – "Men have been taught that the highest virtue is not to achieve, but to give. Yet one cannot give that which has not been created. Creation comes before distribution—or there will be nothing to distribute. The need of the creator comes before the need of any possible beneficiary. Yet we are taught to admire the second-hander who dispenses gifts he has not produced above the man who made the gifts possible. We praise an act of charity. We shrug at an act of achievement.
"Men have been taught that their first concern is to relieve the suffering of others. But suffering is a disease. Should one come upon it, one tries to give relief and assistance. To make that the highest test of virtue is to make suffering the most important part of life. Then man must wish to see others suffer—in order that he may be virtuous. Such is the nature of altruism. The creator is not concerned with disease, but with life. Yet the work of the creators has eliminated one form of disease after another, in man’s body and spirit, and brought more relief from suffering than any altruist could ever conceive."

'Suffering is a disease.' Rand identifies this well, but due to her rejection of God she also implicitly rejects the sin explanation of suffering. In a broken world there will always be some in need of assistance, and provision of that assistance is a worthy endeavor. Ideologies exist, Rand's being one of them, that wish mightily that suffering might be eliminated; the (pre-millenial) Christian worldview argues that these are vain and foolish in the present age. I do agree partly with Rand, in that elevation of altruism to the highest virtue is folly—per my prior argument, though, I do not agree that a proper understanding of Christianity requires one to elevate altruism as such.

28 October 2010

AP & Bloomberg Spin The Pre-Election Unemployment Numbers

The last weekly unemployment application numbers before next week's election are out. The MSM spin machines are firing on all cylinders:

AP:

Unemployment claims drop sharply to 434K

Fewer people applied for unemployment benefits last week, the second drop in a row and a hopeful sign the job market could be improving.

The Labor Department said Thursday that initial claims for jobless benefits dropped by 21,000 to a seasonally adjusted 434,000 in the week that ended Oct. 23.

It was the second-lowest number for claims this year. The only time it was lower was during the July 10 week, and that week was affected by the Independence Day holiday when state unemployment offices were closed.

Bloomberg:

Jobless Claims in U.S. Unexpectedly Drop To Three-Month Low

Claims for jobless benefits unexpectedly dropped last week to a three-month low, a sign the U.S. labor market may be starting to mend.

Initial jobless claims decreased by 21,000 to 434,000 in the week ended Oct. 23, the lowest since early July when fewer auto plants than normal closed for retooling, Labor Department figures showed today in Washington. The total number of people receiving unemployment insurance dropped to a two-year low, while those getting extended payments also fell.

Well! Sounds like good news! I mean, the second-lowest number of claims of the year! Two weeks in a row with declining new jobless claims! We're on our way!

Enh, not so much. Take a look at the data going back through June of last year, when the recession 'officially' ended:


All data is from the Department of Labor: data up through 2-Oct-2010 is from a report generated from here; data from 9-Oct through 23-Oct is from the press release here (possibly stale).

New jobless claims dropped pretty steadily from June '09 to about the end of the year, and they've stayed basically level since then. The questions at hand, though, are whether the data of the last three weeks heralds a 'sharp drop', presaging an economy resurgent; and if, really, this 'three-month low' really qualifies as an 'unexpected drop.'

In a word: No. All three most recent weeks fall within two standard deviations of the mean of the 2-Jan-2010 to 2-Oct-2010 data set. 'Sharp drop?' If the trend of these last three weeks holds for several weeks more, absolutely! In the context of historical data? It's just noise. Expected. Noise.

In fairness, the AP article does -- squishily -- present a few caveats of this sort:
Claims will need to keep falling to signal a widespread increase in hiring. Claims have fluctuated around 450,000 for most of this year, and have fallen below that level seven times. But they have always rebounded in subsequent weeks, and haven't remained below 450,000 for longer than two weeks.

You wouldn't infer any of that from reading their headline, however.

16 September 2010

The Vote Heard 'Round The World

Rubio. Angle. Miller. Paul. Lee. And now O'Donnell.

The Tea Party seems to slowly be realizing its true strength; that it may in fact be a 'silent majority', and not just a large minority. How is each Tea Party supporter to know, really, how deep and how wide is the support for small-government fiscal conservatism? We are, by nature, averse to shouting loud our opinions, for all to hear.

For decades--most of the twentieth century, in fact--people who have just wanted government out of their lives have had only sporadic representation in government, especially on the national level. The question was not, "Is government too big?" It was, basically, "To what end do we direct the spending?" Goldwater stood no chance in his era; whatever Reagan's underlying goals, he was undercut by the geopolitical necessity of the Cold War arms race; even much of the 'Contract with America' of the GOP Congress of 1994 was more about a particular flavor of government-sourced populism than about actually reducing the intrusion of government into private life.

What if this is about to change?

"What if," Tea Partiers seem to be asking themselves, "there are more of us than I think? What if it's not just me, my family, and those few people I know in the neighborhood? What if ... we can actually do this?" Each of us only sees a small piece of the picture--none of us knows the full scale of the amassed discontent--what if it is enough? What if we are many enough?

*   *   *

Over the summer, I visited Minuteman National Historical Park, near Lexington, MA, with my wife and in-laws. The park commemorates the entire span of events from the night rides of Paul Revere and his companions, to the march of the British troops out to Concord, the "shot heard 'round the world," and the running firefight most of the way back to Boston from Concord that, looking back, we now mark as the start of the armed portion of the American Revolution.

The American colonists had great discontent over the perceived injustice of British rule - punitive taxation without representation in Parliament and intrusive laws attempting to reduce the possibility of revolt. The British march out to Concord was in support of one of these laws: the soldiers were to locate and destroy a large cache of muskets & ball, gunpowder, cannonballs, tents, and other militia supplies that was suspected (rightly) to be located in Concord. The "shot heard 'round the world" took place at the Old North Bridge, which crosses the Concord River north of the town center, as the British troops were beginning their return march after failing to locate the stockpile.

At the park's visitor center they have a short multimedia presentation (video, animated maps, etc.) that sets the scene vividly. Paul Revere's ride with William Dawes forewarned the colonists that the British 'regulars' were on the march. Tensions were raised even before the troops reached Concord: a tense standoff in (IIRC) Lexington had ended with the regulars firing a musket volley into a group of colonial militia, killing and wounding several, though there was no return fire from the militia. Further, as the regulars were searching the area across the Old North Bridge, a fire had (accidentally, as it happened) started on the roof of one of the buildings in Concord Center. The militia knew that the regulars had demonstrated a willingness to draw blood, and didn't know whether the rising smoke was intentional or accidental.

As this group of regulars moved to re-cross the Old North Bridge and rejoin the main body before beginning the march back to Boston, they were confronted by militiamen. In the midst of the tense standoff that resulted, a British regular fired a shot despite a 'hold fire' order. Haltingly, some of the militia returned fire. More of the regulars fired. In the end, the commander of the militia unit gave the official 'fire' order. The remaining regulars fell back, then broke and ran under the fire of the militia. By this time, thousands of colonial militia had converged from surrounding towns, and the rout of the British regulars continued. By the time the remnants of the force of regulars regrouped with a body of troops sent out from Boston in response to the militia assault, they had suffered grievous casualties at the hands of a tens-of-thousands-strong militia force. The American Revolution had begun.

*   *   *

One of the most remarkable things about the presentation (and, notably, something that never really sunk in even after years of repetitive presentation in school) was the sense of uncertainty on the part of the colonists. We are able to look back at these events and say, "This is the moment when the American Revolution began." In the moment, though, the tension on the part of the militia in sort of a, "What are we doing? Do we have a chance? Is this, at all, a good idea?" fashion was palpable in the retelling of the events.  I seriously doubt that those militiamen making the initial charge across the Old North Bridge had any real sense of the dramatic progression of events that was to follow. The tale of the unfolding battle seems one of people gradually growing in confidence in a cause that to them was, or became, deeply righteous.

Perhaps they were asking themselves this same question as the Tea Party seems to be: "What if ... we are many enough?" Perhaps we are seeing this in, for example, the nearly $1 million donated to the Christine O'Donnell campaign, as of this writing. Perhaps we are seeing a 'second American Revolution.' Perhaps, on November 2nd, we will be amazed to witness "the vote heard 'round the world."

Update, 19-Sep-2010: Forgot to mention Scott Brown, starting things off in January. Also, less than a week after winning the primary, donations to O'Donnell's campaign have now crossed the $2 million mark stand at just shy of $1.9 million. I believe Coons is now either at parity with O'Donnell in cash-on-hand, or at a slight disadvantage.

16 May 2010

Most Driver's Licenses Acceptable For New Arizona Law

One of the fusses going around about the new law in Arizona is that it will place an undue burden on residents to carry documentation at all times.  Specifically, the argument is made that a driver's license will not be acceptable documentation of legal presence in the US.  The new law does provide for the use of federal-, state-, or locally-issued identification as a means of establishing legal presence, as long as (per the text of the bill, SB 1070 Sec 2, amending ARS 11-1051B(4)) this ID "requires proof of legal presence in the United States before issuance."


So, how many states' driver's licenses require proof of legal presence (PLP) before issuance?  All but two, New Mexico and Mississippi.  (Technically New Hampshire also does not require PLP, but they also appear only to issue driver's licenses to US citizens - mooting the question.)  New Mexico does have a weak form of PLP confirmation, in that a Mexican consular card or an ITIN card are acceptable as part of the identity confirmation process.  Mississippi's process seems remarkably incomplete, given the near-universal PLP requirements elsewhere in the country.  In the end, New Mexico is likely to be the most problematic jurisdiction in terms of its interaction with Arizona's new law, with the two states sharing a border.

(To note, some states have only very recently enacted laws requiring PLP documentation, potentially complicating the validity of their licenses in the near term.  Others, probably most others, have had PLP verification in place for at least several years - California first enforced PLP requirements in 1994, for example.  Regardless of the tenure of the PLP requirements, as the renewal cycles of existing licenses turn over, the transient consideration of date of enactment will become irrelevant.)


The following is a list of all forty-eight states whose driver's licenses should be acceptable under AZ SB 1070, linked to their respective webpages describing proof-of-legal-presence documentation requirements for driver's licenses.  States with recently-enacted PLP laws are noted separately.

AK AL AR AZ CA CO CT DE FL GA
IA ID IL IN KS KY LA MA ME MI MN
MO MT NC ND NE NJ NV NY OH OK
OR PA RI SC TN TX VT WA WI WV WY 
HI - See 'General Requirements' sections (c) & (d)
MD - Current law effective 1 Jun 2009
NH - NH appears not to issue licenses/IDs to immigrants/visitors; a NH license thus indicates citizenship
SD - Current law effective 31 Dec 2009
UT - Current law effective 1 Jan 2010
VA - Follow questionnaire form to see requirements

States with driver's licenses likely without acceptable PLP verification under AZ SB 1070:
MS NM

18 January 2010

A Thought On Brown's Appeal

I'm no political whiz, so take this with a grain of salt.

I've been following Republican Scott Brown's special election campaign here in MA, in which he's competing with Democrat Martha Coakley for the Senate seat opened by the passing of Ted Kennedy last year. It's been quite a thing to see, how he's blazed from near-obscurity, thirty points behind to major political standing (in MA, at least), at the leading edge of the margin of error in the two most recent major polls of the race. There's been speculation all over the blogosphere as to what chord he's struck with the electorate of Massachusetts that's allowed him this (I daresay) historically unprecedented performance in the state.

But I really wonder if anyone's really hit it. Much has been made of Brown's deft riposte to moderator David Gergen during the final debate last week, referring to the open MA Senate seat, in short: "It's the people's seat." Sure, it was a stinging rebuke to Coakley and other Democrats who took it for granted that the seat in which the 'Liberal Lion' had sat for almost five decades would continue to be filled by a Donkey. But I really wonder if the line doesn't tap into something deeper in people's psyches.

A major critique I have of the Democratic party is its inclination toward the increase in government scope and power. (Not that the Republican party has been all that different of late, sadly!) Correspondingly, a major critique I've seen made by more than one person (often in wrangling political discussions on Facebook - hey, guys!) of the Republican party is its tendency toward handing favors and, indirectly or directly, power and (debatably appropriate) freedom of action to corporations, businesses and Wall Street. (And again, not that the Democratic party has been all that different on this count, either!) You may notice a commonality here, in that in both cases power is being handed to large, impersonal entities that often, and in many cases I believe rightly so, are seen to have very little real interest in the well-being of the individual... of the people.

Maybe Scott Brown's appeal stems mainly from his populist stance. Maybe his appeal is part of the same phenomenon that's led to the flourishing of the Tea Party movement. Perhaps it's all part of a broader populist resurgence; perhaps many citizens feel that self-governance is slipping away, with ever more power and freedom being shackled up in the form of endless waits in government office lines and on automated help line calls. Maybe neither mainstream party truly has its finger on the pulse of the nation, a strengthening beat of "Give Us Our Lives Back."

I think I don't neatly fit any major political labels... I'm not a pure populist, I don't think - but neither am I a socialist or a pure capitalist. Much of our current prosperity stems from the logistical and material economies of scale that large companies/corporations provide -- I can't fathom how computers would ever have come about without, among other things, the enormous semiconductor industry to manufacture them. A friend is convinced that it's possible to set up a market system that regulates itself -- I'm highly skeptical, as I think that some government regulation, judiciously balanced, is necessary and inevitable. National defense also (leaving aside please whatever you may think of the current exertions bearing this label) would probably be a nightmare absent the undergirding federal structure. (I'm reading Federalist Papers now, and I found Jay's case in #s 2-5 solidly convincing.) So, I think radically stripping back the government and corporate structures to next to nothing is neither feasible nor wise.

But I think what we're seeing in Massachusetts right now is a symptom of a desire for people to have more of their lives to themselves, and I think that Brown's message to the voters of, 'I'll be an independent voice, and if you elect me this seat will be your seat,' strikes exactly the right note to resonate with that sentiment. When you have 'Progressives Against Coakley' and a Cape Cod paper that "[does] not agree with Brown on everything," including "[his] position on health care reform" but still endorses him anyways, it seems clear to me that he's touching something that transcends the particular hot-button topics being tossed around today.

02 November 2009

PelosiCare Bureaucracy Break-out

Via a conversation in a comment thread on Facebook, I went through all 111 of the new bureaucratic agencies/programs/whatnot that would be created by the House health care bill, as laid out here. I did a quick topical sort on them, based on a variety of keywords that jumped out at me as seeming important. There are some items that would fall under multiple categories; I weakly cross-referenced these with a mention of the number from the original list.

Quoted here is my response comment, roughly tied to the list pasted below. It's lacking some context, regrettably, but I think still makes some useful points:

To the first: Criticism accepted, I trusted the source without double-checking that all 111 were independent. However, I just went through and loosely categorized each of them (will post this as a note here shortly & share it), and I see very few, if any, that are identical duplicates. There are a number that apply to the same general entity/concept/whatever but that are distinct.

To the second: what does it matter if these are independent or not? Independence has no obvious causal link to, and to my mind even an implication of, greater cost. Subordinate, dependent, or corollary, it matters little - they'll still suck down resources. Further, out of the 111 entities listed, only 26 or so contain the word 'grant', and I could find only one contains 'scholarship'. In context, that's hardly 'many'. And, these grant programs, too, will require funding. And, thus, oversight to determine where the funding will go; and, thus, a director or committee to handle this oversight. $$$.

To the third: Do you really expect these few 'transitional' committees for the establishment of whatnot will allow themselves to dissolve out of existence once their nominal function is achieved? Further, I see only two with names implying a transitory function, #10 and #111. The rest are boards, committees, programs, grants, funds, trustees, secretaries and the like.

In short, it's a forest's worth of paper, laden with bureaucratic-job-creating, special-interest-pandering, taxpayer-money-wasting, cost-bloating fail.



And, the list:


---
Simplification and Improvement
4. Program of administrative simplification (Section 115, p. 76)
(#27)
(#28)
58. Center for Quality Improvement (Section 2401, p. 1322)


---
Advisory committees
5. Health Benefits Advisory Committee (Section 223, p. 111)
17. Telehealth Advisory Committee (Section 1191 (b), p. 589)
50. Advisory Committee on Health Workforce Evaluation and Assessment (Section 2261, p. 1275)
92. Personal Care Attendant Workforce Advisory Panel (Section 2589(a)(2), p. 1624)
(#100, Indian matters)


----
Demonstration programs (incl. #55)
18. Demonstration program providing reimbursement for "culturally and linguistically appropriate services" (Section 1222, p. 617)
19. Demonstration program for shared decision making using patient decision aids (Section 1236, p. 648)
23. Independence at home demonstration program (Section 1312, p. 718)
32. Demonstration program for approved teaching health centers with respect to Medicare GME (Section 1502(d), p. 933)
38. Demonstration program for Medicaid coverage to stabilize emergency medical conditions in institutions for mental diseases (Section 1787, p. 1149)
64. "No Child Left Unimmunized Against Influenza" demonstration grant program (Section 2524, p. 1391)
79. Grant program to support demonstration programs that design and implement regionalized emergency care systems (Section 2553, p. 1480)
95. Demonstration program for chronic shortages of health professionals (Section 3101, p. 1717)
96. Demonstration program for substance abuse counselor educational curricula (Section 3101, p. 1719)

Demonstration 'projects'
76. Demonstration project of grants to medical-legal partnerships (Section 2537, p. 1464)
102. Indian Health Service tribal facilities joint venture demonstration projects (Section 3101, p. 1809)
107. Indian youth telemental health demonstration project (Section 3101, p. 1909)
103. Urban youth treatment center demonstration project (Section 3101, p. 1873)


---
Wellness grants
2. Grant program for wellness programs to small employers (Section 112, p. 62)
54. Grant program for community prevention and wellness research (Section 2301, p. 1305)
55. Grant program for research and demonstration projects related to wellness incentives (Section 2301, p. 1305)
56. Grant program for community prevention and wellness services (Section 2301, p. 1308)


---
Women's Health
90. Health Resources and Services Administration Office of Women's Health (Section 2588, p. 1618)
91. Food and Drug Administration Office of Women's Health (Section 2588, p. 1621)
86. Health and Human Services Coordinating Committee on Women's Health (Section 2588, p. 1610)
87. National Women's Health Information Center (Section 2588, p. 1611)
88. Centers for Disease Control Office of Women's Health (Section 2588, p. 1614)
89. Agency for Healthcare Research and Quality Office of Women's Health and Gender-Based Research (Section 2588, p. 1617)


----
'Choices'
6. Health Choices Administration (Section 241, p. 131)
10. Mechanism for insurance risk pooling to be established by Health Choices Commissioner (Section 306(b), p. 194)


----
'Exchange'
8. Health Insurance Exchange (Section 201, p. 155)
9. Program for technical assistance to employees of small businesses buying Exchange coverage (Section 305(h), p. 191)
11. Health Insurance Exchange Trust Fund (Section 307, p. 195)
12. State-based Health Insurance Exchanges (Section 308, p. 197)
34. Special Inspector General for the Health Insurance Exchange (Section 1647, p. 1000)


---
'Public Health Insurance Option'
14. "Public Health Insurance Option" (Section 321, p. 211)
15. Ombudsman for "Public Health Insurance Option" (Section 321(d), p. 213)
16. Account for receipts and disbursements for "Public Health Insurance Option" (Section 322(b), p. 215)
42. Public Health Investment Fund (Section 2002, p. 1214)
46. Public Health Workforce Corps (Section 2231, p. 1253)
47. Public health workforce scholarship program (Section 2231, p. 1254)
48. Public health workforce loan forgiveness program (Section 2231, p. 1258)
57. Grant program for public health infrastructure (Section 2301, p. 1313)


---
'Accountable Care'
20. Accountable Care Organization pilot program under Medicare (Section 1301, p. 653)
36. Accountable Care Organization pilot program under Medicaid (Section 1730A, p. 1073)


---
'Home pilot' programs
21. Independent patient-centered medical home pilot program under Medicare (Section 1302, p. 672)
22. Community-based medical home pilot program under Medicare (Section 1302(d), p. 681)
35. Medical home pilot program under Medicaid (Section 1722, p. 1058)


---
'Comparative Effectiveness'
24. Center for Comparative Effectiveness Research (Section 1401(a), p. 734)
25. Comparative Effectiveness Research Commission (Section 1401(a), p. 738)
26. Patient ombudsman for comparative effectiveness research (Section 1401(a), p. 753)
39. Comparative Effectiveness Research Trust Fund (Section 1802, p. 1162)


---
Nursing facilities (both 'skilled nursing' and 'nursing' - difference in jargon terms?)
27. Quality assurance and performance improvement program for skilled nursing facilities (Section 1412(b)(1), p. 784)
28. Quality assurance and performance improvement program for nursing facilities (Section 1412 (b)(2), p. 786)
29. Special focus facility program for skilled nursing facilities (Section 1413(a)(3), p. 796)
30. Special focus facility program for nursing facilities (Section 1413(b)(3), p. 804)
31. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 1422, p. 859)
37. Nursing facility supplemental payment program (Section 1745, p. 1106)


---
Anti-fraud (note: *one* entity)
33. Pilot program to develop anti-fraud compliance systems for Medicare providers (Section 1635, p. 978)


---
Tracking to prevent 'double-dipping' (*ONE* entity)
40. "Identifiable office or program" within CMS to "provide for improved coordination between Medicare and Medicaid in the case of dual eligibles" (Section 1905, p. 1191)


---
'Innovation'
41. Center for Medicare and Medicaid Innovation (Section 1907, p. 1198)
49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)


---
'Grant programs'
(#2)
3. Grant program for State health access programs (Section 114, p. 72)
13. Grant program for health insurance cooperatives (Section 310, p. 206)
45. Grant program for training in dentistry programs (Section 2215, p. 1240)
(#49)
(#54)
(#55)
(#56)
(#57)
60. Grant program to support the operation of school-based health clinics (Section 2511, p. 1352)
61. Grant program for nurse-managed health centers (Section 2512, p. 1361)
62. Grants for labor-management programs for nursing training (Section 2521, p. 1372)
63. Grant program for interdisciplinary mental and behavioral health training (Section 2522, p. 1382)
65. Healthy Teen Initiative grant program regarding teen pregnancy (Section 2526, p. 1398)
66. Grant program for interdisciplinary training, education, and services for individuals with autism (Section 2527(a), p. 1402)
68. Grant program to implement medication therapy management services (Section 2528, p. 1412)
69. Grant program to promote positive health behaviors in underserved communities (Section 2530, p. 1422)
70. Grant program for State alternative medical liability laws (Section 2531, p. 1431)
71. Grant program to develop infant mortality programs (Section 2532, p. 1433)
72. Grant program to prepare secondary school students for careers in health professions (Section 2533, p. 1437)
73. Grant program for community-based collaborative care (Section 2534, p. 1440)
74. Grant program for community-based overweight and obesity prevention (Section 2535, p. 1457)
75. Grant program for reducing the student-to-school nurse ratio in primary and secondary schools (Section 2536, p. 1462)
80. Grant program to assist veterans who wish to become emergency medical technicians upon discharge (Section 2554, p. 1487)
93. Grant program for national health workforce online training (Section 2591, p. 1629)
94. Grant program to disseminate best practices on implementing health workforce investment programs (Section 2591, p. 1632)
(plus others?)


---
American Indian
97. Program of Indian community education on mental illness (Section 3101, p. 1722)
98. Intergovernmental Task Force on Indian environmental and nuclear hazards (Section 3101, p. 1754)
99. Office of Indian Men's Health (Section 3101, p. 1765)
100. Indian Health facilities appropriation advisory board (Section 3101, p. 1774)
101. Indian Health facilities needs assessment workgroup (Section 3101, p. 1775)
(#102)
104. Grants to Urban Indian Organizations for diabetes prevention (Section 3101, p. 1874)
105. Grants to Urban Indian Organizations for health IT adoption (Section 3101, p. 1877
(#107)
110. Native American Health and Wellness Foundation (Section 3103, p. 1966)
111. Committee for the Establishment of the Native American Health and Wellness Foundation (Section 3103, p. 1968)


---
Trusts
1. Retiree Reserve Trust Fund (Section 111(d), p. 61)
(#11)
(#39)
51. Prevention and Wellness Trust (Section 2301, p. 1286)


---
Scholarships
43. Scholarships for service in health professional needs areas (Section 2211, p. 1224)


---
Boards
52. Clinical Prevention Stakeholders Board (Section 2301, p. 1295)
53. Community Prevention Stakeholders Board (Section 2301, p. 1301)


---
Training programs
44. Program for training medical residents in community-based settings (Section 2214, p. 1236)
106. Mental health technician training program (Section 3101, p. 1898)


---
CLASS Fund
83. CLASS Independence Fund (Section 2581, p. 1597)
84. CLASS Independence Fund Board of Trustees (Section 2581, p. 1598)
85. CLASS Independence Advisory Council (Section 2581, p. 1602)


---
Emergency Care
77. Center for Emergency Care under the Assistant Secretary for Preparedness and Response (Section 2552, p. 1478)
78. Council for Emergency Care (Section 2552, p 1479)


---
Treatment programs
108. Program for treatment of child sexual abuse victims and perpetrators (Section 3101, p. 1925)
109. Program for treatment of domestic violence and sexual abuse (Section 3101, p. 1927)


---
Misc
7. Qualified Health Benefits Plan Ombudsman (Section 244, p. 138)
59. Assistant Secretary for Health Information (Section 2402, p. 1330)
67. University centers for excellence in developmental disabilities education (Section 2527(b), p. 1410)
81. Interagency Pain Research Coordinating Committee (Section 2562, p. 1494)
82. National Medical Device Registry (Section 2571, p. 1501)




Call your representatives and tell them they'll lose your vote next November if they vote for this monstrosity...

31 August 2009

Linking Facebook & Blogger

Soo... Facebook and Twitter integrate well - any tweets I make that aren't direct replies to people are automatically shunted into FB status updates as well. This is nifty.

However, there've been some really good discussions going on in some comment threads of some of my FB posts, and I would really like to open them up to a broader audience, if I could. Does anybody know of a way to tightly integrate comments on a particular blog post on Blogger with the comments on a particular FB link/status update/other entity?

I wouldn't want it to be across-the-board, and the initial link wouldn't necessarily need to be automatic. (That is, I'd be happy to have to establish the initial link between blog post and FB post manually, as long as all the comment integration proceeded automatically from there.)

Anybody have any ideas, or know of anything that would achieve this?

13 April 2009

Facebook and Twitter

To let anyone know who might happen to check this blog regularly, most of my online interactions lately have been on Facebook (find me at brian[dot]skinn[at]gmail[dot]com) and/or Twitter (khemboy). There are a few things I have rattling around that might make it up here eventually, mostly some long-form thoughts and/or social/political/etc. analysis... but for the most part, if you want (for whatever strange reason ;-) an idea of what's rattling around in my head, look for me there.

08 April 2009

Mike Judge, Almost FTW

Just about anyone reading this blog probably has seen Office Space, and as such will nigh-on automatically grin at the mention of 'TPS reports'. Ten years after the original launch of the film, its creator, Mike Judge, revealed that the acronym stands for 'Test Program Set'.

However, the use of TPS is potentially ironic in an entirely different way. Toyota, well known for its manufacturing efficiency, has developed an integrated system and philosophy for its production facilities, called the 'Toyota Production System'... which also fits the 'TPS' acronym. How awesome would it have been if Mike Judge had used as an emblem of corporate bureaucratic drudgery a system that in real life represents one of the most successful examples of streamlined industrial efficiency?

Teh *sigh*...

06 February 2009

Incidental Words

It's remarkable how words that mean one thing in my mind, can mean so many different things in someone else's. How there is so much potential for miscommunication, in virtually every interaction we have with others. How a word, chosen carelessly (or sometimes even carefully), can profoundly alter a situation or a relationship.

How profoundly comforting, then, that though 'man looks at the outward appearance, the Lord looks at the heart.' (1 Samuel 16:7) Regardless of the words (or even non-words) we use, we need never fear God misunderstanding the intent, the heart, that moves our prayers.