[Trinidad]

Al_U_Card, on 2017-March-31, 08:16, said:

Zelandakh, on 2017-March-31, 06:48, said:

Funny, I would say that people's safety is paramount. That difference probably says something about our respective views of the world.

Well, that would make you wrong... since individual well-being is the only thing that really matters.

I get the idea that Zel is right... Something is said about your respective views of the world...

Rik

[kenberg]

This "philosophy of life" stuff is perhaps the most difficult part of the discussion.

David Ignatius has an interesting column (he often does):
https://www.washingt...m=.8533c2673dd0

Quote

The Academy offers a four-point plan for altering this miserable combination of high cost and poor care. First, providers should be paid for value — for patient outcomes, not for the volume of procedures. Second, incentives should empower people to take better care of themselves through wellness programs or lifestyle changes. Third, better connectivity is needed among doctors, patients and others to encourage data-driven advances.

Finally, the Academy argues for community strategies that target the highest-need patients, who are also most costly to treat. The top 5 percent of spenders, often with multiple ailments brought on by obesity or other chronic conditions, account for 50 percent of total U.S. health outlays.

Sounds good, but I am not sure I agree. Take his second point about encouraging healthy lifestyle. I was talking to a friend in Minnesota last night and he mentioned that he goes to the gym 12 (maybe 13, I forget, but the number was a precise figure) times a month. His health care plan pays him to do so. I go to the Y, and I pay them. I prefer my way. I long ago quit smoking, at a time of my choosing. I once drank too much alcohol. I no longer do. I am overweight, but when I increase my exercise my weight goes down. I don't need someone to tell me that my weight goes down when I exercise, and often choose to I act according. I do not respond well to advice, I never have, and I respond even less well to bribes or orders, however well intention ed. I believe I am far from alone in this. Giving people help is fine, coming on as daddy knows best is, for me, a non-starter.

I also am a little skeptical of his first point of "paying for outcomes". How could this be bad? I'll tell you. I have long thought that docs often are too narrowly focused. Patient has complaint X, medicine Y addresses X, so give it too him. Wait. There is no such thing as a medicine that has no side effects, or at least very few. Our current opioid problem is a display of this, but I have seen it again and again in less dramatic form. Doctors do important work, of course they do, but it is a serious error to treat any profession as godlike. If you make pay dependent on doctors solving problem X, you are encouraging the prescription of medicine Y, and often an uncritical encouragement of that medicine.

How do we see life? Not such an easy question.

[gwnn]

So people working in guaranteed safe conditions is not a requirement for well being? Did I or you misread something or are you just a blind ideologue?

[barmar]

kenberg, on 2017-March-31, 08:55, said:

Sounds good, but I am not sure I agree. Take his second point about encouraging healthy lifestyle. I was talking to a friend in Minnesota last night and he mentioned that he goes to the gym 12 (maybe 13, I forget, but the number was a precise figure) times a month. His health care plan pays him to do so. I go to the Y, and I pay them. I prefer my way. I long ago quit smoking, at a time of my choosing. I once drank too much alcohol. I no longer do. I am overweight, but when I increase my exercise my weight goes down. I don't need someone to tell me that my weight goes down when I exercise, and often choose to I act according. I do not respond well to advice, I never have, and I respond even less well to bribes or orders, however well intention ed. I believe I am far from alone in this. Giving people help is fine, coming on as daddy knows best is, for me, a non-starter.

You have to know that you're somewhat exceptional in achieving all those lifestyle improvements. Most people know that they should do these things, but it's difficult to put it into practice. Smokers mostly say they know it's a nasty habit, but it's an addiction and difficult to stop. Everyone knows they should eat healthy and exercise, but they have busy lives and it's hard to fit these in.

If we give these people additional help and incentives, they're more likely to make these improvements. This will cut costs for whoever is paying for health care (insurance companies here, national health services in other developed countries), and these savings get passed on to rate-payers and taxpayers. This is a win-win situation.

[Al_U_Card]

Trinidad, on 2017-March-31, 08:34, said:

I get the idea that Zel is right... Something is said about your respective views of the world...

Rik

Support of a strawman is hardly germane to tbe issue. Opposing or tangential viewpoints serve to broaden our horizons and help to encourage an open mind. Lock-step agreement, like consensus and knee-jerk reactions (on both sides) lead nowhere of interest or importance. I learn much and change my position with each new piece of information and try to discern conjecture and subjectivity when it alters a perception. Different is not always (or even often) worse.

[kenberg]

barmar, on 2017-March-31, 09:05, said:

You have to know that you're somewhat exceptional in achieving all those lifestyle improvements. Most people know that they should do these things, but it's difficult to put it into practice. Smokers mostly say they know it's a nasty habit, but it's an addiction and difficult to stop. Everyone knows they should eat healthy and exercise, but they have busy lives and it's hard to fit these in.

If we give these people additional help and incentives, they're more likely to make these improvements. This will cut costs for whoever is paying for health care (insurance companies here, national health services in other developed countries), and these savings get passed on to rate-payers and taxpayers. This is a win-win situation.

Talking with a friend, I forget the topic, I began "I know I am unusual but" and I was immediately interrupted with emphatic agreement. Well, yes and no. We are all unusual. But in many ways I think I am not. Resisting those who have decided what is best for us and then try to impose it on us is, I think, very widespread. We see it in books, movies, songs, and in real life. Help is useful. Help is very useful. I favor help.

But we have all heard the story, I have probably referred to it before, of the boy who showed up at the Boy Scout meeting with bruises. He had tried to help an old lady across the street and she didn't want to go.

[Zelandakh]

kenberg, on 2017-March-31, 19:19, said:

Resisting those who have decided what is best for us and then try to impose it on us is, I think, very widespread.

Where the person concerned notices it yes. But most people seem to be fairly unaware of the social games that go on all of the time and therefore go along with those around them without thinking too much about it. Peer pressure was the term I heard all of the time when I was a child. That is one form of this. I have a book recommendation for you here Ken - Games People Play is widely regarded as one of the definitive works in this field and might open your eyes to some of the manipulation going on around you that you are missing. The fact is that everyone is "imposed on" every day; we just do not notice it the majority of the time.

[kenberg]

Zelandakh, on 2017-April-01, 05:23, said:

Where the person concerned notices it yes. But most people seem to be fairly unaware of the social games that go on all of the time and therefore go along with those around them without thinking too much about it. Peer pressure was the term I heard all of the time when I was a child. That is one form of this. I have a book recommendation for you here Ken - Games People Play is widely regarded as one of the definitive works in this field and might open your eyes to some of the manipulation going on around you that you are missing. The fact is that everyone is "imposed on" every day; we just do not notice it the majority of the time.

Published 1964. I think I bought it, I recall it being often cited. Of course we do get manipulated. I put a lot of trust in my instincts but sometimes they go wrong. Sometime in the mid 1970s I was visiting the Berkeley campus for a bout a week. One day on campus a young woman suggested I join her for dinner at her place. Yes she was attractive but she was also interesting. I was not married at the time. I accepted. It was a group house and after not long I decided something was weird. I abruptly announced that I was leaving and I left. The next morning there was an article in the SF Chronicle identifying the house as a Mooney recruitment center. There have been many such things in my life and, I assume, in everyone's.

Yes people get suckered. I have been suckered. But we must develop our instincts to identify and avoid it.

Of course I am straying a bit. Paying people to go to the gym is different from getting them into the Moonies. But the instincts that keep you out of the Moonies are closely related to the instincts that produce rebellion at this sort of care managing.

[awm]

There are already plenty of incentives to do the wrong thing -- sitting on the couch is cheaper than going to the gym, unhealthy food is cheaper than healthy food, gas guzzling cars are cheaper than hybrids, etc.

I don't think trying to reverse those incentives is really a bad thing. In particular here it's being done by making the "better" thing cheaper (pay people to go to the gym) rather than making the "worse" thing more expensive (taxes on extra large soft drinks).

Of course there are some people who just like to be contrary...

[PassedOut]

American novelist Stephen King has a piece about Trump in the Guardian today: ‘How do such men rise? First as a joke’

Quote

I started thinking Donald Trump might win the presidency in September of 2016. By the end of October, I was almost sure. Thus, when the election night upset happened, I was dismayed, but not particularly surprised. I didn’t even think it was much of an upset, in spite of the Huffington Post aggregate poll, which gave Hillary Clinton a 98% chance of winning – an example of wishful thinking if ever there were one.

Some of my belief arose from the signage I was seeing. I’m from northern New England, and in the run-up to the election I saw hundreds of Trump-Pence signs and bumper stickers, but almost none for Clinton-Kaine. To me this didn’t mean there were no Clinton supporters in the houses I passed or the cars ahead of me on Route 302; what it did seem to mean was that the Clinton supporters weren’t particularly invested. This was not the case with the Trump people, who tended to have billboard-sized signage in their yards and sometimes two stickers on their cars (TRUMP-PENCE on the left; HILLARY IS A CRIMINAL on the right).

Brexit also troubled me. Most of the commentators brushed its importance aside, saying that the issue of whether or not Britain should leave the EU was very different from that of who should become the American president, and besides, British and American voters were very different animals. I agreed with neither assessment, because there was a vibe in the air during most of 2016, a feeling that people were both frightened of the status quo and sick of it. Voters saw a vast and overloaded apple cart lumbering past them. They wanted to upset the mother*****er, and would worry about picking up those spilled apples later. Or just leave them to rot.

I was seriously worried about a Trump victory, expecting that Nate Silver had it about right, but I supposed that Hillary would win in the end. Wrong.

But, as Ken has pointed out several times, it's important to know the concerns of folks who voted for Trump. King's characters are fictional, but I know a couple of them anyway -- and I expect that I'm not alone in that.

[cherdano]

Jared Kushner must be a true genius. He

• is in charge of peace in the middle east (Haaretz),
  
• will solve the opioid crisis (Vox),
  
• headsthe White House Office of Business Innovation, which aims to reform the US government to make it "run like a company", (AOL), and
  
• is leading the preparation for the first Trump-Xi Jinping meeting (Financial Times).

Since surely Trump wouldn't give a 36-year old such responsibility unless he was capable of mastering all these tasks in a truly outstanding manner, I am sure he is the most brilliant man alive. So we will soon see peace in the middle east, drug problems in the US as an issue of the past, a US government that works efficiently for everyone, and China will be a cooperative and suddenly fully democratic partner.

There is just one piece of bad news - Kushner quietly transferred peace in the middle east to next week's to-do list. Hard to believe this is the only Onion link in my list.

ldrews - still expecting lots of positive change from this administration? Just checking.

[kenberg]

awm, on 2017-April-01, 10:10, said:

There are already plenty of incentives to do the wrong thing -- sitting on the couch is cheaper than going to the gym, unhealthy food is cheaper than healthy food, gas guzzling cars are cheaper than hybrids, etc.

I don't think trying to reverse those incentives is really a bad thing. In particular here it's being done by making the "better" thing cheaper (pay people to go to the gym) rather than making the "worse" thing more expensive (taxes on extra large soft drinks).

Of course there are some people who just like to be contrary...

Contrary perhaps. I would describe it as a lifelong aversion to being monitored. Becky got back from a walk a couple of hours ago, she and a group of women usually meet on Saturdays and walk somewhere. I asker where she went and whether she enjoyed it. She had, and she told me a couple of amusing things about it. It would never cross my mind to ask her how far she walked, how long ot took whether she had recorded this in a notebook, etc. She recently finishe a maybe 12 week program at the Y. I did not sign up . I had done one previously They give you a pedometer to wear. You record the weights you lift. Other things that I don't recall. No. I don wear a pedometer. I go for various walks, I know about how long they are, I know roughly my pace. That's enough for me, and I cannot imagine why anyone else would care. I recently had some problems and stopped lifting weights, but I plan to get back to it. Does anyone really care how much and how often?

This takes many forms. I was coming to a party bringing two bottles of wine.Someone asked me what wine I was bringing. One white and one red, I said,. I wasn't trying to be a smart aleck, that was just the first thing that came into my head. I can tell one red wine from another but I was not focused on just what I was bringing and didn't care to. He can drink what I bring or not.

People are now talking of paying kids to do their homework. Maybe some schools are already doing this. It repels me. And it would not have worked for me. I got paid for doing work. I often did not do my homework, but unless the pay was too large to resist, I would have laughed it off. If they paid enough I suppose I would do it. And maybe someone else's also, we could split the pay. But who is the idiot that would be paying me to prove a trig identity?

I'm not exactly Greta Garbo, as in "I want to be left alone". But I do think we are going way overboard in monitoring. If a guy wants to go to the gym, let him. It's a simple act. Or it should be..

[ldrews]

cherdano, on 2017-April-01, 12:02, said:

ldrews - still expecting lots of positive change from this administration? Just checking.

Yep, I pretty much like the way things are going. Attempts to reduce size of government, reduce amount of regulation, doing cost/benefit analysis on regulations, starting to bring immigration and borders under control, reducing tensions with Russia, renegotiating adverse trade agreements, changing direction in the Middle East. Pretty much what Trump promised during the campaign.

How about you? Still focusing on the theatrical goings on? Not enough holding hands and singing "Kumbaya"?

I am loving the circus surrounding the Russia Connection/Wiretapping/Incidental Surveillance/Unmasking, aren't you?

[Al_U_Card]

ldrews, on 2017-April-01, 13:28, said:

Yep, I pretty much like the way things are going. Attempts to reduce size of government, reduce amount of regulation, doing cost/benefit analysis on regulations, starting to bring immigration and borders under control, reducing tensions with Russia, renegotiating adverse trade agreements, changing direction in the Middle East. Pretty much what Trump promised during the campaign.

How about you? Still focusing on the theatrical goings on? Not enough holding hands and singing "Kumbaya"?

I am loving the circus surrounding the Russia Connection/Wiretapping/Incidental Surveillance/Unmasking, aren't you?

I just watched LBJ's last interview (with Cronkite) and the man certainly knew how to deal with congress. (His having run the place for almost a decade surely helped....) Trump has no such bona fides so he appears to be treating them like a business associate and his advisors as subordinates. So few "swamp-dwellers" is causing a disconnect with Congress and they may never have seen such an approach and it might just shake them up enough to get some stuff done.
Will we like what that is? Plus ca change......

[ldrews]

Al_U_Card, on 2017-April-01, 16:14, said:

I just watched LBJ's last interview (with Cronkite) and the man certainly knew how to deal with congress. (His having run the place for almost a decade surely helped....) Trump has no such bona fides so he appears to be treating them like a business associate and his advisors as subordinates. So few "swamp-dwellers" is causing a disconnect with Congress and they may never have seen such an approach and it might just shake them up enough to get some stuff done.
Will we like what that is? Plus ca change......

Trump is a political neophyte and it shows. Also, Trump is not really a Republican, but rather a populist who hijacked the Republican nomination by going directly to the voters. So Trump has almost no traditional political capital. We will see if his direct appeal to the voting base is sufficient to accomplish anything legislatively.

[barmar]

ldrews, on 2017-April-01, 16:57, said:

We will see if his direct appeal to the voting base is sufficient to accomplish anything legislatively.

So are you expecting him to accomplish everything through Executive Orders? Didn't he accuse Obama of abusing that power?

But he also complained that Obama spent too many weekends on the golf course. Maybe it doesn't count if you own the course.

[ldrews]

barmar, on 2017-April-01, 17:46, said:

So are you expecting him to accomplish everything through Executive Orders? Didn't he accuse Obama of abusing that power?

But he also complained that Obama spent too many weekends on the golf course. Maybe it doesn't count if you own the course.

Since I see Trump as having little clout with Congress, yes I expect him to use Executive Orders. The problem is that, as we have seen, Executive Orders can be reversed by the next Administration. To me, the upside is that most of things that I would like to see happen can probably be accomplished via Executive Orders.

Focusing on golf course usage is again getting distracted from the essential operations. I really don't care how often he plays golf, I care that he initiates actions to reduce government, reduce regulations, etc., etc.

Don't watch the hands, don't listen to the chatter, focus on what cup is the pea under! Otherwise you will lose.

[cherdano]

ldrews, on 2017-April-01, 13:28, said:

Yep, I pretty much like the way things are going. Attempts to reduce size of government, reduce amount of regulation, doing cost/benefit analysis on regulations, starting to bring immigration and borders under control, reducing tensions with Russia, renegotiating adverse trade agreements, changing direction in the Middle East. Pretty much what Trump promised during the campaign.

I see, ldrews already needs to coddle snowflake Trump and award him participation trophies for attempting to fix things...

Oh, and if the Russia scandal is so ridiculous, why did the White House lie about it so many times? Ah, sure, brilliant strategy to distract the media!!! Trumps is playing 5D chess again!!!!!

[kenberg]

ldrews, on 2017-April-01, 16:57, said:

Trump is a political neophyte and it shows. Also, Trump is not really a Republican, but rather a populist who hijacked the Republican nomination by going directly to the voters. So Trump has almost no traditional political capital. We will see if his direct appeal to the voting base is sufficient to accomplish anything legislatively.

I think you are understating the issue. Here is a thought experiment. Imagine Trump, after shedding his political neophytism (probably not a word), is able to push through exactly the healthcare bill that he thinks is best. What would be in it? I have no idea, and I doubt anyone else has. Maybe Ivanka knows, or Jared knows, but I don't. Trump likes to win. Everyone understands that. But beyond winning, what does he wish to accomplish?

Some people pay more attention to politics than I do, some less, place me maybe in the seventieth percentile. Everyone notices something eventually. I think if the plan is to appeal to a voting base, after a while the base will ask just what the hell he really has in mind. If it is simply that he likes winning, never mind at what as long as it is winning, the appeal will fade away.

[jogs]

barmar, on 2017-April-01, 17:46, said:

So are you expecting him to accomplish everything through Executive Orders? Didn't he accuse Obama of abusing that power?

Obama used executive orders to legislate from the oval office. Trump has used executive orders to overturn Obama's executive orders and to facilitate the enforcing of current law.

Immigration and Nationality Act of 1952
https://en.wikipedia...ity_Act_of_1952

Where is the judicial branch given any authority on immigration?

Immigration and Nationality Act of 1965
https://en.wikipedia...ity_Act_of_1965

This judicial overreach started with the Warren Court. Where in the constitution are low level circuit judges given the authority to stay an order by the president of the United States?