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    January 31

    Little Foxes - Lilian Hellman

    I read this play back in college, i still remember the book with Hellman's plays - it was golden color with red title.
     
    This brings back old memories from my school days except that the potrayal of a southern family in 1900s with some serious greed issues is something you dont see that often.
     
    The theater is really intimate, I actually really liked the acting even though its quite sad to see so many mean people but the play was really good. Review from Chicago Reader:
     
    ------------------
    Sharp Claws

    Lillian Hellman’s portrait of a family with predation in its blood

    THE LITTLE FOXES Shattered Globe Theatre

    By Albert Williams

    January 15, 2009

    I belonged, on my mother’s side, to a banking, storekeeping family from Alabama,” wrote Lillian Hellman in her 1973 memoir Pentimento. “Sunday dinners were large [and] long, with high-spirited talk and laughter from the older people of who did what to whom, what good nigger had consented to thirty percent interest on his cotton crop and what bad nigger had made a timid protest, what new white partner had been outwitted.” Though her teenage sense of righteous morality was outraged by the corruption she observed at her family’s dinner table, Hellman recalled, “I began to think that greed and the cheating that is its usual companion were comic as well as evil and I began to like the family dinners with the talk of who did what to whom.”

    It’s that mixture of horrified revulsion and amused fascination that makes Hellman’s 1939 drama The Little Foxes such a durable and compelling work. This isn’t only a classic work of theater, it’s ripping good entertainment—suspenseful, sharp-witted, thought-provoking, sometimes harrowing, and sometimes laugh-out-loud funny. And it’s a fabulous vehicle for good ensemble acting, as Shattered Globe Theatre’s fine revival makes abundantly clear.

    The central figure, Regina Hubbard Giddens, is one of the great antiheroines of American literature: monstrous but also human, ruthless and cunning but also full of grit, vigor, intelligence, and dark wit. Modeled on Hellman’s grandmother Sophie—a German Jew whose family settled in New Orleans in the 1850s—Regina is deeply frustrated because, as a woman living in 1900 Alabama, she’s relegated to second-class status. Her late father left all his money to her brothers, Ben and Oscar Hubbard, even though she’s smarter and shrewder than both of them put together. She’s financially dependent on her husband Horace Giddens—a wealthy businessman with a serious heart condition—although their relationship went sour years ago. At the play’s start, Regina and Horace haven’t slept together in ten years.

    When Regina and her brothers get an opportunity to invest in a cotton mill a Chicago businessman wants to build in their town, Regina must coax her share of the investment out of Horace, who wants no part of the deal—or any deal involving his wife’s rapacious family.

    Many critics have analyzed The Little Foxes as an attack on the racism of the jim crow south or a protest against predatory capitalism. Some detractors, citing Hellman’s unabashed liberal-left politics, have called it communist propaganda. As the program note for this 70th-anniversary revival points out, today’s “government bailouts, predatory loans, and the socialism/capitalism debate” render it more significant than ever. But what strikes me most about the play is its depiction of the obstacles its female characters confront, and the choices they must make. The Hubbard clan’s other matriarch is Regina’s genteel and eccentric sister-in-law Birdie, wife of the stupider of Regina’s two brothers, Oscar—a vulgar bully who married Birdie for her family’s cotton fields. Delicate where Regina is tough, submissive where Regina is assertive, she’s the victim Regina is determined not to be.

    Yet the two are much alike, trapped in the inferior position imposed upon them by custom. And Ben and Oscar are intent on perpetuating custom by arranging a marriage between Oscar and Birdie’s rascally, feckless son Leo, and Alexandra, Regina and Horace’s 17-year-old daughter—a sweet and spirited girl pulled between the influences of her mother and her aunt.

    Owning a piece of a cotton mill would launch the Hubbards from upper-middle-class prosperity to genuine wealth. To Ben and Oscar, riches mean joining Alabama’s ruling aristocracy. For Regina, they represent a chance to get the hell out. She dreams of going to Chicago, with its “crowds of people and theatres and lovely women.” She wants freedom, and she’ll do anything to get it, whether it’s using her sex appeal to charm the Chicago businessman or—but that would be giving away the ending. Suffice it to say that The Little Foxes is about people who will lie, cheat, steal, blackmail, and even murder to get what they want.

    The Little Foxes is a well-made play in the classic style, though in this staging the original three acts have been compressed into two. The opening scene is a textbook example of traditional dramaturgy, as minor characters set the scene with exposition-packed chitchat, paving the way for the entrance of the star playing Regina.

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    CC2C

    I just saw the worst movie ever, think bad chinese kung fu combined with the worst david dhavan flick and you get Chandini Chowk to China. I was laughing the whole time, imagine this scene - most intense kung fu climax is about to happen and there is a 10 minute monologue and flashback sequence that goes through the whole movie... arghhhh...
     
    from Wiki:
     

    Chandni Chowk to China (Hindi: चाँदनी चौक टू चाईना , Urdu: چاندنی چوت ٹو لندچوس) is a Hindi film which released on 16th January 2009. It is directed by Nikhil Advani and stars Akshay Kumar and Deepika Padukone in the lead roles, with Hindi cinema veteran Mithun Chakraborty and Hong Kong action cinema veteran Gordon Liu among the co-stars. In addition to being shot in China, many parts of the film were shot in Bangkok, Thailand,[1][2] although some of the China scenes were shot in sets in the Shanghai Film Studio.[2] This is Warner Bros. Pictures' first Hindi film.[2] The film is the first Bollywood movie to get a North American release from a major studio.[3]

    January 30

    Zadie Smith on reading

    Such an amazing writer!
     
    I am in the process of listening to Smith's White Teeth on audio tape and I am thoroughly enjoying it, all the different languages and accents that she has so beautifully and accurately captures in England.
     
    Here's a piece of her's telling the reader that he has an obligation to the writer :-)
     
    Note to readers: a novel is a two-way street
    A novel is a two-way street, in which the labour
    required on either side is, in the end, equal. ...
    The more accurate analogy is that of the amateur
    musician placing her sheet music on the stand and
    preparing to play. She must use her own, hard-won,
    skills to play this piece of music. The greater the
    skill, the greater the gift she gives the composer and
    the composer gives her.
     . .
    Reading is a skill and an art and readers should take
    pride in their abilities and have no shame in
    cultivating them if for no other reason than the fact
    that writers need you. To respond to the ideal writer
    takes an ideal reader, the type of reader who is open
    enough to allow into their own mind a picture of human
    consciousness so radically different from their own as
    to be almost offensive to reason. . . .
    What I'm saying is, a reader must have talent. Quite a
    lot of talent, actually, because even the most
    talented reader will find much of the land of
    literature tricky terrain. For how many of us feel the
    world to be as Kafka felt it, too impossibly
    foreshortened to ride from one village to the next? Or
    can imagine a world without nouns, as Borges did? How
    many are willing to be as emotionally generous as
    Dickens, or to take religious faith as seriously as
    did Graham Greene?
     . . .
    Readers fail writers just as often as writers fail
    readers. Readers fail when they allow themselves to
    believe the old mantra that fiction is the thing you
    relate to and writers the amenable people you seek out
    when you want to have your own version of the world
    confirmed and reinforced.
     . .
    "A work of art," said Nabokov, "has no importance
    whatever to society. It is only important to the
    individual, and only the individual reader is
    important to me."
    A writer with such strong opinions would find it hard
    to survive in the present literary culture, the idea
    of the "individual reader" having gone into terminal
    decline. In writing schools, in reading groups, in
    universities, various general reading systems are
    offered - the post-colonial, the gendered, the
    postmodern, the state-of-the-nation and so on. They
    are like the instructions that come with furniture at
    IKEA. All one need do is seek out the flatpack novels
    that most closely resemble the blueprints already to
    hand. There is always, within each reading system, an
    ur novel - the one with which all the other novels are
    forced into uncomfortable conformity. The first
    blueprint is drawn from this original novel, which is
    usually a work of individual brilliance, one that
    shines so brightly it creates a shadow large enough
    for a little cottage industry of novels to survive in
    its shade. Such novels have a guaranteed audience: an
    appropriate reading system has been created around the
    first novel and now makes room for them.
    This state of affairs might explain some of the
    present animosity the experimentalist feels for the
    realist or the cult writer or the bestseller - it's
    annoying and demoralising to feel that readers are
    being trained to read only a limited variety of
    fiction and to recognise as literature only those
    employing linguistic codes for which they already have
    the key. The upshot of this is that the intimate and
    idiosyncratic in fiction is everywhere less valued
    than the ideologically coherent and general. When the
    world is nervous, state-of-the-nation novels bring
    great comfort. The Nobel went to Pasternak, not
    Nabokov.
    January 26

    NPR Report: Team Works To Identify Birds Hit By Planes

    I heard this on All Things Considered this morning...!
     
    Team Works To Identify Birds Hit By Planes
     
    Carla Dove and her team at the feather-identification lab at the Smithsonian Institution's National Museum of Natural History, study snarge — that's the bird goo that is wiped off an aircraft after it hits a bird.

    If any bird remains are found on the US Airways jet that crashed Thursday in the Hudson River in New York City, it will be sent to Dove's lab in Washington. The lab gets about 4,000 such samples each year.

    "Every day we get bird strikes in the mail and we have a whole team here and we have a couple of tools in our toolbox here to help us do bird IDs," Dove tells NPR's Melissa Block.

    Feathers from bird strikes can yield a lot of information about the birds, Dove says.

    More....

    Statement by the President on the occasion of India Republic Day

     
    THE WHITE HOUSE
    Office of the Press Secretary
    For Immediate Release                                                        January 25, 2009
    STATEMENT BY THE PRESIDENT
    Message on the occasion of India Republic Day
    As the people of India and people of Indian origin in America and around the world celebrate Republic Day on January 26, I send the warmest greetings of the American people to the people of India.  Together, we celebrate our shared belief in democracy, liberty, pluralism, and religious tolerance.
    Our nations have built broad and vibrant partnerships in every field of human endeavor.  Our rapidly growing and deepening friendship with India offers benefits to all the world⿿s citizens as our scientists solve environmental challenges together, our doctors discover new medicines, our engineers advance our societies, our entrepreneurs generate prosperity, our educators lay the foundation for our future generations, and our governments work together to advance peace, prosperity, and stability around the globe.
    It is our shared values that form the bedrock of a robust relationship across peoples and governments.  Those values and ideals provide the strength that enables us to meet any challenge, particularly from those who use violence to try to undermine our free and open societies.  As the Indian people celebrate Republic Day all across India, they should know that they have no better friend and partner than the people of the United States.  It is in that spirit, that I also wish Prime Minister Singh a quick recovery.

    A Dog with a History!

    Facinating!
     
    Puppy love: rare breed offered to Obamas

    The government in Peru has offered Barack Obama and his family a rare breed of dog after the president-elect promised his daughters a new puppy for the White House.
    The uncommon South American breed is hairless and hypoallergenic. It is precisely for this reason that the dog has been offered to Obama as his older daughter Malia, 10, is allergic to most breeds.
     
    The bald, jagged-toothed canine also comes with a rich history.
     
    It dates back to around 750 A.D. in Peru. Some theories point to the dog being used for trade between Peru and Mexico for textiles. The Spanish may have also used it for food.
     
    While there are both coated and hairless breeds, the Incans used to call them in their native language of Quechua 'Ca-Allepo' or 'dog without vestments'.
    When the Spanish conquered Peru, legend has it that the dogs were found in Inca homes among orchids and the Spanish gave them the name 'Perros Flora' or 'flower dog'.
     
    Over the years the name has stayed close to the original as the dog is known throughout Europe and the United States as the Peruvian Inca Orchid. 
    With the announcement that Obama would be getting a dog for his daughters, countless offers and suggestions for particular dogs have poured in. However, it could be the South American hairless hound that could be roaming the gardens of 1600 Pennsylvania soon.
     
    http://www.russiatoday.com/features/news/33112?gclid=CL7D2sfYrJgCFQdrgwodvROzmg

    Slumdog Reaction in India

    Finally a good review from India.. such a strong dislike to this movie in mumbai.. its quite shocking.
     
    Slum Dil De Chuke Sanam
     

    Every now and then life presents you with a movie to fall completely and unequivocally in Love with. It might not necessary be the finest film around -- not that there is any empirical measure -- but smitten, you adore the film despite, and even for, its flaws, loving it warts and all. It's irrational, immature, and born out of a purely personal whimsy that can never quite be explained.

    Love is never about quality, about banal star-ratings and any sort of technical competence checklist. This is about a kind of cinematic experience that, for whatever reason, fills you with such unbridled joy that you long to share it, to gush over it, to grinningly tattoo it into your brain. Like all Love, you want to partake in it repeatedly, show the film off to your closest comrades, and eventually bring her home and hope your mother likes her too.

    My current obsession just happens to be the world's pin-up girl, but even if they weren't slathering over Slumdog Millionaire [Images], I would have been. Love, as said, capital L and all.

    Which is why, as the film finally releases in India this Friday, I found it prudent to rush to her defence. She'll do wonderfully well by herself, of course, but it hurts me how misunderstood she is, and I felt the need to speak up.

    First off, I'm all for debate. Opinion can never be wrong, every film has its share of detractors, and a cogently argued review ripping apart a masterpiece is as valid as any other, likely even more so because of the fresh perspective it offers. Some of my most frequently read critics have expressed misgivings about the film and -- obviously not making me like the film any less -- these are opinions to reflect upon.

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    Flexible Display Screens

    cant wait for these laptops, e-newspapers...!
     
     
    Bend me, shape me, anyway you want me
    Jan 22nd 2009
    From The Economist print edition


    Electronic screens as thin as paper are coming soon

    OVER the years, the screens on laptops, televisions, mobile phones and so on have got sharper, wider and thinner. They are about to get thinner still, but with a new twist. By using flexible components, these screens will also become bendy. Some could even be rolled up and slipped into your pocket like a piece of electronic paper. These thin sheets of plastic will be able to display words and images; a book, perhaps, or a newspaper or a magazine. And now it looks as if they might be mass produced in much the same way as the printed paper they are emulating.

    The crucial technological development happened recently at the Flexible Display Centre at Arizona State University. Using a novel lithographic process invented by HP Labs, the research arm of Hewlett-Packard, and an electronic ink produced by E Ink, a company spun out of the Massachusetts Institute of Technology, the centre’s researchers succeeded in printing flexible displays onto long rolls of a special plastic film made by DuPont. To make individual screens, the printed film is sliced up into sections rather as folios for magazines or newspapers would be cut from a printed web of paper.

    The resulting “electrophoretic” screens are lightweight and consume only a fraction of the power of a typical liquid-crystal display (LCD). Their first use is likely to be by the American army, which helped pay for the project. It hopes its soldiers will be able to use the screens as electronic maps and to receive information. The idea is that the flexible screens will replace some of the bulky devices that soldiers now have to lug around. If that works, the retail market beckons. The first trials of consumer versions could begin within a few years.


    Although printing flexible screens in this way will help to make them affordable, they still have a long way to go to catch LCDs. For that, two things need to happen. One is that the displays must turn from black-and-white to colour. The other is that they must be able to refresh their images at a rate fast enough to show moving pictures. Researchers at the Flexible Display Centre and elsewhere are working on ways to do that, and there seems little doubt it will happen. Yet even with their present limitations, flexible screens have some important advantages over LCDs.

    For a start, LCDs are difficult and costly to make. Most are produced in huge, ultra-clean factories using batch processes similar to those for making silicon chips. Layers of material which work as filters, electrodes, transistors and the liquid crystal itself are deposited onto a thin glass plate to form a sandwich that is covered with another pane of glass. At each stage the layers are etched to make electrical connections. This is a fractious, finicky process and tiny defects in the materials, or failures in the alignment of the different layers, can result in 20% or more of a batch being scrapped. Moreover, the glass means LCDs are heavy and easily broken, as anyone who has dropped a laptop knows to his cost.

    Another drawback is that LCDs consume a lot of power because they are lit from behind. An LCD works because, when an electrical field is applied to the transparent liquid crystals that form each picture element, or “pixel”, within the screen, the crystals become opaque. Red, green and blue filters then allow different colours to show within each pixel, but light has to be shone through them for this to happen. That, plus the fact that the liquid crystals will revert to transparency if the power goes off, mean an LCD eats batteries. It also means that the image can be hard to see in bright sunlight.

    Electrophoretic displays work in a different way, using a form of electronic ink that has been under development since the 1970s. E Ink’s version employs tiny capsules filled with a clear fluid containing positively charged white particles and negatively charged black ones. The capsules are arranged as pixels and electric charges applied to each pixel pull either the black or the white particles towards the top of the capsule (and the opposite colour to the bottom). Unlike an LCD’s, this image does not require backlighting. Instead, the user relies on reflected light, as he would if he were reading a sheet of printed paper. Moreover, once the particles in the capsules have settled down they stay put. That means the image remains on the screen without drawing power. A further dose of electricity is required only when the image changes; when a user “turns” to the next page, for example. Not only does this mean that electrophoretic displays are cheaper to run, the lack of constant refreshment makes them more comfortable to read—as comfortable, it is claimed, as printed paper.


    In fact, electrophoretic displays are already available, but they are built on glass in a similar way to an LCD. One such device is the Kindle, launched by Amazon, an American online retailer, in November 2007. Thanks in part to a ringing endorsement by Oprah Winfrey on her television show, it is now a big hit and prospective purchasers face long delays getting their hands on one. The Kindle, which costs $359, is about the size of a slim paperback (see picture below). It can download books and other publications directly using a built-in wireless connection, and offers electronic editions of some newspapers.

    It is not alone, though. Its rivals include Sony’s Reader, and a device with a larger screen launched late last year by iRex, a Dutch company. And, later this year, an electrophoretic reader that is built the LCD way, but on plastic, rather than on glass, will also be launched to take them on.

    Plastic Logic, the firm that makes this reader, was founded by researchers at the University of Cambridge, has its headquarters in Silicon Valley and does its manufacturing in Germany. The firm uses an adapted version of LCD manufacturing which employs electronic ink and plastic substrates to make its screens. Plastic Logic’s prototype reader, which has a screen about the size of a magazine, is a mere 7mm thick and weighs less than 450 grams. It should run for a week in normal use before its battery needs recharging.

     

    Plastic Logic says its reader will be aimed at businessmen who might want to store, on a single machine capable of being slipped into their briefcase, all the paper documents and spreadsheets that at present they normally print out. Books and periodicals can be read too. And for those who think they would miss the ability to scribble comments and underline things that paper provides, the reader’s screen will be touch-sensitive, allowing such annotations to be made.

    Even Plastic Logic’s approach, though, is likely to be transitional. If Hewlett-Packard’s “self-aligned imprint lithography”, as it describes its new technology, can be commercialised, it will take the manufacture of screens through what has proved a crucial transition in every industry in which it has happened—from batch processing to continuous manufacture.

    The breakthrough here was to work out a way to simplify the process by which the electronic circuit that controls the pixels is carved out of layers of conducting, semiconducting and insulating materials. In standard silicon-based electronics, this involves the repeated application of resistive materials to protect those parts of the layer being etched that need to be preserved. Hewlett-Packard’s scientists, however, have worked out how to print a layer of resistive material of variable height on top of all the other layers. After each stage of the etching process a fixed depth of this is dissolved away, exposing a different part of the circuit to the etching chemicals.

    The result is a continuous process, much like a printing press. This promises to become a cost-effective mass-production method which Hewlett-Packard will license to other producers, says Prith Banerjee, the company’s research director. Once that happens, he hopes, flexible screens could be used in all sorts of devices.

    $43,000 Suit!

    and we are in a recession.. hmm.. for some people I guess it never changes!
     

    The $43,000 Recession Suit

    Even as overall sales wane, some luxury makers push the price envelope; 'one really special thing'

    By RAY A. SMITH

     Qiviuk; Ericka Burchett/Wall Street Journal; Startraks Photo

    Brioni 'Vanquish II' suit, $43,000 (far right); earrings, from Van Cleef & Arpels, in 18-karat white gold with diamonds and pink sapphires, $52,500; at the Qiviuk store in New York, suits cost $20,000.

    As the worst financial crisis since the Great Depression swept the globe in October, the high-end Italian clothier Brioni introduced the most expensive line of men's suits in its history. Made to measure from rare fibers such as vicuna, pashmina and Qiviuk, the suits have price tags as high as $43,000.

    "The timing was not fortunate for us," says Andrea Perrone, Brioni's co-chief executive. But Mr. Perrone decided to go ahead, figuring it would send a reassuring signal to customers that Brioni was refusing to compromise on "high-quality initiatives."

    As manufacturers and retailers hunker down for what could be a prolonged recession, Brioni and a handful of other luxury-goods companies continue to roll out new products at exorbitant prices. This past fall, French luxury label Hermès introduced limited-edition silk scarves inspired by works of the artist Josef Albers at an eye-popping $2,800 each -- the most expensive silk scarf Hermès has ever offered. Van Cleef & Arpels last month launched its 120-piece couture jewelry line, Les Jardins, with prices as high as $2.5 million. Kiton, the Italian designer label, says an $8,125 cashmere-and-vicuna sport coat will be arriving at its stores in a few weeks.

    These products and price points were in the works long before consumer spending fell sharply this fall. But the labels behind them are taking comfort in the belief that their target customers -- the wealthiest 1% to 2% of consumers world-wide -- are still spending, even if they are buying fewer things. Individuals in this group, whom Mr. Perrone calls the "elite of the elite," have bought 30 of the $43,000 suits.

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    Khabar Article: If I were an Indian Muslim

    Such a timely article but it defeats much of what it says knowing that the writer is not an Indian Muslim himself. It seems to have one message at the end, that of trying to suggest repealing the set of laws that are meant to protect muslims. Something that is lacking is the description of this law, its origin and its meaning. Also I find that describing the Shah Bano case a little will explain to the reader why this was such an important case.
     
    All laws are made for a reason and without going into an understanding of why that reason does not serve to solve rather than aggravate the issue, your request to reappeal it is only seen as an emotional complaint at trying to solve a bigger problem. A solution not based on logic and rational thought cannot be taken seriously.
     
    If I Were an Indian Muslim
    One of the central beliefs of the Hindu worldview is the concept of maya, which suggests that the world, as we know it, does not exist—that it is a grand divine illusion.

    It may be ridiculous to even suggest something so seemingly outlandish, if it were not for the fact that today this belief has the stamp of scientific validity. Modern quantum physics confirms that matter does not exist. Broken down to their final elemental level, all sub-atomic particles of all matter—from dirt to human bodies, and from pins to airplanes—are ultimately matter-less.

    If the world were indeed maya (illusory) at the subtlest level, then it follows that there could be countless other illusions within which mankind must function. One such illusion could well be the belief that if YOU fix up and improve yourself, MY world will become fine. From the individual to the collective, from spousal conflicts to national and religious conflicts, this belief that the problem is the other is perhaps as grand an illusion as any. Appearing real, no doubt!

    I have therefore been reluctant—even when it comes to religious conflict in India—to point at the other; and have always looked inwards at the Hindu collective for solutions to this growing menace. To the disappointment of some of my fellow Hindus, we have written in this space about the rising divisiveness, animosity, aggression, and violence that characterize the present day Hindutva movement. This reversal of core values of the age old Hindu way of life is particularly painful as, in the name of defending Hinduism, it is corrupting the very ideals of inclusivity, tolerance, diversity and pluralism that are the foundations of this timeless religion.
     
    http://khabar.com/jsp/mag_feature_view.jsp?sessionid=T8YhVATYpBPcx7o7z58U79WpvSo&tempid=7259979481739620463&_articleid=2286
     
    Folks,
     
    Khabar is seeking responses towards its article in the past issue titled 'If I were an Indian Muslim". You can read it at the link above and if you would like to submit any responses for the print edition you can email your message to letters@khabar.com
     
    January 24

    What would you do if you know you were going to be killed tomorrow?

    This guy predicted his own death in his final article. The next day he was murdered, predictably by the government!
     
    "Every newspaper has its angle, and we do not hide the fact that we have ours. Our commitment is to see Sri Lanka as a transparent, secular, liberal democracy. Think about those words, for they each has profound meaning. Transparent because government must be openly accountable to the people and never abuse their trust. Secular because in a multi-ethnic and multi-cultural society such as ours, secularism offers the only common ground by which we might all be united. Liberal because we recognise that all human beings are created different, and we need to accept others for what they are and not what we would like them to be. And democratic... well, if you need me to explain why that is important, you'd best stop buying this paper.
    ....
     
    It is well known that I was on two occasions brutally assaulted, while on another my house was sprayed with machine-gun fire. Despite the government's sanctimonious assurances, there was never a serious police inquiry into the perpetrators of these attacks, and the attackers were never apprehended. In all these cases, I have reason to believe the attacks were inspired by the government. When finally I am killed, it will be the government that kills me.
    ....
    People often ask me why I take such risks and tell me it is a matter of time before I am bumped off. Of course I know that: it is inevitable. But if we do not speak out now, there will be no one left to speak for those who cannot, whether they be ethnic minorities, the disadvantaged or the persecuted. An example that has inspired me throughout my career in journalism has been that of the German theologian, Martin Niem"ller. In his youth he was an anti-Semite and an admirer of  Hitler. As Nazism took hold in Germany, however, he saw Nazism for what it was: it was not just the Jews Hitler sought to extirpate, it was just about anyone with an alternate point of view. Niem"ller spoke out, and for his trouble was incarcerated in the Sachsenhausen and Dachau concentration camps from 1937 to 1945, and very nearly executed. While incarcerated, Niem"ller wrote a poem that, from the first time I read it in my teenage years, stuck hauntingly in my mind:
    First they came for the Jews
                and I did not speak out because I was not a Jew.
    Then they came for the Communists
                and I did not speak out because I was not a Communist.
    Then they came for the trade unionists
                and I did not speak out because I was not a trade unionist.
    Then they came for me
                and there was no one left to speak out for me.
    If you remember nothing else, remember this: The Leader is there for you, be you Sinhalese, Tamil, Muslim, low-caste, homosexual, dissident or disabled. Its staff will fight on, unbowed and unafraid, with the courage to which you have become accustomed. Do not take that commitment for granted.  Let there be no doubt that whatever sacrifices we journalists make, they are not made for our own glory or enrichment: they are made for you. Whether you deserve their sacrifice is another matter. As for me, God knows I tried."

    Mixed Races

    I found this article in the Indian Express interesting:

    There is an increasing number of people of Indian origin entering in relationships with white partners, prompting a new study to conclude that in future some ethnic groups may well disappear.
    One in 10 children in Britain now lives in a mixed-race family, which raises the prospect of a non-racist Britain, according to the study conducted at the University of Essex.
     
    Young Britons are 6 times more likely to marry someone of a different ethnicity, according to the study. But look at how much lower the current rate is for Indians, and particularly for Pakistanis:
    Over the past 14 years the number of children of Caribbean heritage with one white parent has risen from 39 per cent to 49 per cent. Among the Indian population it has increased from 3 per cent to 11 per cent, for Pakistanis from 1 per cent to 4 per cent, and for Chinese from 15 per cent to 35 per cent.
     
    http://publication.samachar.com/pub_article.php?id=3463558&navname=General%20&moreurl=http://publication.samachar.com/theindianexpress/general/theindianexpress.php&homeurl=http://www.samachar.com&nextids=3463556%7C3462387%7C3462391%7C3463557%7C3463558&nextIndex=0

    Obama's books

    I just started:  Team of Rivals: The Political Genius of Abraham Lincoln
    by Doris Kearns Goodwin
     
    From the article:  A book about Abraham Lincoln's decision to include former opponents in his cabinet, informed Mr. Obama's decision to name his chief Democratic rival, Hillary Rodham Clinton, as Secretary of State.
     
    Very interesting read, just got through the first 100 pages yet.
     
     
    "Mr. Obama's first book, "Dreams From My Father" (which surely stands as the most evocative, lyrical and candid autobiography written by a future president), suggests that throughout his life he has turned to books as a way of acquiring insights and information from others ­ as a means of breaking out of the bubble of self-hood and, more recently, the bubble of power and fame. "
     
    Books I have put on hold, that I plan to read sometime:
     
    The Golden Notebook," Doris Lessing
    Lincoln's collected writings
    "Moby-Dick," Herman Melville
    "Song of Solomon," Toni Morrison
    Works of Reinhold Niebuhr
    "Gilead," Marilynne Robinson
    F. D. R.'s first hundred days in office and Steve Coll's "Ghost Wars,"
    Ellison's "Invisible Man"
    poems of Elizabeth Alexander
    verse of Derek Walcott
    "The Singapore Story" and "From Third World to First" by Lee Kuan Yew
    Flatland" by E. A. Abbott
    The Twenty-Fifth Hour (La 25e Heure)by Constantin Virgil Ghorghiu
    Jane Mayer, "The Dark Side
    Naomi Klein, "Shock Doctrine
    Frank Conroy, "Stop-Time
    Justice as Fairness: A Restatement" by Rawls
    The Cardinal. This novel by Henry Morton Robinson
    The Guns of the South. In this novel that came out in 1992 Harry Turtledove
    Common Wealth: Economics for a Crowded Planet by Jeffrey D. Sachs
    Dai Sijie "Balzac and the Little Chinese Seamstress
    What is America" by Ronald Wright
    Caro's Power Broker;
    Caro's Johnson Bio (emphasis on Master of the Senate);
    Gilbert's History of the Second World War;
    Halberstam's Best and the Brightest;
    Kearns Goodwin, No Ordinary Time;
    Machiavelli's, The Prince;
    Heller's, Catch 22;
    Herr's, Dispatches;
    Gordon/Trainor, Cobra II;
    Le Carre, Tinker Tailor, and Smiley's People
    Dexter Filkin's, The Forever War.
    Matthew Eck's, The Farther Shore.
    Omar Khayyam's, "The Rubaiyat
     William F Buckley Jr's "Gratitude - Reflections on What We Owe to Our Country
    "Three Cups of Tea" by Greg Mortenson
    "Only in America" written by Harry Golden

    Unsex me now, has a new meaning for me

    Just got back from an electric performance of Shakespeare's Macbeth... this time a major upgrade from my last Shakespeare play Merchant of Venice in Honolulu. I am back in the land of powerful acting and extremely creative productions. This time, Lady Macbeth - Shakespeare's favorite anti-heroines, and in my opinion the most powerful role for a woman in shakespearean plays does a completely outstanding performance in Karen Aldridge's performance yesterday in Chicago Shakespeare Theatre's production of Macbeth.
     
    Some of the things that were shown were a little too obvious and killed the subtlety of the dialogues but at the same time very interested techniques used.. banquo's bloody face on the dinner table and images of dead macduff's family hanging from the walls was perhaps the most shocking imagery in the play (ofcourse the bloody head of macbeth in the end is pretty cool too). Lad Macbeth's bathtub scene was pretty intense too.
     
    Overall a real good performance, and probably the best one I have seen of Macbeth in recent times..
     
    here's a review from the tribune:
     
     

    Chicago Shakespeare stages a gutsy 'Macbeth' with hints of Chicago

    Lady Macbeth (Karen Aldridge), tormented into madness, is observed sleepwalking by her Maid (Carolyn Klein) and Doctor (Patrick Clear) in Macbeth

    THEATER REVIEW: "Macbeth" ★★★ Through Mar. 8 by Chicago Shakespeare Theater on Navy Pier; Running time: 2 hours, 40 minutes; Tickets: $44-$70 at 312-595-5600 or www.chicagoshakes.com. Lady Macbeth (Karen Aldridge) is observed sleepwalking by her Maid (Carolyn Klein) and Doctor (Patrick Clear).

    In Barbara Gaines’ rollicking, restless, R-rated, recession-busting production of “Macbeth” at Chicago Shakespeare Theater, the action bounces from press conference to airport to strip club to a video-conferencing room where ghosts fly across the Internet. The Thane of Cawdor and his restless Lady reside in an expansive penthouse in downtown Chicago. And when this sexually charged pair hold a cocktail party to further their murderous ambitions, you hear the tinkle of a piano.

    The tune? “Witchcraft.”

    That’s not the only musical clue in Ganies’ cheerfully campy conceit—at another point I thought I heard a few bars of Blondie’s “One Way or Another,” which contains quite the apt lyric for the Scottish play, “I’m gonna getcha.” But it should be enough to warn you off if you like your Shakespearean tragedy lean, minimalist, subtle or simple, or if you think the best classical directorial concepts are seen little and heard less. But this is “Macbeth,” that most uneasy and stylistically inconsistent work of Shakespeare’s greats, a drama that, at once, contains politics, poetry and paganism, awesome insight and sustained irony, witticisms and witches. As fans of the TV show “Slings and Arrows” well know, it’s an article of faith in theatrical circles that this hellacious, hybrid play is impossible to realize in an aesthetically consistent fashion. That would be like trying to shove a sprig of battery-powered heather into a bottle of smooth Scotch.

    So why not cast the octogenarian actor Mike Nussbaum as one of a morphing trio of witches, who spend much of the show in the guise of journalists? Why not have Lady M. half-naked in a bathtub? Why not play up the comedy? Why not suggest links between Malcolm and Barack Obama, and have the lingering witches rain on that conclusionary parade like a triangular personification of the economic meltdown?

    As long as all of this is in service of some interesting ideas, a potent point of view and a desire to forge an accessible link between a contemporary audience and the play’s stew of ideas, then play on McGaines, say I. This is the kind of gutsy show—and it is a very gutsy show—that invites objection in part because it dares to be excessively generous with the fodder to which one might object.

    Aside from intellectual rigor, this is an exceptionally stimulating and sexy production that throws all manner of things up into the frigid air of this most nervous of winters. And it manages some things that most productions of “Macbeth” don’t. Most notably, it reminds us that what’s usually staged as a clash of ambitious adults is actually a family tragedy. I don’t mean a family-friendly tragedy; I mean a lot of murdered children.

    More...
    January 16

    Ghosh on Mumbai Attacks

    Finally a sensible article in all the hyperbolic ones that I have seen. Atleast someone can see through the media bullshit.
     
    --------------------
    Hindustan Times
    Defeat or victory determined by response
    Amitav Ghosh
     
    Since the start of the terrorist invasion of Mumbai on November 26, the metaphor of the World Trade Center attacks has been repeatedly invoked. In India and elsewhere commentators have taken to saying, over and again, 'This is India's 9/11.' There can be no doubt that there are certain clear analogies between the two attacks. In both cases the terrorists were clearly at great pains to single out urban landmarks, especially those that serve as points of reference in this increasingly interconnected world.
     
    There are similarities too, in the unexpectedness of the attacks, the meticulousness of their planning, their shock value and the utter unpreparedness of the security services. But this is where the similarities end. Not only were the casualties far greater on September 11, 2001, but the shock of the attack was also greatly magnified by the fact that it had no real precedent in America's historical experience.
     
    Our experience of terror attacks, on the other hand, far predates 2001. Although this year has been one of the worst in recent history, the year 1984 was arguably worse still. That year a burgeoning insurgency in the Punjab culminated in the assassination of Prime Minister Indira Gandhi. This in turn led to riots, which took the lives of some two thousand Sikhs.
     
    I was living in Delhi then and I recall vividly the sense of besetting crisis, of extreme fragility, of being pushed to the edge of an abyss. It was the only time I can recall when the very project of the Indian republic seemed to be seriously endangered. Yet for all its horror, the portents of 1984 were by no means obvious. In the following years, there was a slow turnaround; the Punjab insurgency gradually quietened down; and although the victims of the massacres never received justice in full measure, a process of judicial retribution was indeed initiated.
     
    This has been another terrible year. Even before the invasion of Mumbai several hundred people had been killed and injured in terror attacks. Yet, let us recall that the attacks on Jaipur, Ahmedabad, New Delhi and Guwahati did not succeed in setting off chains of retaliatory violence of the sort that would almost certainly have resulted ten or fifteen years ago. Nor did the violence create a sense of existential crisis for the nation, as in 1984. Thus, despite all its horrors, this year could well be counted as a victory not for terrorism but for India's citizenry. The question now is: will the November invasion of Mumbai change this?
     
    Although there is no way of knowing, this at least is certain: if the precedent of 9/11 is taken seriously the outcome will be profoundly counterproductive. As a metaphor, the words '9/11' are invested not just with the memory of what happened in Manhattan on September 11, 2001, but also with the penumbra of emotions that surround the events: the feeling that 'the world will never be the same', the notion that this was 'the day the world woke up' and so on. In this sense '9/11' refers not just to the attacks but also to its aftermath, in particular to an utterly misconceived military and judicial response, one that has had disastrous consequences around the world.
     
    When commentators repeat the metaphor of '9/11' they are in effect pushing the Indian government to mount a comparable response. If they succeed in doing this the consequences are sure to be equally disastrous. The very power of the 9/11 metaphor blinds us to the possibility that there might be other, more productive analogies for the November invasion of Mumbai. One such is the Madrid train bombings of March 11, 2004, which led to a comparable number of casualties and created a similar sense of shock and grief. If 9/11 is a metaphor for one kind of reaction to terror, then 11-M (as it is known in Spanish) should serve as shorthand for a different kind of response: one that emphasises vigilance, patience, and careful police work in coordination with neighbouring countries.
     
    This is exactly the kind of response that India needs now: a refusal to panic, heightened vigilance, and most particularly, judicious cooperation with those elements of the Pakistani State who have come around to a belated recognition of the dangers of terrorism. The choice of targets in Mumbai clearly owes something to the September bombing of the Islamabad Marriott. Here already there is common ground between the two countries — for if this has been a bad year for India in regard to terrorism, then for Pakistan it has been still worse. It is clear now that Pakistan's establishment is so deeply divided that it no longer makes sense to treat it as a single entity. Sometimes a crisis is also an opportunity. This, if any, is a moment when India can forge strategic alliances with those sections of Pakistani society who also perceive themselves to be under fire.
     
    Much will depend, in the coming days, on Mumbai's reaction to the invasion. The fact that the city was not stricken by turmoil in the immediate aftermath of the attack is undoubtedly a positive sign. The fact that the terrorists concentrated their assault on the most upscale parts of the city had the odd consequence of limiting the disruption in the everyday lives of most Mumbaikars. Chhatrapati Shivaji station, for instance, was open within a few hours of the attack. Although there was much fear and uncertainty, the city was not panic-stricken. But with each succeeding day, tensions are rising and the natural anxieties of the inhabitants are being played upon. But this is not a moment for precipitate action.
     
    If India can react with dispassionate but determined resolve then 2008 may yet be remembered as a moment when the tide turned in a long, long battle. For if there is any one lesson to be learnt from the wave of terror attacks that has convulsed the globe over the last decade it is this: defeat or victory is not determined by the
    success of the strike itself. It is determined by the response.
     
    (Amitav Ghosh is the author of Sea of Poppies)
    January 14

    Why Americans pay more for health care?

    Interesting article.

    The McKinsey Quarterly
     
    Why Americans pay more for health care
    The United States spends more on health care than comparable countries do and more than its wealth would suggest. Here's how—and why.
    December 2008 • Diana M. Farrell, Eric S. Jensen, and Bob Kocher
    The health care debate in the United States excites great passion. Issues such as how to make care available, to structure insurance, and to rein in spending by the government, corporations, and individuals frequently take center stage. Often missing, though, are basic economic facts. New research from the McKinsey Global Institute (MGI) and McKinsey's health care practice sheds light on a critical piece of the puzzle: the cost of care.
     
    Our research indicates that the United States spends $650 billion more on health care than might be expected given the country's wealth and the experience of comparable members of the Organisation for Economic Co-operation and Development (OECD). The research also pinpoints where that extra spending goes. Roughly two-thirds of it pays for outpatient care, including visits to physicians, same-day hospital treatment, and emergency-room care. The next-largest contributors to the extra spending are drugs and administration and insurance.
    It's not clear whether the United States gets $650 billion worth of extra value. Parts of the US health care system, such as its best hospitals, are clearly world class. Cutting-edge drugs and treatments are available earlier there, and waiting times to see physicians tend to be lower. Yet the country lags behind other OECD members on a number of outcome measures, including life expectancy and infant mortality. Furthermore, access to health care is unequal: more than 45 million Americans lack insurance.
     
    The challenge for health care reformers is to retain the current system's strengths while addressing its deficiencies and curbing costs. That won't be easy. Our research on the system's costs and the incentives underlying them indicates that without the involvement of all major stakeholders (such as hospitals, payers, and doctors) reform is likely to prove elusive. The research also suggests that while there are many possible paths to reform, it is unlikely to succeed unless it deals comprehensively with health care demand, supply, and payments.
    A $650 billion spending gap
     
    Across the world, richer countries generally spend a disproportionate share of their income on health care. In the language of economics, it is a "superior good." Just as wealthier people might spend a larger proportion of their income to buy bigger homes or homes in better neighborhoods, wealthier countries tend to spend more on health care.
    Yet even accounting for this economic relationship, the United States still spends $650 billion more on health care than might be inferred from its wealth. MGI arrived at this figure by using data from 13 OECD countries to develop a metric called estimated spending according to wealth (ESAW), which adjusts health care expenditures according to per capita GDP. No other developed country's spending above the ESAW level approaches that of the United States (Exhibit 1).
     
    Is it paying so much more because its people are less healthy than those of other countries? Our research indicates that the answer is no. While lifestyle-induced diseases, such as obesity, are on the rise in the United States, the most common diseases are, on average, slightly less prevalent there than in peer OECD members. The factors contributing to the lower disease rates include the relatively younger (and therefore less disease-prone) population of the United States, as well as the low prevalence of smoking-related problems. Factoring in the average cost of treatment for each disease, we still find that the relative health of the US population does not account for the higher cost of health care.
     
    Analyzing the problem
    MGI broke down health care costs into their components to identify the sources of this higher-than-expected spending (Exhibit 2). Outpatient care is by far the largest and fastest-growing part of it, accounting for $436 billion, or two-thirds of the $650 billion figure. The cost of drugs and the cost of health care administration and insurance (all nonmedical costs incurred by health care payers) account for an additional $98 billion and $91 billion, respectively, in extra spending. By contrast, US expenditures on long-term and home care, as well as on durable medical equipment (such as eyeglasses, wheelchairs, and hearing aids), is actually less than would be expected given the country's wealth.
     
    Outpatient care
    The high and fast-growing cost of outpatient care reflects a structural shift in the United States away from inpatient settings, such as overnight hospital stays. Today, the US system delivers 65 percent of all care in outpatient contexts, up from 43 percent in 1980, and well above the OECD average of 52 percent. In theory, this shift should help to save money, since fixed costs in outpatient settings tend to be lower than the cost of overnight hospital stays. In reality, however, the shift to outpatient care has added to—not taken away from—total system costs because of the higher utilization of outpatient care in the United States.
    We evaluated the economic impact of this structural shift by analyzing US inpatient care and comparing it with the practices of other OECD health systems. We estimate that the United States saves $100 billion to $120 billion a year on inpatient care thanks to shorter hospital stays and fewer hospital admissions. If we attribute these savings to the US health system's ability to provide care in outpatient settings, that would reduce above-ESAW outpatient expenditures—but only to $326 billion. This enormous figure still represents half of the US health care system's $650 billion in extra costs (Exhibit 3).
     
    The two largest and fastest-growing categories of outpatient spending are same-day hospital care and visits to physicians' offices (Exhibit 4). From 2003 to 2006, the cost of these two categories increased by 9.3 and 7.9 percent a year, respectively. Growth in the number of visits played only a modest role in explaining the increase in costs—the number of same-day hospital visits rose by 2.1 percent annually, and the number of visits to physicians' offices remained relatively flat during this period. 
     
    Far more important was a surge in the average cost per visit resulting from factors such as the additional care delivered during visits, a shift toward more expensive procedures (for example, diagnostic ones such as CT and MRI scans), and absolute price increases for equivalent procedures.1 In all likelihood, costs have also gone up because over the past decade there has been a marked shift in the delivery of care, from general practitioners to specialists.
    Behind those proximate causes, several forces contribute to the rising cost of outpatient care across the entire range of settings, not just same-day hospital stays and visits to physicians' offices. For starters, outpatient care is highly profitable—US hospitals earn a significant percentage of their profits from elective same-day care—which prompts investments in the facilities and people supporting it. These investments can be recouped only by offering more (and more expensive) services. The significant degree of discretion that physicians have over the course and extent of outpatient treatment also probably plays a role, as does the fee-for-service reimbursement system, which creates financial incentives to provide more outpatient care.
     
    Finally, there is no effective check on it. On average, the out-of-pocket expense of patients represents only 15 percent of the total cost, so they are relatively insensitive to it and apt to follow the advice of their physicians. Other countries also have low out-of-pocket expenses but use supply-oriented controls to compensate for the lack of demand-side value consciousness.
    Pharmaceuticals
     
    After outpatient care, the category with the highest above-ESAW expenditures, at $98 billion, is prescription drugs—not because Americans are buying more of them but rather because they cost 50 percent more than equivalent products in other OECD countries (Exhibit 5).2 The United States also uses a more expensive mix of drugs; the price of a statistically average pill is 118 percent higher than that of its OECD equivalents. One reason is probably that new drugs, which tend to carry a price premium, are widely prescribed one to two years earlier in the United States than in Europe.
    Several frequent explanations for higher US drug prices deserve examination. One is the wealth of the United States, which enables it to spend more on economically superior goods, such as drugs. Another is that high US prices subsidize research and development for the rest of the world. Marketing and sales spending by companies is higher in the United States than in other OECD countries (which generally restrict direct-to-physician or consumer advertising), and that also could play a role.
     
    But none of these factors, by itself, can explain the gap between the price of drugs in the United States and the rest of the OECD. When we adjust for US wealth, we find that the country's branded-drug prices should carry a premium of some 30 percent, not 77 percent for branded small-molecule drugs. Similarly, if global pharma R&D spending—$40 billion to $50 billion in 2006—were financed entirely through higher branded-drug prices, the US price premium over similar countries would be 23 to 28 percent. Finally, in 2006 the sales and marketing expenditures of US pharma companies came to $30 billion to $40 billion, only 17 to 23 percent of current US prices.
    Health administration and insurance
    The third-largest source of above-ESAW spending is health administration and insurance, at $91 billion. In this category, the United States spent $486 per capita in 2006—twice the outlay of the next-highest spender, France, with $248, and nearly five times the average of $103 across peer OECD countries.
    Of the $91 billion in above-expected spending, $63 billion is attributable to private payers. Profits and taxes—a negligible expense in OECD countries with single-payer systems—account for nearly half of this total. The cost of public administration for Medicare, Medicaid, and other government programs accounts for the remaining $28 billion in US above-ESAW spending.
     
    These higher costs largely reflect the diversity and number of payers as well as the multistate regulation of the US health care system. Its structure creates additional costs and inefficiencies: redundant marketing, underwriting, claims processing, and management overhead. In other OECD countries, with less-fragmented payment systems, these costs are much lower. Interestingly, we find that given the structure of the US system, its administrative costs are actually $19 billion less than expected, suggesting that payers have had some success in restraining costs (Exhibit 6).
    Of course, the US multipayer system could create value to the extent that it develops effective programs to promote health and prevent disease, competes to drive down prices, innovates to improve customer service or benefits, or offers patients greater choice. But do the virtues of the US system outweigh its inefficiencies, and can these inefficiencies be reduced within its current structure?
    A framework for reform
     
    The United States can take no single path to address the level and growth of every one of its health care costs. Any reform effort should involve all of the system's stakeholders, for the inclusion of hospitals, payers, and doctors in the reform effort will increase the odds of arriving at a plan for change that each party will truly embrace. Furthermore, each party can play a distinct role in addressing the full spectrum of issues that must be part of any major system overhaul. For each of these areas, there are several possibilities for reform—such as raising public awareness, creating appropriate incentives, mandating desired behavior, and taking direct action.
    For health care reform to generate lasting improvements in cost, quality, access, and equity, it must effectively address supply, demand, and payment.3 A number of our McKinsey colleagues recently completed an effort to determine what would be required to change trends in health care costs fundamentally. Here, we briefly lay out the principal issues for consideration by all health care reformers.
     
    Demand
    The general health of the US population is a significant issue. Although disease is no more prevalent in the United States than in peer OECD countries, the health of its population is falling, and this decline contributes to the growth in medical costs. In fact, our analysis suggests that in the two-year period from 2003 to 2005, the decline raised them by $20 billion to $40 billion. Reformers should therefore focus on the preventative efforts that present the largest opportunity to improve overall health and thereby save money.
     
    Equally important is the lack of any real value consciousness. In the United States, the "average" consumer of health care pays for only 12 percent of its total cost directly out of pocket (down from 47 percent in 1960), as well as for 25 percent of health care insurance premiums, a share that has stayed relatively constant for the last decade. Well-insured patients who bear little, if any, of the cost of their treatment have no incentive to be value-conscious health care consumers.
    Moreover, even if they wanted to be value conscious, they don't know enough. Despite recent efforts to expand consumer access to information on health care, its cost and quality remain opaque—arguably more so than in any other consumer industry. Consumers also know vastly less than providers do and therefore understandably rely on the advice and guidance of physicians. If Americans are to become more value-conscious consumers of health care, reformers must therefore determine how to create an appropriate level of price sensitivity and to give patients the right information, decision tools, and incentives.
    Supply
     
    In many industries, such as consumer electronics, innovation tends to drive down prices. The opposite is true in health care, where lower prices don't necessarily boost sales and may even create the perception of low quality. Instead, innovation tends to focus on the development of increasingly more expensive products and techniques. High-priced technologies, from imaging to surgical equipment, also mean higher reimbursements for providers, who therefore demand cutting-edge products. So what emerges is a constant cycle of cost inflation along the entire health care value chain—from manufacturers of health products to equipment manufacturers to physicians to hospitals to payers and, ultimately, to employers and patients. At each step, the stakeholders absorb part of the cost increase and attempt to pass an even larger one onto the next stakeholder. Reformers must determine how to address this cost inflation cycle while retaining the beneficial aspects of innovation.
    Intermediation
     
    Medicare and many commercial payers base their reimbursements for inpatient care on episodes or diagnosis-related groups (DRGs). This forces providers to bear part of the risk of treating a patient and largely creates incentives to use resources efficiently. But fee-for-service reimbursement, the predominant method in outpatient treatment, does not have that effect and actually gives providers strong financial incentives to provide more (and more costly) care, not more value. Fear of malpractice suits boosts care volumes too. Our research indicates that the direct costs of malpractice are limited—about $30 billion in 2006—but the risk of litigation creates an incentive to err on the side of caution. Reformers therefore need to develop more effective financing and payment approaches ensuring that care providers have the right incentives to give patients an appropriate type and amount of care.
    Medicare's role in influencing coverage and pricing dynamics also bears investigation. Private payers use this public program as a critical benchmark, more often than not following its lead, when they make decisions about which new procedures and technologies to reimburse. Because Medicare essentially uses a cost-plus formula to set reimbursement rates, it puts care providers under less pressure to reduce expenses than it could with another reimbursement mechanism. What's more, trends in the reimbursement rates of commercial payers are strongly correlated—but inversely—with Medicare pricing trends: private insurers grant providers higher increases when Medicare reimbursements grow more slowly. This suggests both that Medicare prices partly drive so-called market prices and that care providers have a significant amount of pricing power with private insurers. Reformers need to determine how public programs, such as Medicare and Medicaid, can lead the market toward rational change in reimbursement approaches and levels.
     
    Reform won't be easy. But armed with the facts about what the United States spends on different aspects of health care, how much above what might be expected that spending really is, and the underlying economic dynamics of the system, policy makers will have a better chance to curb the growth of costs.
    About the Authors
    Diana Farrell is director of the McKinsey Global Institute, and Eric Jensen is a consultant in McKinsey's Washington, DC, office, where Bob Kocher is a principal.

    Notes
     
    1CT (computerized tomography) and MRI (magnetic resonance imaging) scans are diagnostic tests that provide high-resolution pictures of the structure of any organ or part of the body requiring examination.
    2Fifty percent represents the weighted average premium for branded drugs (77 percent), biologics (35 percent), and generics (–11 percent).
     
    3 For more on a reform framework encompassing supply, demand, and payment for care, see Diana Farrell, Nicolaus P. Henke, and Paul D. Mango, "Universal principles for health care reform," mckinseyquarterly.com, February 2007; and Jean P. Drouin, Viktor Hediger, and Nicolaus Henke, "Health care costs: A market-based view," mckinseyquarterly.com, September 2008.
    © Copyright 1992-2009 McKinsey & Company

    Miss Pakistan says we must 'CONDONE' the mumbai attacks

    Poor Miss Pakistan World.
     
    She, ie. 23-year-old Natasha Paracha, agreed to appear on CNN to speak about something she clearly doesn't know anything about: India-Pakistan relations in the wake of the Mumbai attacks. She was also caught on camera, self-consciously touching her face as it to make sure her makeup were okay. And her earpiece kept falling out of her ear. And if that weren't humiliating enough, they made her wear her Miss Pakistan World sash.
    But then she had to go and say this:
    "The image of Pakistan has been threatened with these recent attacks. And I feel that now as Pakistanis we have to stand up and condone what has happened in the country of India and in these Mumbai attacks."
     
    Surely she meant "condemn," yes? Well, unfortunately for the two nations on the brink of war, she repeated herself, most confidently.
    CNN host ANNA COREN: How can this image be improved?
     
    PARACHA: We as Pakistanis need to work together. And Indians as well need to work. And work on this friendship we have. And condone these attacks, thoroughly.
    CNN's Coren must've thoroughly enjoyed the exchange. She had not one but two chances to subtly correct Paracha, and chose not to.
     
    Paracha, by the way, is a graduate of UC Berkeley, according to this interview, and currently works as the chair of Pakistani affairs with the United Nations International Renewable Energy Organization..
     
    She concluded by saying, "The government is doing the best it can but definitely it's going to be long battle, it's going to be a long war against terrorism."

    Obama and Healthcare IT ... where are we headed?

     
     
    National eHealth Group Meets Today with Obama Transition Team
     
    Jan 9, 2009, News Report
     
    The National eHealth Collaborative, formerly AHIC Successor, was officially launched yesterday in Washington, D.C. The National eHealth Collaborative is a public-private partnership dedicated to the creation of a secure, interoperable, nationwide health information network that will advance the American public's interest in health and improve the quality, safety, efficiency and accessibility of healthcare. The Collaborative builds on the accomplishments of the American Health Information Community (AHIC), a federal advisory committee established in 2005, and AHIC Successor, founded in 2008 to transition AHIC's accomplishments into a new non-profit membership organization, now known as the National eHealth Collaborative (NeHC).
    The NeHC's membership and board represent virtually all stakeholders whose participation is needed to drive the rapid development and adoption of an interoperable health system. The list of participating stakeholders includes federal and state agencies, health systems, payers, health professionals, medical centers, community hospitals, patient advocates, major employers, non-profit health organizations, commercial technology providers, and others.
    The NeHC brings together these stakeholders to accelerate development of the health IT systems, infrastructure, standards, protections, participation, and education needed to create a secure, interoperable, nationwide electronic health information network. It provides a needed and credible forum for stakeholders to transparently vet and prioritize national advancement efforts and leverages the value, resources and best practices offered by both the public and private sectors. The NeHC works in close partnership with the Health Information Technology Standards Panel, the Certification Commission for Health Information Technology, and the Nationwide Health Information Network, as well as other health and IT member organizations.
     
    "As the National eHealth Collaborative continues to guide and drive the most important transformation of healthcare in our nation's history, we are committed to working with all stakeholders to encourage the use of interoperable health IT," said Dr. Tooker, the chair of the newly announced NeHC Board of Directors. "I am pleased to serve alongside some of the most respected leaders in healthcare and information technology as we work to improve the health and well-being of all Americans through the nationwide exchange of interoperable electronic health information."
    Toward that end, representatives of the Collaborative's Board are scheduled to meet with President-elect Obama's transition team to brief them on the group's efforts and plans. The NeHC will also offer assistance as the new Administration follows through on President-elect Obama's stated commitment to promote the use of electronic health records and health information technologies as part of a national economic stimulus package and comprehensive healthcare reform.
    The NeHC intends to work cooperatively and aggressively in the months ahead to accelerate progress on a number of initiatives critical to the achievement of a secure, nationwide electronic health information network, including:
     
    Consistent standards to guide the development, sharing and updating of confidential individualized health information within a secure national network;
    Education, guidance and incentives for widespread adoption of electronic health records by health systems, health professionals and individuals;
    Creation of the secure, interoperable network that enables immediate, consistent, protected access to relevant personal health information at the point of care, anywhere and anytime it is needed;
    Collaboration among a wide variety of institutions and organizations to enable broad, efficient, seamless and confidential exchange of secure, individualized health information--leading to system-wide improvements in health outcomes, access, and quality of care, as well as reduced costs over time; and
    Partnership with members of the Nationwide Health Information Collaborative and others to develop a governance plan for the Nationwide Health Information Network.
     
    The NeHC is moving rapidly to expand its membership, assuring that all key stakeholders are adequately represented, and will soon call on those stakeholders to participate in committees and workgroups tasked with addressing various barriers to health information technology adoption and use.

    In-flight disturbances!

    Interesting blog post on Economist regarding the way people are stepping up to keep down/take down unruly passengers.. but is that really what they should be doing?
     
    In-flight disturbances are all the rage
    Posted by:
    Economist.com | TORONTO
    Categories:
    Passengers
    IN CASE anyone needs reminding of the consequences of disorderly behaviour on an aircraft, two recent cases make the point. On January 7th a man flying from Atlanta to Los Angeles with Delta was tackled by fellow passengers after he made bomb threats and tried to open a cabin door while the plane was landing. No bomb was found on the plane and the man—who will not face federal charges—is undergoing psychological tests. Then a Russian citizen was fined C$30,000 ($25,000) by a judge in Gander, Newfoundland for disrupting a Delta flight from Moscow to Atlanta on January 4th. The plane was forced to make an unscheduled landing in Gander after the man, who had been drinking, fought with his family, slammed his head against a window and assaulted a flight attendant before being restrained by passengers and crew.
     
    While it's clearly commendable when passengers take it upon themselves to police their own space, such incidents do not always end well. Back in 2000 a passenger was killed on a Southwest Airlines flight from Las Vegas to Salt Lake City. The man tried to break into the cockpit, but was restrained by around eight people whose actions asphyxiated him.
    That was before September 11th and the heightened sense of in-flight watchfulness that is one of its legacies. Post 9/11, Gulliver expects passengers to be even more likely to react with excessive force, thanks to a greater awareness of the disaster that could follow if an agitator is not controlled. Dealing with a disruptive passenger is one area where an on-board marshall would earn his salary. But if there is no marshall on the flight, it is up to the attendants to take charge and to try to ensure the safety of all (and that includes the miscreant)—one more reason why Gulliver couldn't give a hoot what they look like, as long as they're competent.

    Ten Reasons Why Fewer People are Flying

    Excellent article in 3 sets on what airlines are doing wrong and why we should be so forgiving!

    Ten Reasons Why Fewer People are Flying

    Air travel is down by almost 10% - is this due to the economy or something else?
     

    The airlines blame the dropping number of passengers on the tough economic conditions at present.  But this reduction in air travel started before the economy 'nose-dived' - and, let's be less histrionic.  The economy shrunk a barely noticeable 0.5% in the third quarter - hardly a 'nose-dive' at all, while air travel dropped by more than ten times that amount.

    Although the airlines are masters at blaming everyone but themselves for every successive problem they encounter (and have you noticed that the last decade seems to have been non-stop problems for the airlines?), let's look carefully at why air travel numbers are down.

    Most of us passengers/customers think it outrageous that it is cheaper to fly a 240lb passenger, complete with amenities and frequent flier miles, than it is to place 120lbs of luggage in the hold.

    That's not the only outrageous fee.  Do you know of a single other industry that sells you something, and then adds an extra fee when you actually choose to buy the product from them?  The airlines will charge you up to $35 to phone their reservations center and buy a ticket - at full price - from them.

    Fees are now commonly charged by most airlines for :

    • Phone Reservations

    • A second piece of luggage

    • A first piece of luggage

    • Even more for luggage weighing more than 50lbs

    • Even more for luggage larger than standard size

    • Note these luggage fees are accumulative - you can end up paying all three fees - the fee for a piece of standard luggage (up to $25), for overweight (up to $150) and oversize (up to $360) - and these fees are each way, not roundtrip.

    • Advance seat selection

    • Premium for 'good' seats

    • Early boarding fee

    • Alcoholic drinks

    • Non-alcoholic drinks

    • Meals

    • Snacks

    • Standby

    • Curbside checkin

    • Unaccompanied minor

    • Traveling with a pet

    • Pillows and blankets

    • Changing your flights

    • Cancelling your flights

    More...

    Part II

    Reason 3 :  Full Flights Limit Airlines' Ability to Accept More Passengers

    Here's a statement of the obvious :  If you're flying a full plane, you can't grow your passenger numbers, no matter how hard you try.

    There has been an enormous increase in the average 'load factor' on flights over the last few years.  The load factor is the percentage of seats on a plane that are sold.

    For the longest time, airlines averaged load factors comfortably below 70%; indeed the rule of thumb for airlines was to price a flight so that it would break even at about a 60% load factor and anything above this represented profit.  Conventional wisdom in the industry maintained that it was somewhere between impossible and ill-advised to have load factors averaging much above 70% because in such cases, with an average load factor of 70%, this meant some flights were full or nearly full, with the result that airlines would sometimes be turning business away.

    It also meant that the airlines had a more stressed system, with less ability to absorb passengers from other flights in cases of cancellations or delays.

    More...

    Part III

    We have all had to endure poor or nonexistent service, unexplained delays, rude and abusive personnel, staff that were even absent from where they should have been (including unattended gates in the hour before their flight time and in cases as much as an hour past the scheduled flight time), additional fees that were poorly explained and often arbitrarily or improperly implemented, damage and or loss of our luggage, airplanes with defective seats, lights, videos, etc, onboard personnel who would ignore the simplest request, flight schedules that are mostly works of fiction, flight cancellations announced with little or no warning (often with explanations that proved to be false), extensive delays in retrieving baggage when in fact it actually did arrive with our flight (but was thereafter 'misplaced'), excessive hold times on the phone for the simplest requests, arbitrary changes in fares (online) that often were increased (but never decreased) in the minuscule seconds between when we decided on a flight and when we tried to book it just a few keystrokes later (can anyone say 'bait and switch'), and so on and so on.

    Add to this massively unfair fees and high fares, and there's nothing positive at all about the thought of having to fly anywhere.

    More...