Friday, September 25, 2015

The GoldfinchThe Goldfinch by Donna Tartt
My rating: 4 of 5 stars

This is a big thick book with excellent character development and quirky plot. There were times when I thought it was wonderful and couldn't stop reading, and other times when I found it annoying and over-done.

The story follows Theo Decker from the age of 13 until his early adulthood. He is dealt a rotten hand when his mother is killed and he is left to his own devices for survival and maturation in New York. Others have noted the resemblance of this work to Dickens' bildungsroman David Copperfield, and indeed, Donna Tartt is masterful at sentence construction, depiction of mood and description of characters, very much like Charles Dickens. Of course she spent 10 years on this opus-- an average of four days per page-- so, I guess it should be crafted well.

Tartt is best when educating the reader, from art history, furniture refurbishing, and even illicit drug use. She is a wealth of information, both useful and not. Tartt is also surprisingly adept at describing the moods and motivations of adolescent males. Odd.

Actually, I found this novel more closely akin to Somerset Maugham's Of Human Bondage: the pained existentialism, the reckless lifestyles, longing for love, the struggle for meaning.  Maugham, however, wrote a semi-autobiographical work and it seemed more realistic and pertinent where The Goldfinch is fantastical in most plot twists.

Certainly, I can see why The Goldfinch is acclaimed. The writing is smooth as butter and the story is compelling, although it devolved into a Robert Ludlum-esque thriller in the final 150 pages, which I found mildly annoying.

Read the book. Better, read Of Human Bondage.

View all my reviews

Sunday, January 25, 2015

Movie Review: Birdman

2 stars out of 5

Michael Keaton played the best Batman way back in the 1989 dark comedy by Tim Burton. Viewers would be better off renting that masterpiece than shelling out $7 for his latest vehicle, Birdman. Themes and acting were great. The filming was distracting and the plot, especially the ending, was annoying.

I wanted this movie to be good. I really did.

There are better reviews written elsewhere (like here), but I am surprised by the sheer number of top ratings --100 out of 100-- at metacritic and a Rotten Tomatoes score of 92%. Am I missing something?

The acting by Michael Keaton, Ed Norton, Naomi Watts, Zach Galifianakis and Emma Stone was top notch.The personal themes were fine: Keaton plays a broken down moviestar trying to reinvent himself as a Broadway actor and director, as well as an absent father feeling like he failed his adult, drug-rehabbed daughter. He is a failure as a husband, questioning his talent and whether his past success was real... yada, yada, yada.

Keaton’s character adapts a short story to Broadway and then goes into debt to produce, direct and act in the play, opening himself up to humiliation and professional and financial ruin.

Ed Norton plays a Broadway pro whose self-confidence wanes when not on the stage. Naomi Watts is a fledgling actress concerned that this play will define her career. Emma Stone is Keaton’s daughter and Zach Galifianakis plays the lawyer and best friend.

It’s billed as a dramedy and the personal dramas are valid, but most of the jokes are inside baseball stuff for the Hollywood and Broadway crowds that those of us living in the Flyover aren’t too concerned with. Who cares if Keaton’s character isn’t respected as a “real” actor?

Many of the reviews remark on the novel way the movie is filmed, with continuous shot-on video making it seem that the whole movie is done in one take. Big whoop. Hitchcock did that in “The Rope” 50 years ago before all the cinematographic tricks. And I noticed the shot-on camera dance about ⅓ of the way through, so if a semi-skilled laborer in a square state can figure it out, it’s not a big deal. Frankly, it became distracting.

The biggest problem is the plot, especially the ending. Keaton struggles, he remembers past glory, he deals with anger, he goes through the dark night of the soul, he anticipates new glory, he resolves issues with his family…. all good stuff.  Then the writer doesn’t have an ending  ….Keaton the Birdman flies away, or some such bullshit.

There’s probably an Oscar in here somewhere because the writer flagellates Hollyweird by portraying a moviestar as a legitimate actor. Kudos for that I suppose.

Sunday, November 02, 2014

Book review: Antifragile: Things that gain from Disorder, by Nassim Nicholas Taleb

Nassim Nicholas Taleb is unique in stimulating thought while often annoying and exasperating the reader. He is likable yet solipsistic, intelligent yet pedantic, compassionate yet abrupt. Antifragile: Things that Gain from Disorder is the second of his books I’ve read (actually listened to the audio version), the first was The Black Swan back in 2007-08. Reviewed here, and in re-reading that review I’ll affirm my 5 star rating. Taleb’s influence was critical to my reassessment of the capital markets in 2008 and his admonitions supported some gainful personal decisions at that time.

Antifragility is defined as the quality of something to benefit from disorder. Unlike a poorly constructed UPS package of wine glasses that will shatter if disturbed, something that is antifragile will actually gain strength if disturbed. This is not to be confused with robust, which is merely something that is less likely to be damaged with disorder, ie, a well-constructed UPS package of wine glasses.  Antifragile takes it a step further to an entity that is actually improved with disorder.

Nassim Taleb says that great thinkers have only one great idea which is refined and adapted over time. Darwin had natural selection, Einstein had relativity, and presumably, Taleb includes himself with the idea he now calls antifragility.  I did mention he has an ego, right? Putting Taleb’s high self-opinion aside for a moment, I’ll grant that Antifragility as a followup to the Black Swan does deserve a place at least in the minor pantheon of cultural memes, albeit a few notches below Darwinism, but yeah.

As an example in nature, Taleb refers to the ability of any species to adapt to environmental stressors as antifragile. Antifragility is  everywhere in nature: the weak succumb while the strong survive and reproduce. Cultural examples are depicted by Adam Smith’s idea of the “invisible hand” that guides markets opaquely by rewarding beneficial actors and punishing the weak. For the record, Taleb later notes that the right-wing corporatist understanding of Adam Smith is incorrect and Smith never used the word “capitalist”, but that is another issue.

Platonic, or top-down, management is differentiated from bottom-up, or empiric, reality. Plato’s idea of a philosopher-king, like a soviet style central planner who has some special understanding, does not jibe with what we observe in the world.  Rather, the world is populated with adapting individuals and evolving ideas, some of which will die off and others that will survive. Taleb extends this notion from business and banking to other fields as wide-ranging as medical care and even religion.

Upon listening to a short interview of Taleb regarding this book, I was a bit unsure if I’d agree with his assessment of health care, but having finished the book, I’ll accept that he has it mostly correct. Medicine is best when it embraces the empiric, guided by what we see that actually works….what Taleb calls the heuristic: the rule of thumb.  Treating numbers, like mildly elevated cholesterol levels or arbitrary blood pressure “abnormals” with medication can lead to iatrogenic (ie, doctor-induced) harm and needless cost. The best examples of pharmaceutical development are rare-- eg, antibiotics and vaccines-- while things like cholesterol-lowering statin medication, developed for only the worst hereditary hypercholesterolemias, are now prescribed to lower mildly elevated levels without evidence of benefit. The human body, much like capital markets, is too complex to adhere to such top-down models since such things as long term sequelae and side effects are impossible to predict a priori. The best medical practice comes from time-tested heuristics, otherwise known as rules of thumb empirically shown to be effective. All else is waste and danger.

The asymmetry of information in medical care is what renders it complex, not only the asymmetry of knowledge between doctor and patient, but also--especially-- the asymmetry of resources between corporate actors and those of us in the trenches. If Big DrugCo floods the evening news shows with advertisements for their latest wonder drug, there isn’t a whole lot that will keep that drug from making it into medicine cabinets around the country. Eventually enough patients and practitioners will succumb to the influence of the moneyed interests. Restless Leg Syndrome has no less than six FDA-approved remedies.

Taleb was an options trader back in the 1980’s, buying mostly out-of-the-money puts and calls on various asset classes, which earned him enough money to retire at an early age to philosophize. He develops the concept of antifragility and how to achieve it, what he calls optionality, by placing a bet on a perturbation in the system. A small bet can become a big winner if that perturbation is large enough. For example, a put option (a bet on a crash) on the stock market would have lost small amounts every year from 2001 to 2007, but then would have resulted in a windfall if held through the debacle of 2008. Options are insurance for when the rare cataclysm, ie, Black Swan event, occurs.

Antifragility is not a how-to investment book, it is a philosophy book. Taleb rails against those individuals in business and government he calls “fragilisitas” who engage in activity and promote policies that increase fragility in the economic system. Alan Greenspan, Robert Rubin, Paul Krugman and Joseph Stiglitz are his favorite foils because they call for supporting weak actors who make bad decisions while ignoring the possibility of fat-tail events, those rare but devastating occurrences that can destroy entire systems.

Taleb, however, reserves special disdain for Alan Blinder, a former Vice-Chairman of the Federal Reserve Bank, who took the cynicism a step further. As a bank official, he enacted all manner of confusing regulations and then parlayed his “inside expertise” into a cottage industry upon leaving office, advising clients how to navigate these regulations. Furthermore, Blinder started a company that took advantage of FDIC deposit insurance for large corporations by splitting their colossal capital accounts into smaller accounts that would qualify for the FDIC protection. When asked if this were ethical, Blinder replied only that it was perfectly legal, while he collected prodigious fees from his clients. Taleb uses this as an example of the introduction of fragility into the economic system by cynical application of asymmetric knowledge and influence.

I enjoy Taleb’s passion and ranting, but it occurs to me that much of his self-admitted “anger” is misplaced. This fragility is inevitable. Relax and be entertained. For the vast majority of us the opportunity or inclination to act unethically is nonexistent, but a few sociopaths will always exist, so why bother fretting about the inevitable? Herb Stein, a Nixon White House economic advisor in the 1970’s, when dismissing the two-pronged dangers of the budget deficit and the trade deficit, coined Stein’s Law. To wit: "If something cannot go on forever, it will stop.” While Taleb never mentions this particular maxim, I think he would embrace it nonetheless. In fact, for all Taleb’s withering banter about fragilisitas and fat-tails and black swans, I sense that he is all too aware of the inexorable nature of humans to embrace harrowing fallacies that lead to destruction. It’s what we do. After all, Taleb successfully navigated the options markets to make a bundle of cash, so while luck likely played a role he does have some concept of risk management and the human propensity to ignore risk. Taleb’s first book was a technical tome on financial options called “Dynamic Hedging”, so he definitely gets it.

On a more personal note, I enjoy listening to the spoken word versions of Taleb’s books, and I search my podcast app for any interviews of Nassim Taleb. One interview on some economic webcast actually took my breath away because of the eerie similarity of Taleb’s personality to that of my father, Vince. The passion, the erudition and even the speech cadence is uncannily similar (the audio books, unfortunately, are read by a polished professional actor.)  Not many people can expound on Seneca one moment and the next give a fairly accurate description of how skeletal muscle fibers function. This is like my father, who could explain how Jungian symbols of the collective unconscious correspond to the three levels of consciousness of the Huna religion one day and the next would give a textbook explanation of quantum mechanics and radioactive decay (he was a radiologist, later turned psychiatrist, by profession).  As they say, all that plus $8 will get you a six-pack of Anchor Steam.

Individuals who have such profound and wide-ranging interests are rare and usually misunderstood.  Their humility is masked by their intellectualism. Taleb’s humility is manifest in his admission that specific predictions about almost anything are impossible, hence the concept of Black Swan events and the importance of protecting yourself against any and all major cataclysms. He notes that financial commentators are forever trying to predict the “next Black Swan”, completely bolloxing the concept that such things are inherently unpredictable. You cannot know, so be humble.  Optionality in a broad sense is the only mitigation available.

My father also had a firm grasp of this idea that increasing fragility, or entropy, is natural and he gave excellent advice about becoming antifragile, although he had different terminology.  Amidst all the discussions about the Caeser’s Gallic Wars or conjecture about whether he could harness the noosphere to control a roll of the dice, pearls of wisdom would occasionally wiggle out. Unlike Taleb, Vince didn’t have an editor so it usually took effort by the listener to keep the conversation focused. Eventually, I gleaned that economic disasters occur once every generation or so, for Vince it was the Great Depression and World War II, and at the time of our discussions it was the crushing inflation of the 1970’s that followed Vietnam.  Shit WILL happen. The Great Recession of 2008 was inevitable in some form, and the next crisis is already in development somewhere.  The best protection, the optionality, is to learn a useful skill that even the Russians or Red Chinese will need. Fix furnaces or cars, or deliver babies; that will never go out of style and you will have insurance against fat-tail events.  Be thrifty, be skeptical, pay off your mortgage. Relax, the rest is entertainment.

Nassim Taleb’s Antifragility synthesizes several fields of interests into an overarching theme. He discusses the problems of agency, actors who lack skin in the game, the failure of even the best economic and biologic models, the human tendency toward bias, etc. My short review cannot do it justice. As a sequel to his previous works, Fooled by Randomness and The Black Swan, this book successfully depicts the nature of the human condition, culturally and biologically. Read it, you’ll be richer for it.

Wednesday, October 01, 2014

Obama hatred, and my response

I got into a back-and-forth at another website with my internet buddy MJ, who is one of these guys who just takes indiscriminate swipes at the current President. Fine, he's entitled to his opinion, but since the website is mainly financial and not politically oriented
I asked politely on what he based his intense dislike. Are there some specific misgivings he has that justifies the constant haranguing? Here is MJ's answer and my subsequent response:

 "Anthony [that's what they call me there] you made me reflect some. That’s good. On what do I base my condemnation of Pres. Obama? On reflection it is not so much his failed policies like Obamacare or his stimulus with its nonexistent “shovel ready jobs” or the Unrealistic budget proposals that have resulted in the “continuing resolution” or the failed sequester gambit that has decimated the military. As you say most presidents have some of these. Maybe not of the magnitude as his. But they do.
"No, I think its more the culture he and the first lady have allowed and promoted. The namby pamby, PC, everybody gets a trophy, no one is accountable, deny-wait-stonewall and it will go away culture. This culture has created the IRS, Fast and Furious, Benghazi, denying domestic terrorism like Fort Hood and recent events in Oklahoma, Vet Admin, Man running in White House, ISIS and Illegal immigrant surge, scandals (and some I am forgetting). The inappropriate vacations and golfing. Failed School lunch menus. Legislating via regulation….. It is second rate at best.
"He is running along the ice as it falls in behind him and Hillary will speed that ice fall as fast as she can so she can right the ship in 2016. Obama is already under the bus. I can hear it in your posts."

That’s a good list to reflect on, MJ. I’ll grant that I take issue as well with some of those items. My curiosity is what criteria you use to include some of them. Some are based on something tangible: like loss of life in the Fast and Furious scandal, or wasted money somewhere (where?), or ignoring IG reports that showed Vet Admin problems. Yes, those were problems that the president should account for, and has not.
Others are bad judgement which may be just part of having a large complex government (IRS scandal) with tentacles all over the world in war zones (Benghazi).
The ones that show me it’s capricious judgement on your part are the intangible “perception” problems that are just piling on, like “everyone gets a trophy” (what is that?), “PC culture” (huh?), “namby-pamby”, or the way he salutes or the clothing the First Lady wears… I mean, come on. Bush took 3X the vacation days that Obama has; presidents take vacations. Get a grip on your pointless anger, dude.
Then there are the issues that are just plain false: illegal immigration is at a multi-decade low. Also, budget resolutions were agreed upon by House Republicans for purely mutual political reasons, nobody wanted to go on record having voted for an evil Obama budget. You should know that these are pure BS.
So, from your list, I can find three substantive issues. Fine. Impeach him over Fast and Furious.
But then you have to look at comparable issues from the previous administration(s) and decide who showed worse judgement or was more willfully criminal. I think being president is probably a tough job, and mistakes happen which can cause death and are visible to everyone, but they happen.
I would judge that Bush made much worse errors of judgement and engaged in outright corruption and coverup. After stonewalling the 9/11 Commission Report for a year, it came out in Chapter 8, titled “The System Was Blinking Red”, that the Bush administration ignored MULTIPLE clues that an attack was imminent in the summer of 2001. Google it, it’s about 20 pages of fuckups, any one of which, if found, would have foiled 9/11. He missed it. Fine. Sh*t happens. Did Obama miss anything of that magnitude?
Then we blunder into a war against the advice of UN weapons inspectors that costs us $2 Trillion and kills over 4K US soldiers, and we lose massive credibility in the world community. We’re laughing stocks. “Curveball”, a source that was never even interviewed by any American agent, was the sole source for the bio-weapons threat that was proved to be pure BS. And you’re worried about how “everyone gets a trophy” political correctness is hurting us? Get real. The there’s L. Paul Bremer and his inept management of the Green Zone, losing $12 billion that just went unaccounted for. Oops– I wonder how many RPG’s and IEDs that money bought.
I guess the 12 embassy bombings under Bush weren’t as important as Benghazi? Or the Marine barracks bombing in Beirut under Reagan, after he was warned that the security wasn’t adequate, that killed a few hundred soldiers. No, Benghazi is much worse I suppose, as shown by the half-dozen GOP-led committee investigations that failed to show wrongdoing.
Then there are the outright willful crimes: The Plame affair was a treasonous offense, the US attorney firings was felonious corruption, NSA wiretapping, Halliburton getting no-bid contracts despite Cheney having been the CEO. Nothing done in the last 6 years even comes close to any one of these. Even if the IRS scandal were willful (not likely), and came from the White House (very doubtful), the damage done by it pales in comparison to even one of the Bush/Cheney crimes. Look up Ahmed Chalabi– who sat NEXT TO the First lady at the SOTU address–to see how our intel was played by self-serving operators. Ugh.
Bad judgments: Abu Ghraib torture (don’t tell me that dictum came from a 2-star general), failure to kill OBL at Tora Bora (wtf?), black site renditions (if they happen that’s one thing, but for god’s sake don’t make it a public spectacle), the same for waterboarding.
Then there were the boondoggles like $1 Trillion dollar Medicare Part D, $800 billion bank bailout--Google “this sucker could go down” or "Hank Paulsen on bended knee to Nancy Pelosi", very dignified.  And the financial near-Armageddon we experienced on his watch, loss of millions of jobs– MILLIONS.
So, yeah, we can lob grenades at Obama for golfing too much or screwing up Fast and Furious that killed a border agent or ignoring the IG reports on the VA, but I think when you total up the corruption, wasted money, and bad judgement, the current administration looks like Utopia.
I don’t know what else to compare Obama’s presidency to, and maybe the sum total of the last 20 years or so merits a re-thinking of the USA in general, but don’t try to tell me that Obama is some kind of outside the norm evil, or 3-standard deviation inept executive.
I’m not making excuses, just trying to join your “reflection” with some comparable examples from a previous administration. If Obama is a corrupt, evil idiot, what does that make Bush and Cheney?

Monday, September 01, 2014

Sean Hannity elevates lying to an artform

I've been trying to engage in more life-affirming activities which means ignoring the ill-informed haranguing about current events. I'm taking a break from my moratorium to point out my appreciation for Sean Hannity's lies which are so elegant that they can be appreciated as art.

Recently, Sean Hannity interviewed sports analyst Stephen A. Smith on his radio show (the Ferguson discussion begins at 7:00) ostensibly to discuss the racial implications of the Ferguson shooting and aftermath with a "reasonable black man". The interview morphed into a dissertation of lies and prejudices without any journalistic acumen or even an attempt to arrive at the truth. To wit, listen starting at the 7:00 mark.

Five points:

1) Suborbital fracture. Hannity broaches the now debunked canard that the police officer had a suborbital facial fracture, implying that Michael Brown beat him up. This is bullshit, and any respectable journalist, commentator or just plain human being would try to corroborate that incendiary factoid before presenting it as fact. The fracture story was made up out of whole cloth by some divisive liar (Gatewaypundit) who has a long history of incendiary lies. Hannity knew this, and if he didn't know it, then he is a poorly informed moron.

2) Protestors are bussed in. Hannity then lies about the the number of non-Ferguson residents who were arrested. ABC reports that of the 78 arrests, 58 were from the Ferguson area.

3) Michael Brown was threatening. Hannity spews the unproven and unproveable conjecture that Brown threatened and rushed at the officer before taking 6 bullets at close range. This is all bullshit, reported as fact. If Hannity wants to investigate something, why doesn't he look into the absence of bodycams and dashcams in Ferguson. We learned over the ensuing 5 days that the Ferguson Police Department has all matter of assault vehicles, MRAPs, body armour, helmets, tactical weapons, etc, but they cannot afford a $100 bodycam? WTF? And since we have no official video, why spew BS about what you think "might have" possibly happened?

4) No police report. Hannity goes into detail about the alleged activities of the fateful day, but has no problem that a police report has not been filed two full weeks (now three as I type) after the incident. The allegations outlined are all based on hearsay and flawed eyewitness accounts. If Hannity were a truthful journalist he would at least mention that he is engaging in blind conjecture and that the police are not forthcoming with their side of the story. At the same time the FPD took the time to release the Quiktrip video of Michael Brown's strong-arm robbery. Why the asymmetric release of information if not to shape the story. A journalist would recognize this as brazen.

5) My final point is subtle, but nonetheless an important weapon in the arsenal of the liar. Stepehn A. Smith was invited to first discuss his suspension from ESPN for alleged sexual harassment and Hannity commiserates with Smith for the first 7 minutes of the interview about how these issues are hard to figure out and the unfairness, yada yada, yada. This is done to disarm the "reasonable black man" for the real discussion: how race in Ferguson unfairly cast blame on a white cop who shot an unarmed black kid. Smith has been de-fanged by the frank conversation of his alleged wrongdoing and much less likely to call out the host when he subsequently lies like a rug.

Hannity is a master.

Book Review: Inferno, by Dan Brown

I listened to the audiobook of Dan Brown's Inferno. He follows his usual formula of phrenetic chases with Robert Langdon and a beautiful, intelligent compatriot, ala James Bond. Langdon is his geeky protagonist who always finds himself in a mess and must save the world using his wits and vast knowledge of some ancient text, this time it's Dante's saga poem The Inferno.

Hewing to the formula, Brown puts Langdon in remarkable places, this time it's Florence, Venice and Istanbul, perusing works of art and architectural wonders, and of course, running through the streets away from the bad guys. Langdon uses his insights on history to uncover the mystery of the story and save the world. This episode involves an evil genius who was developed a vector virus designed to reduce human fertility and thus save the planet from being overrun by our species in a Malthusian catastrophe of overpopulation.

While not garnering the positive reviews of his past books, Inferno was a commercial success and spurred popular interest in Dante as well as increased travel to Italy and Turkey. It does stimulate desire to see the cathedrals and museums described in the book.

One complaint I have is the length of the book. Sure, Brown is extremely readable and the plot moves fast, but hours of chase scenes (on the audiobook) is too much. No editor was available? Another issue is the absence of explanation as to how this vector virus renders humans infertile. What is the mechanism? How do they know it will only affect 30% of the population? The third quibble is the presence of not only one, but TWO evil geniuses. Come on.

Putting the small problems aside, Inferno does what it is supposed to do: keep the reader interested while getting educated about architecture, ancient literature and art. Mission accomplished. Brown's forte is not molecular biology and reproductive medicine. Fine.

Wednesday, August 27, 2014

Book Review: Catherine the Great, by Robert K. Massie

4.5 stars out of 5. 

I read this book as part of a reading group recommendation, not because of some overweening compulsion to dive into Russian history. Massie is most famous for writing Nicholas and Alexandra (published in 1967 and made into a movie in 1971), the story of the last Romanovs who were exiled and killed after the 1917 Russian revolution. Massie, an American from Kentucky and educated at Yale and Oxford, has also written books on Peter the Great and other European history topics. This current volume is published in 2011; Massie has been around a long time.

Catherine the Great is a big book, approaching 600 pages including the must-read author interview in the back. She was born into a small Prussian principality in 1729, the daughter of a financially struggling duke and a socially ambitious mother who was only 16 years her senior. The story begins with Empress Elizabeth of Russia, the daughter of Peter the Great (reigned 1682-1721), who took the Russian throne in 1741 and her first order of business was to secure the succession of power by finding a wife for her nephew-- and Peter the Great’s grandson-- Peter III. Answering a summons, Catherine (known as Sophia as a child) and her mother moved from Prussia to St. Petersburg to be formally courted.

Catherine married the odd Grand Duke Peter, heir to the throne, at the age of 16, but did not conceive the desired offspring for seven years, when Paul I was born. The paternity of Paul has always been questioned and Massie makes the case that his father was one of the court members. Upon Elizabeth’s death in 1761, the power transferred to Peter III, who reigned for only 6 months before dying under suspicious circumstances. Catherine, an outgoing, attractive and intellectually curious woman, had made significant political connections during her decade and a half living in the Russian capital, and much intrigue has been entertained as to the cause of Peter’s death. Catherine grasped the throne with the help of the military and immediately assumed leadership with poise and skill.

Several themes emerge from her reign. Her long tenure (1762 to 1796) was marked by social reforms for serfs (analogous to slaves in the US), expansion of the Russian Empire, and incorporation of Enlightenment values into the Russian Orthodox rule of law. She was famous for keeping her compassionate pledge to never execute a Russian citizen during her tenure, and she made every effort to grant criminals--even revolutionaries-- their day in court.

Catherine navigated the troubled diplomatic environment between France and Britain, keeping Russia safe during the Seven Years’ War (1754-1763). Massie makes the point that this was actually the first world war with battles fought as far away as India and North America, where it was known as the French and Indian War. Britain was the considered winner, taking land from France, but alliances had been cast that partially set the stage for World War One fifty years later.

The Russian empire was the most populous in the world with over 100 million citizens and Catherine increased trade, land and military power over her nearly 40-year reign. She courted the ideas of the French philosophes, invited Diderot and others to spend time in St Petersburg, and corresponded with Voltaire for decades. French was the primary language spoken in the Russian capital. From these humanist values she broached the notion of freeing Russian serfs but was met with vehement opposition from the nobility whose wealth was directly related to ownership of serfs.

To say her reign was complex is an understatement. Catherine quelled populist uprisings as serfs fought for their freedom while appeasing the nobility by granting certain rights for those same serfs. The American Revolution in 1776 and French Revolution in 1789 tested Catherine’s dedication to humanist values and she walked back many of her Enlightenment values in favor of her notion that the best form of government was benign dictatorship. The unwashed masses, while deserving of a certain quality of life, were just too ignorant to be trusted with governance. 

Parenthetically, Massie makes the point that as sketchy as our view of Russian human rights might be, the fact remains that Russia in many respects led the move away from treating humans as chattel and eventually Catherine’s great-grandson formally freed all serfs two years *before* the US freed the slaves. He points out that our sense of moral superiority is misplaced, since 15 American presidents owned slaves, including the writer of Declaration of Independence.

Catherine is responsible for acquiring the Ukraine and Crimea (in the headlines today) from the Turkish Ottoman empire. She established, with the help of her consort and close adviser Grigory Potemkin, the strategically important seaports of Sevastopol and Odessa on the Black Sea. The derogatory term “Potemkin Village” comes from this era when Grigory built cities and towns along the Dneiper River after the bloody Turkish wars in order to show Empress Catherine the magnificence of her newly won territory as she traveled the river to the Crimea. Massie says that much of the disdain for these towns is misplaced, manufactured by his political enemies; the towns, while built quickly, eventually did become important centers of commerce and strategic military outposts.

Robert Massie is an excellent writer and no matter your desire to know Russian history, this book is highly recommended. His narrative is remarkable for presenting complex ideas about military strategy, human rights, advantages and disadvantages of women as leaders, and international alliances with ease. 

One note on the paperback Random House edition is that it fell apart quite easily; maybe the glue was not intended for the Arizona desert. Also, the book would have been improved with maps of the military adventures.

Tuesday, August 06, 2013

Nobody pays $384 for a physical therapy visit

The headline from a WaPo op-ed reads:

For a stiff neck, nearly $6,000 in physical therapy seemed too much

The author is a patient who had physical therapy prescribed for a simple musculoskeletal problem.

My insurance company sent me notification it was “seeking additional information about these charges,” which would mean a “delay in payment” for my PT treatments. My insurer had been billed $412 for my first appointment and $384 for the second. I can hardly blame the company for wanting to know the justification of such costs.
Now I understand why the front desk seemed so eager to have me use my maximum of 12 visits before the end of June: I was leaving nearly $5,000 worth of payments on the table. [bold mine-- Tony]
Notice the confusion of bills, payments and cost.
The author assumes that the insurance company gets no discount and will pay the full $384 billed for the physical therapy appointment and the thousands of dollars of visits. It's satisfying I suppose for health care consumers to read these bills and feel that they have found the real reason, the Holy Grail, of the health care cost crisis, -- $6,000 !!!! OMG!!!--so they fire off an op-ed finally enlightening all of us on the true nut of the issue.
Of course, it's way more complicated than $6,000 in bills. Every insurance company and payer, even cash payer, negotiates a discount to the amount billed. In fact, the amount billed, the $6,000 is a compete fiction. Stop talking about it. 
There's a discount. It might be $100 or $300 or $50.
For a nation ostensibly built on the notion of capitalism and finance I continue to be astounded at the lack of sophistication of the arguments regarding health care finance.
If the Washington Post can publish such an inane op-ed then there is no hope. We should be way beyond the griping about the $384 charged for a physical therapy visit. Nobody ever pays $384 for a physical therapy visit. The insurance company gets a discount. Medicare gets a discounts. Medicaid gets a BIG discount (if it's covered at all). Even cash customers negotiate a discount.

Maybe it's a problem that we really don't know how much is reimbursed for that visit. Fine. But nobody PAYS $384 for a physical therapy visit.

Let me say it again, nobody pays $384 for a physical therapy visit.

Nobody pays $384 for a physical therapy visit.

$384 was the CHARGE, not the payment, NOT the cost.

Get it?

Nobody pays $384 for a physical therapy visit.

Please, if you are an editor for the Washington Post, the USAToday, the Wall Street Journal, the New York Times, or a producer for any news network do NOT conflate charges with payments with costs. Don't embarrass yourselves by publishing op-eds and letters like this without explanation. You are morons.

Nobody pays $384 for a physical therapy visit.