Good Articles That Don't Deserve Their Own Threads

Actually it was the "and that he plans to get a permit to serve liquor soon" that I really loffed at.

really? its just an extension of this rich douchebag lifestyle. 'hey, gonna get your shoes shined by a hot bimbo? might as well have a scotch while you do it!"
Hospitals profit off of their own mistakes:

Hospitals make money from their own mistakes because insurers pay them for the longer stays and extra care that patients need to treat surgical complications that could have been prevented, a new study finds.
Changing the payment system, to stop rewarding poor care, may help to bring down surgical complication rates, the researchers say. If the system does not change, hospitals have little incentive to improve: in fact, some will wind up losing money if they take better care of patients.
The study and an editorial were published Tuesday in The Journal of the American Medical Association. The study authors are from the Boston Consulting Group, Harvard’s schools of medicine and public health, and Texas Health Resources, a large nonprofit hospital system.
The study is based on a detailed analysis of the records of 34,256 people who had surgery in 2010 at one of 12 hospitals run by Texas Health Resources. Of those patients, 1,820 had one or more complications that could have been prevented, like blood clots, pneumonia or infected incisions.
The median length of stay for those patients quadrupled to 14 days, and hospital revenue averaged $30,500 more than for patients without complications ($49,400 versus $18,900). Private insurers paid far more for complications than did Medicare or Medicaid, or patients who paid out of pocket.
Didn't read the article but assume that's referring to acupuncture and chiropractors, right?

No. The FDA found out this lab had been doing fraudulent research and said research had been used in getting a whole host of drugs approved. From blood clotters to cancer treatments, to even ibuprofen. So once the FDA found out the did...nothing. Not a god damn thing. They didn't even tell the doctors that were prescribing these drugs. Seriously, read it. Its infuriating.
Looks like this wasn't the first time they shit the bed either!

The first hint of trouble at MDS Pharma came in July 2003, when FDA investigators found problems with a study of a generic form of the allergy medicine Claritin during an inspection of the company's facility in St. Laurent, Quebec. After originally insisting that there was no need to redo the study, the company relented. But when the FDA conducted a follow-up inspection six months later, it found that data related to the reanalysis was missing.
In another inspection, lasting more than three weeks in September and October 2004, FDA investigators found multiple problems with MDS studies. In addition, the agency determined that MDS had misled the FDA about what studies it reviewed — in particular, that it had failed to review tests for drugs that were already on the market.
The FDA gave MDS well over a year to complete another review of its own work. But when FDA inspectors arrived at the facility in March 2006, they determined that the company's internal audit was incomplete and inaccurate. As an example, the FDA pointed out that one test "pivotal to the approval of the sponsor's generic drug application" had been left out of the audit.
In January 2007, three and a half years after first finding problems at MDS, the FDA informed drug makers that studies done by MDS between 2000 and 2004 needed to be reevaluated. FDA officials told the media that 217 generic drugs were potentially implicated, 140 of which were already approved for sale.
The agency was unsure how many new drugs might have relied on studies carried out by MDS, according to news accounts, so it asked the manufacturers of every new drug approved between 2000 and 2004 — some 900 medicines — to check to see if MDS had conducted any relevant tests.
The FDA made no effort to warn doctors or patients that it now had doubts about the data underlying some of the drugs it had approved. Instead, the agency sounded a public "all clear".
Matt Taibbi shits on Thomas Friedman again. I love these columns:

ome Up With the Ultimate Thomas Friedman Porn Title
By Matt Taibbi
POSTED: May 2, 2:15 PM ET
Thomas L. Friedman
Kris Connor/Getty Images
Yesterday I was clicking my way through the Times editorial page when I hit upon Tom Friedman's column, ominously entitled, "It's a 401(k) World." When I see headlines like that on Tom's pieces I have to make sure my airways are clear of food or drink before proceeding – there is real medical danger of power-laughing your way into a choking episode if you try eating and Friedman-reading simultaneously.
But lunch was over: airways clear. I gathered myself, took a deep breath, and read:
It's hard to have a conversation today with any worker, teacher, student or boss who doesn't tell you some version of this: More things seem to be changing in my world than ever before, but I can't quite put my finger on it, let alone know how to adapt.
Nothing like a lede sentence that offers no information and requires another lede sentence. Standard Friedman so far, chuckle level, safe to proceed:
So let me try to put my finger on it: We now live in a 401(k) world — a world of defined contributions, not defined benefits — where everyone needs to pass the bar exam and no one can escape the most e-mailed list.
What does he mean by defined contributions, defined benefits, passing the bar exam and escaping the most e-mailed list? Let's hold those four or five thoughts while we plow ahead, four or five life-preservers in hand(s), to try to rescue this reading experience:
Here is what I mean: Something really big happened in the world's wiring in the last decade, but it was obscured by the financial crisis and post-9/11. We went from a connected world to a hyperconnected world. I'm always struck that Facebook, Twitter, 4G, iPhones, iPads, high-speech broadband, ubiquitous wireless and Web-enabled cellphones, the cloud, Big Data, cellphone apps and Skype did not exist or were in their infancy a decade ago when I wrote a book called The World Is Flat . . .
Airway alert! Was it possible? Friedman wrote another "The world is increasingly hyperconnected" column!
Racing to Google, I entered GAWKER FRIEDMAN HYPERCONNECTED and called up a piece from, yes, just a few months ago (January 29, 2013 to be exact), in which the king-snark site rolled its eyes over Friedman's last "The world is increasingly hyperconnected" column ("It's P.Q. and C.Q. as much as I.Q.") which contained the following passage:
What do I mean by the Great Inflection? I mean something very big happened in the last decade. The world went from connected to hyperconnected in a way that is impacting every job, industry and school . . .
Gawker went on to painstakingly document the elaborate history of such columns, finding the source of the Nile at January 8, 2004 in a piece called "War of Ideas, Part I," which contained the line, "Trust is built into . . . every interaction in our increasingly hyperconnected world." They then went on to find fifteen more columns over the next eight years built on or around the same concept.
Many of them are virtually word for word the same column as this past January's or this week's column, which incidentally is the seventeenth such column according to their count. Anyway, check the list out if you have a few minutes (which Friedman, apparently, hasn't). It's outstanding.
As for "401(k) World," it's solid stuff, really top-drawer. As Rob Zombie would say, it's more Friedman than Friedman.
In fact, it was such a meta-performance that I wondered if Friedman has been using the brilliant automatic Thomas-Friedman-column-making machine. It really is becoming hard to tell the difference. Go ahead, I dare you pick out the human-penned lede:
Last week's events were truly historic, although we may not know for years or even decades what their final meaning is. It is impossible not to be tantalized by the potential of these events to change the course of history.
It's hard to have a conversation today with any worker, teacher, student or boss who doesn't tell you some version of this: More things seem to be changing in my world than ever before, but I can't quite put my finger on it, let alone know how to adapt.
Imagine if grassroots activists sat down with ordinary people like you and me and ironed out some real solutions to our transportation crisis.
Uncanny, right? I tweeted something out about this yesterday, asking if it was possible that Friedman was actually using the machine to save time. This led to a lot of back and forth, until finally I tripped on one of the repeat lines in yesterday's "401(k) World" piece and tweeted:
Okay, contest time. What would a Tom Friedman porn film be called? I nominate "Something Really Big Is Happening."
Which led to an explosion of responses, many of them aneurysm-level funny. It's a testament to Friedman's unique reach around . . . um, his unique connection with audiences around the world that thousands of people across different states and countries (and languages, even) were ready to instantly pounce here, and many people had multiple solid ideas ready within seconds.
How did we not see that Friedman's whole career has been a series of porn titles? From The Golden Straitjacket to In Three Holes to My Special Sauce to The External Midwife to Hot, Flat and Crowded and, most obviously, Suck On This (which, as many readers noted, is a real porn movie), it's almost like Friedman has been using his New York Times columns to send, across decades, coded battlefield commands to the worldwide army of porn producers. Which is just about the funniest thing imaginable.
Anyway, a small sampling of the best responses:
• Fred Simmons at @fsimmons was one of many to go with some variation on the theme of The Next Six Inches Are Critical. For those who don't know, Friedman's mania for writing that the next six months of the Iraq war would be critical – he did it an awe-inspiring 14 times over a period of two and a half years – led to Fairness and Accuracy in Reporting establishing the so-called "Friedman Unit," which became shorthand for any six-month period. Which in turn led, yesterday, to @ogamble, @bobbybaird, @Casual_Obs, @douglasstruth, @dpinsen, and @chris_labarthe all suggesting The Friedman Unit as their porn title.
• There were lots of excellent naturally-double-entendred Bangalore-themed submissions, like @hortonia's Bangalore Babez, @bhavkp's Bangalore Bangers (which, as he noted, was an actual show), @DavidMizner's elegant Gang Bangalore, and @hot2sandy's rich Maxxxed Metawhores Gone Bangalore. "Dunno about a name," commented @andyferris, "but filming should be split between a taxi and a Bangalore golf course." I totally agreed and replied that I thought the first scene should actually be Friedman and Nandan Nilekani roasting a caddy on a Bangalore putting green. Separately, @Voodoo_Ben was thinking along the same lines: his submission was Your Pussy Reminds Me Of An Anecdote My Indian Caddy Told Me On A Golf Course Overlooking A Pizza Hut Billboard.
• There were probably two hundred or so submissions that were simple but powerful variations of Tom's actual book titles. My two favorites here were probably @rollotomasi3030's Longitudes and Shat-on-Dudes and @raouldukeinLA's The Lexus in Miss Jones, but there were many other strong contenders, like @maizedandconfused's The World is Flaccid, @phillipspasha's unpleasant Hot, Flat and Shrouded, @JayReed13's Trite, Fat and Pounded, @ursus_marit's The World Is Flat, But She Isn't and, lastly, @sousibrown's simple, probably female-perspectived Hot, Flat and Over.
• Brilliant: @salamibaloni's B Anal.
• Many contenders worked with the "Debbie Does Dallas" concept, among them @WordsofVikram's boilerplate Friedman Does Dallas and @youseemfine's more elaborate Devi Does Dallas Cheaper and Harder, Saving Companies Money and Allowing Debbie and Her Pals to Get New, Better Jobs – Everyone Wins. Multiple entrants, including @nomoremister, found what I think is the true theme here, Debbie Does Davos.
• Bonus points to @mr_mxyplyzyk for his cleverly irrelevant entry, Inside Lydia's Ass. Dinner at Dorsia?
• Finally, with relevance to yesterday's historic 17th "hyperconnected" column, we had multiple enties: @amags30's Hyperconnect to Dat Azz, @snowbankbb's Hypercocknected, @bighiller's Hypercocked and many, many others. My favorite, however, was probably @bermanshaker's Hyperconnected – To Your Vagina.
There are so many more, but I don't have the space to get into all of them here. However, I am ultimately going to give a prize to the best entry – my first idea was this Seventies-porn-stache-themed mug, but some readers have said this is a poor reward. I'm willing to spend a little if someone has a better prize idea. In the meantime, I'm definitely looking for feedback and new entires. Winner announced next week . . .
Porn Star Mo Bro Mug by Gift House International
Courtesy of Gift House International
Incidentally, there were many hilarious footnotes to yesterday's Friedmania traffic on Twitter, but I just had to point out one. I couldn't help but notice that self-help guru Tony Robbins (who should definitely be in the cast of B Anal – maybe a green room scene backstage at Joel Osteen's Lakewood Megachurch) read Friedman's "401(k) World" column and, naturally, loved it. From his i-seat at @TonyRobbins, he tweeted:
Why self education & self direction are a necessity & the Ultimate Edge today society! Thomas Friedman is Brilliant!
If you open the ensuing conversation, one of Robbins's revolting self-help cohorts, Tom Corley – author of Rich Habits: The Daily Success Habits of Wealthy Individuals – piled on approvingly. From his bold Twitter perch @RICHHABITS (successful people keep their Twitter addresses in all caps!) he wrote, irrelevantly but characteristically:
New research: 88% of millionaires read self-help books. Only 2% of poor people do this.
To which someone – it's since been deleted – replied, "Thanks for nothing, cuntface." And then people just piled the hell on from there, calling Corley a "narcissistic whoredog marketing shitmeister," among other things. Which had nothing to do with Friedman, but somehow felt like the perfect conclusion to the whole conversation.
Anyway – see you next week!
The dark side of home schooling:

The dark side of home schooling: creating soldiers for the culture war

The Christian home school subculture isn't a children-first movement. Some former students are bravely speaking out
Several decades ago, political activists on the religious right began to put together an "ideology machine". Home schooling was a big part of the plan. The idea was to breed and "train up" an army of culture warriors. We now are faced with the consequences of their actions, some of which are quite disturbing.
According to the Department of Education, the home schooling student population doubled in between 1999 and 2007, to 1.5 million students, and there is reason to think the growth has continued. Though families opt to home school for many different reasons, a large part of the growth has come from Christian fundamentalist sects. Children in that first wave are now old enough to talk about their experiences. In many cases, what they have to say is quite alarming.
When he was growing up in California, Ryan Lee Stollar was a stellar home schooling student. His oratory skills at got him invited to home schooling conferences around the country, where he debated public policy and spread the word about the "virtues" of an authentically Christian home school education.
Now 28, looking back on his childhood, it all seems like a delusion. As Stollar explains:
"The Christian home school subculture isn't a children-first movement. It is, for all intents and purposes, an ideology-first movement. There is a massive, well-oiled machine of ideology that is churning out soldiers for the culture war. Home schooling is both the breeding ground – literally, when you consider the Quiverfull concept – and the training ground for this machinery. I say this as someone who was raised in that world."​
Too frequently, Stollar says, the consequences of putting ideology over children include anxiety, depression, distrust of authority, and issues around sexuality. This is evident from the testimonials that appear on Home schoolers Anonymous, the website that Stollar established, along with several partners.
Stollar's own home schooling experience started off well. But over time, as his family became immersed in the world of Christian home schooling, his "education" became less straightforward and more ideological. "I particularly remember my science curriculum," he says. "We used It Couldn't Just Happen, which wasn't really a science textbook. It was really just an apologetics textbook which taught students cliché refutations of evolutionism."
Many parents start off home schooling with the intention of inculcating their children in a mainstream form of Christianity. However, as many HA bloggers report, it is easy to get sucked into the vortex of fundamentalist home schooling because extremists have cornered the market – running the conventions, publishing the curricula, setting up the blogs.
As HA blogger Julie Ann Smith, a Washington state mother of seven, says:
"If you are the average Christian home schooler with no agenda, and you have the choice between attending a secular home schooling convention and a Christian one, chances are you'll choose the Christian convention. But they only allow certain speakers who follow their agenda. So you have no clue. What you don't realize is that they are being run by Christian Reconstructionists."​
Smith is referring to the Calvinist movement, founded by Rousas John Rushdoony, that advocates a Christian takeover of the political system in order to "purify" the nation and cleanse it of the sin of secularism. Rushdoony taught that public schools – "statist education," in his words – promote chaos, primitivism, and "a vast disintegration into the void". He advocated home schooling as a way to rear a generation that could carry out the mission of retaking the nation for Christ.
Much of fundamentalist home schooling is driven by deeply sexist and patriarchal ideology. The Quiverfull movement teaches that women need to submit to their husbands and have as many babies as they possibly can. The effects of these ideas on children are devastating, as a glance at HA's blogs show.

"The story of being home schooled was a story of being told to sit down and shut up. 'An ideal woman is quiet and submissive,' I was told time and time again," writes Phoebe. "The silence and submission I was pushed into was ultimately a place of loneliness, bitterness and almost crippling insecurity."
The fundamentalist home schooling world also advocates an extraordinarily authoritarian view of the parental role. Corporal punishment is frequently encouraged. The effects are, again, often quite devastating. "People who experienced authoritarian parents tend to turn into adults with poor boundaries," writes one pseudonymous HA blogger. "It's an extremely unsatisfying and unsustainable way to live."
In America, we often take for granted that parents have an absolute right to decide how their children will be educated, but this leads us to overlook the fact that children have rights, too, and that we as a modern society are obligated to make sure that they get an education. Families should be allowed to pursue sensible homeschooling options, but current arrangements have allowed some families to replace education with fundamentalist indoctrination.
As the appearance of HA reminds us, the damage done by this kind of false education falls not just on our society as a whole, but on the children who are pumped through the ideology machine. They are the traumatized veterans of our culture wars. We should listen to their stories, and support them as they find their way forward.
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Exactly why it didn't merit its own thread. But I had no idea any of those problems even existed, hardcore people running the conventions, so I thought it merited a post here if for no other reason than the information.

Coming Corporate Control of Medicine Will Throw Patients Under the Bus

One of the most effective scare techniques employed to preserve our grotesquely inefficient, overpriced health care system has been to invoke the red peril of “socialized medicine”. Never mind that foreigners in advanced economies fail to recognize the caricatures scaremongers supply, or that Americans who need emergency care while overseas are almost without exception impressed with the caliber of care and astonished by the low (sometimes no) cost to them. After all, Americans live in the best of all possible worlds,and consumer and business freedom are always better.
In fact, business freedom here increasingly means the God-given right to exploit the vulnerability of the public. The example slouching into view is more corporate control over the practice of medicine. And based on the previews, it will make the horrors falsely attributed to socialized medicine look pale.
Two accounts last week bring the issue home. The first came in the Health Care Renewal blog (hat tip Lysa). It’s a reminder of how the current institutional efforts to regiment doctors undermine the caliber of medical care. It has become distressingly common for HMOs and other medical enterprises to have business-school trained managers putting factory-style production parameters on doctor visits. Outside of foreclosure mills, it’s hard to find similar approaches in other professions.
The post describes how a pediatrician, Pauline, who has developed a reputation for treating chronic conditions is at loggerheads with her for-profit practice. The suits don’t like her patient mix. She gets too many tough cases, when they’d rather have basically healthy kids who are there for a cold or ear infection. Mind you, this is only partly a money issue. These visits can be “up coded” so as to get larger insurance/patient payments, but she get a higher level of patients in less-generous state insurance programs. But some of the pushback is that her practice is perceived as disruptive, since she uses what is perceived as too much of her and staff time, separate and apart from the economics. She’s constantly breaking management’s precious guidelines. One of her turf struggles:
She had set up a visit to see a new medically complex patient and had blocked off 40 minutes, the amount of time she felt she needed to do a good job. The child had a complex genetic disorder, cerebral palsy, and heart, lung, and kidney problems. Both the cardiologist and the nephrologist had called asking her to take this patient. She agreed. After she had scheduled the visit, a manager called her and told her that she was being allowed only 15 minutes to see that patient. After some fruitless discussion with him, Pauline finally said, “Okay, I guess that means that you’ll be seeing the patient instead of me, right?” The shocked voice at the other end of the phone line replied, “What do you mean? I don’t know how to take care of patients.” “That’s exactly my point,” Pauline put in.
Pauline explained that this manager assigned to her office is not even a college graduate. Physicians cannot access the schedule electronically and have no control over scheduling. These functions are controlled by the office manager and (amazingly) by some of the medical assistants who have received some “leadership” training. These medical assistants are even allowed to evaluate the clinical competency and skills of the physicians.​
And to add insult to injury, how long did this discussion take? All those minutes the doctor spent fighting with a petty bureaucrat come at the expense of patient care.
As an aside, it’s hard to stress enough that this sort of demoralizing micromanagement an unwillingness to listen to and learn from workers, is a widespread shortcoming of management American-style. And it has weirdly been airbrushed out of the media. When I was a kid in business school, US manufacturers were having their clocks cleaned by Germans and the Japanese. There was a good deal of critical self examination back then. One source of foreign ascendancy was that they had newer factories, so you couldn’t really blame American management for that one. But the second was that it was widely acknowledged that US managers were generally poor at dealing with labor. And this wasn’t “labor” in the union sense, but at having productive relationships with factory workers (note that there has been massive revisionist history since then. When I was in Bschool, none of my classmates, nearly half of whom had worked in major manufacturing companies, had bad things to say about unions. Now you’ll often see the decline of American manufacturing attributed to unions in an “everybody knows that” tone.
Now before you come running to the defense of management against the doctor, think twice:
So let me add a further nugget about Pauline’s background. In one of her previous jobs, she was made the manager of a pediatric outpatient center within a county hospital caring for a largely indigent population. This center had been running in the red for a good while. Pauline took over and within 28 months she’d streamlined the place and had them running well in the black, while still administering a quality of care that Pauline and her colleagues could be proud of. In short, Pauline could probably tell the managers of her current practice a thing or two about how to optimize patient scheduling without compromising care or cost —if they’d listen.​
As bad as that is, most patients are unware of how much their care has been fitted to a Procrustean bed. The deliberate degradation in the name of profits is going to become more obvious, at least if the health care industry has its way.
I strongly encourage you to read this post from Whole Health Chicago (hat tip Lambert) in full. It shows how the future of American medicine is to fire the ones who are unhealthy. No, I am not making that up. The writer, Dr. David Edelberg, describes a recent presentation by a large insurance company. They’ve apparently been hosting similar sessions with physicians in the Chicago area in large medical practices. Here are the key bits (emphasis original):
The speaker at these evenings is always a physician employed by the insurance company. His/her title is medical director (I begin to think there must be dozens and dozens on their payroll) and he always begins by reassuring the audience that he was in clinical practice himself so he understands something of what physicians–especially primary care physicians–are facing. I view this physician more as a “Judas steer,” the animal that leads an innocent but doomed herd of cattle through the slaughterhouse corridors to the killing floor.
The health industry hopes that individual medical practices and small medical groups will ultimately disappear from the landscape by being financially absorbed into larger groups owned by hospital systems.
And why do the powers that be regard this as desirable? Although the article does not stress this point, doctors have an established revenue stream. So the acquirers buy them out and impose discipline on those artistic, freewheeling doctors. The “practice style,” which used to mean the independence that doctors once enjoyed, is now an Orwellianism and includes hewing to corporate guidelines as to how to operate.
And here’s what to expect:
Physicians are expected to spend a limited amount of time with each patient, and are encouraged to see as many patients as possible during a workday. The insurance companies, sometimes with the token cooperation of a few physician-employees, create vast books of patient-care guidelines to which they believe their physicians must be “accountable” (remember this word, it will crop up again). These guidelines might mean documented Pap smear and mammogram frequency, weight management and exercise, colonoscopies for patients over 50, and getting that evil LDL (bad cholesterol) below 99 by any means possible…
If the chart audit system discovers that a physician, for whatever reason, is an “outlier”–that she’s either not following the guidelines exactly or not getting the results anticipated for her patient population—she’ll be financially penalized. A quick example of what might occur: if your LDL is 115, you may be on the receiving end of a statin sales pitch from your doctor, not because bringing it down to 99 will improve your longevity, but because your refusal to do so will impact her financial bottom line.​
Now of course, you might say, “Well, in fairness, medicine is too much of a cottage industry. Look at how many doctors give unnecessary annual EKGs to patients in low risk groups. How else are we going to get to evidence-based medicine?” The problem is that what we as patients will get isn’t driven by best outcomes, it’s driven by profits. Edelberg explains:
…the subtext of “standardized” always includes the unspoken “spend less money on the patient.” Thus, a doctor might be financially penalized for recommending nutritional counseling to lower cholesterol (“counseling is expensive”) instead of writing a generic statin drug (cheap). Or recommending psychotherapy (“therapy is very expensive”) instead of generic Prozac (cheaper than M&M’s). Or referring patients for massage, acupuncture, or even chiropractic (“expensive, expensive, expensive!”) instead of pushing an over-the-counter antiinflammatory (free to the insurance company, as it’s OTC).​
And I shudder to think what becomes of patients who don’t hew to standard templates: the person who had a high body mass but not due to dangerous abdominal fat (which is what creates the health risk) who is pushed to take the latest, greatest diet drug. What about people who don’t buy into the religion of getting your LDL down to below 100 (one reader argued that while it may lower your risk of heart disease, it increases your all-factor death risk by reducing your ability to fight MRSA)? Will they face penalties if they fail to comply?
No, you just will find it nearly impossible to get a doctor to take you:
• Let me close with a best-as-I-recall quote from an insurance company medical director. “We can no longer afford to pay for health care under the PPO model. Our plan is to phase out all fee-for-service care during the next few years. We’ll pay you doctors a finite amount of money to take care of a defined population. We tell doctors, ‘Don’t spend much money and you can keep the difference. Period. Don’t follow guidelines, and you’ll be leaving behind some serious money on the table and we’ll just take it back.’”​
In case you think I overstated the implications, Edelberg recapped the discussion that ensued:
One physician piped up…. “But what about the non-compliant patients who won’t take the meds, don’t eat well, don’t have mammograms, continue to smoke? And what about super-health-conscious patients who want their vitamin levels measured and want referrals to acupuncturists?”
Another physician answered wearily for the medical director (who didn’t disagree): “You’ve got to fire patients like that. Get the non-compliant and the super-demanding out of your system. They’ll drag your numbers down. Hit your personal bottom line.”
Hey you, patient. Yes, I mean YOU. Pink slip time! Canned! Take your medical records and don’t let the frosted glass door hit you in the…on the way out.​
In other words, if you are high maintenance because you don’t do what your doctor says (and remember, “non-compliant” includes people who don’t follow orders because they think the cookie-cutter approach isn’t right for them) or want higher service or per the example of the pediatrician Patricia’s 40 minute case, have a complicated set of ailments, you’ll be shunted. The brave new world of corporate medicine will eject you.
The rich are unlikely even to know that this change is occurring. There will be a tier of doctors on the high end to cater to patients who want more personalized, cutting edge treatment and might need some prodding. And they can always go abroad if they can’t find what they need here. But for ordinary schlubs, expect to find the doctor’s office become more hostile as the brave new world of corporatized medicine becomes entrenched.
The massive scale of China's cyberhacking of US DoD contractors. This is nuts:

Key quote:
The confidential list of compromised weapons system designs and technologies represents the clearest look at what the Chinese are suspected of targeting. When the list was read to independent defense experts, they said they were shocked by the extent of the cyber-espionage and the potential for compromising U.S. defenses.
“That’s staggering,” said Mark Stokes, executive director of the Project 2049 Institute, a think tank that focuses on Asia security issues. “These are all very critical weapons systems, critical to our national security. When I hear this in totality, it’s breathtaking.”
The experts said the cybertheft creates three major problems. First, access to advanced U.S. designs gives China an immediate operational edge that could be exploited in a conflict. Second, it accelerates China’s acquisition of advanced military technology and saves billions in development costs. And third, the U.S. designs can be used to benefit China’s own defense industry. There are long-standing suspicions that China’s theft of designs for the F-35 fighter allowed Beijing to develop its version much faster.
“You’ve seen significant improvements in Chinese military capabilities through their willingness to spend, their acquisitions of advanced Russian weapons, and from their cyber-espionage campaign,” said James A. Lewis, a cyber-policy expert at the Center for Strategic and International Studies. “Ten years ago, I used to call the PLA [People’s Liberation Army] the world’s largest open-air military museum. I can’t say that now.”
I'm sorry, but if you're in prison, you don't have a right to complain about broken toilets or rats.

Or sexual assault for that matter. Don't commit the crime in the first place.
I'm sorry, but if you're in prison, you don't have a right to complain about broken toilets or rats.

Yeah, yeah you do. This is supposed to be a time away from society as a penalty for your misdeeds. Not Auschwitz. Did you read about the guy getting assraped for 3+ hours?
I did, and after reading his letter about repeatedly shoplifting, being caught (in the wrong place), missing probation, etc. I felt very little sympathy.

If you don't want to end up in prison, take steps to prevent it.

Also, what's up with this "required Edit reason" now?

It's not about time away from society, it's about punishment. Cable TV, consistent food and supplies is not punishment.
I did, and after reading his letter about repeatedly shoplifting, being caught (in the wrong place), missing probation, etc. I felt very little sympathy.

If you don't want to end up in prison, take steps to prevent it.

Also, what's up with this "required Edit reason" now?

It's not about time away from society, it's about punishment. Cable TV, consistent food and supplies is not punishment.

Yes, time away from society is punishment. Being able to watch a predefined show for almost an hour isn't exactly a luxury. Getting a white bread and slop isn't exactly a luxury. And always fearing for your safety, and your asshole, isn't exactly a luxury. Its hard to explain if you've never been. Go volunteer at a prison. It'll open your eyes.
Alright, that's one scenario I didn't address, operating under the assumption that those in prison legitimately broke the law and deserve to be there.
Alright, that's one scenario I didn't address, operating under the assumption that those in prison legitimately broke the law and deserve to be there.

So where's the line? A guy who stole a carton of smokes? Someone who boosted a car for a joyride? At what point does the crime you're imprisoned for sign you up for having an erect penis forcibly inserted into your rectum at knife point?

How about this guy:

Wednesday, April 17, 2013

More Washington Sleaze: Lobbyist Tip Stoked Health Care Stock Jump

Yesterday, we featured an important article by Noam Scheiber on how Obama insiders cash out on their connections once they leave the fold. Today, in the Wall Street Journal, we read of the Congressional version in terms of how a tip by a lobbyist (and former Congressional aide) connected to an investment research firm led to a Congressional decision being leaked to investors before it was announced officially.
Understand how this connection game works. One way is that Corporate America tries to influence policy in Congress, with regulators, and with the Administration. Former insiders advise business chieftans and their minions who to approach, whose campaigns to support, how to craft their message, and with lobbying and with regulators, will act as agents, often fronting for industry associations with Orwellian names. Notice only working to influence Congress is considered “lobbying” and requires registering as a lobbyist.
The second sort of information flow is that of pending Congressional and regulatory actions (and Fed thinking) that can move markets. The Journal stresses that the political intelligence industry heretofore hasn’t gotten much attention, but the SEC has launched a probe of the case in question, that of a lobbyist Mark Hayes, who has Humana as a client. Hayes is a former health care aide to Senator Chuck Grassley. He also works for a broker-dealer and investment research firm, Height Securities.
Here is the basic outline of what happened, per the Journal:
…on April 1 Height sent a report to clients 18 minutes before the end of trading that predicted—correctly, it turned out—a government agency would drop planned cuts in funding for insurers that offered Medicare Advantage plans.
The report snagged the attention of big hedge-fund firms that placed profitable trades, according to people familiar with the trading activity. Shares in several health-care companies, including Humana, climbed sharply before the market close and again when trading opened the next day….
Mr. Hayes lobbies for Humana, which pressured the government’s Centers for Medicare & Medicaid Services to drop its planned cuts to certain insurance plans. A Humana spokesman said the company had no advance warning of the decision…
The back-and-forth between Mr. Hayes and Height transpired April 1 after a Height policy analyst, Justin Simon, scrambled to chase rumors of CMS’s decision, emailing an array of contacts around Washington, including an aide to Sen. Orrin Hatch (R., Utah,) the top Republican on the Finance Committee, and a lobbyist for Humana. Neither responded, according to the correspondence reviewed by the Journal.
At 3:12 p.m., Mr. Hayes told Mr. Simon in an email he had “heard from very credible sources” a decision had been made to restore the payments.
“Our intel is that a deal was already hatched,” Mr. Hayes wrote in the email.
As Height scurried to verify the tip with public officials, another Height employee forwarded Mr. Hayes’s email to several congressional aides in at attempt to confirm the information. At 3:42 p.m., Height sent a similarly worded alert to its Wall Street clients. Trading in health-care stocks surged.​
Ironically, it is Hayes’ former boss, Chuck Grassley, who has been pushing for curbs on political intelligence, who has opened an investigation. The SEC has also opened a preliminary probe.
It’s also unfortunate, and unlikely not a coincidence, that the partial repeal of the STOCK act was signed into law yesterday. From Roll Call:
President Barack Obama signed a partial repeal of the STOCK Act on Monday, with the White House citing national security concerns in canceling a planned online database of investment information of top congressional staffers and administration employees.​
It is also key to notice that the sort of multiple hats that Hayes wears is endemic in Washington. The best single work on power in the US is Janine Wedel’s Shadow Elite: How the World’s New Power Brokers Undermine Democracy, Government, and the Free Market. The book describes how connected insiders with shared ideological visions work through what she calls “flex networks.” She calls the perps “flexians” and describes how they collaborate to direct the policies and conduct of governments and major businesses. And they put their cause and their crowd first, and care little about the outcomes of their actions (one of the examples she describes at length is the Harvard cabal that led and tried to profit handsomely from the liberalization of Russia in the early 1990s.
Unfortunately, it is not clear that either the SEC or Grassley will be able to pin anything on Hayes. Insider trading historically was limited to “insiders,” as in people who had a duty of care to the corporation (officers, managers, executives, and agents they employes like law firms and investment banks). The SEC has successfully expanded the notion of what constitutes insider trading as investors have become much more aggressive about obtaining an information advantage (for instance, firms like Gershon Lerman who try to get corporate employees to moonlight on behalf of their clients. Everyone understands that what the clients want is inside information, even though everyone goes through the forms of pretending that the “information” is arms-length research). Case law does not exist in this area, and it will be interesting to see how far the SEC goes in this situation. Hayes’ emails show that he was upset with Height about the leak, but honestly, what did he expect?
So get out your popcorn. This will make for good theater, and it will at least around the margin lead some of the information-hustlers to be a tad more careful about how they play the game. Sadly, that is often the most we can get out of scandals like this.
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So where's the line? A guy who stole a carton of smokes? Someone who boosted a car for a joyride? At what point does the crime you're imprisoned for sign you up for having an erect penis forcibly inserted into your rectum at knife point?

How about this guy:

I think you misinterpret me. I don't wish forcible rape on anyone, but if you can't afford to do the time, don't do the crime. You know the consequences and what might happen in jail. Go ahead and boost that car if you don't think you'll get caught, but don't moan and groan after the fact that you're in over your head in prison when "don't drop the soap" jokes have been around for years.
Taibbi on another SEC whistleblower fiasco:

Why Didn't the SEC Catch Madoff? It Might Have Been Policy Not To
More and more embarrassing stories of keep leaking out the SEC, which is beginning to look somehow worse than corrupt – it's hard to find the right language exactly, but "aggressively clueless" comes pretty close to summing up the atmosphere that seems to be ruling the country's top financial gendarmes.
The most recent contribution to the broadening canvas of dysfunction and incompetence surrounding the SEC is a whistleblower complaint filed by 56-year-old Kathleen Furey, a senior lawyer who worked in the New York Regional Office (NYRO), the agency outpost with direct jurisdiction over Wall Street.
Furey's complaint is full of startling revelations about the SEC, but the most amazing of them is that Furey and the other 20-odd lawyers who worked in her unit at the NYRO were actually barred by a superior from bringing cases under two of the four main securities laws governing Wall Street, the Investment Advisors Act of 1940 and the Investment Company Act of 1940.
According to Furey, her group at the SEC's New York office, from a period stretching for over half a decade through December, 2008, did not as a matter of policy pursue cases against investment managers like Bernie Madoff. Furey says she was told flatly by her boss, Assistant Regional Director George Stepaniuk, that "We do not do IM cases."
Some background is necessary to explain the significance of this tale.
There are four main laws that the SEC uses to regulate the financial sector. At least as far as numbers go, the agency has a fairly extensive record of enforcement actions with the first two, which are aimed at the securities markets.
The first of those is the Securities Act of 1933, also commonly known as the "Blue Sky laws," which among other things set down the rules mandating public disclosure of pertinent information to investors in securities. The second is the Securities Exchange Act of 1934, which governs securities already issued, and includes the laws barring insider trading. Both of these laws are primarily intended to prevent fraud in the securities markets.
But the agency's record is a little spottier when it comes to the other two key pieces of legislation, the Investment Advisers Act of 1940 and theInvestment Company Act of 1940. These are the agency's main tools for prosecuting fraud and malfeasance involving people who manage other people's money – mutual funds, hedge funds, investment managers. Somebody like Bernie Madoff, who took billions from investors and simply stole the money instead of investing, would largely be regulated under the latter two acts.
Kathleen Furey joined the SEC in September of 2004, starting as a law clerk in the Enforcement Division. She steadily rose within the agency and was promoted three times over the next three years.
Then in 2007, Furey started work on a case that involved Value Line, a high-profile family of mutual funds that was being accused of charging tens of millions of dollars in bogus commissions. The company had appeared on the SEC's radar via a referral in 2004, but the agency's higher-ups had not yet approved a formal investigation, which is necessary for the issuance of subpoenas.
When she tried to take that next step in the Value Line case, Furey says she was denied. This is when she says Stepaniuk filled her in on his "We don't do IM cases" policy. Upset, and convinced that the Assistant Director of the New York office did not have the authority to unilaterally non-enforce two major portions of the SEC's regulatory mandate, Furey appealed to Stepaniuk's superior in the NYRO.
According to Furey's complaint, this official, instead of helping her and paving the way for the investigation to proceed, gave Furey two options. He said she could either recant her statement about being told not to pursue "IM cases," or she could go to the SEC Inspector General.
Incidentally, Furey in her internal arguments over this case specifically warned that the agency needed to begin enforcing section 206 of the Investment Advisers Act, which barred money managers from employing "any device, scheme, or artifice to defraud any client or prospective client." She warned that pursuing cases under that statute "may save the agency from future embarrassment." Section 206 was the exact statute that the SEC ultimately employed both in the Value Line case (many years later), and in the case against Bernie Madoff.
This background is key to understanding the timeline of the SEC's response to both the Madoff story and Investment Management cases in general.
In Furey's complaint, she cites statistics that provide unsettling evidence that there was, in fact, some kind of policy in place that prevented her group from going after investment advisers. During the period from January 1, 2002, through January 20, 2009, Stepaniuk's group did not file a single case under the Investment Advisors Act (IAA) or Investment Company Act (ICA).
During this time frame, Stepaniuk reportedly approached the SEC's Commission 60 times with requests to to file cases or to open formal investigations, which, again, is necessary to file subpoenas. Out of those 60 cases, only one, the Value Line investigation opened on April 18, 2008, was an Investment Management case.
In a not-so-amazing coincidence, April 18, 2008 happened to be the same day that the SEC's Inspector General released a report that in part addressed the office's apparent mishandling of that same Value Line case. In other words, the SEC seemed not to move on Value Line until it became a public issue.
Even more damning, however, was the reaction after the Madoff story broke, toward the tail end of 2008. The scandal was incredibly embarrassing to the SEC, which had failed to investigate Madoff despite being tipped off in extraordinarily detailed fashion by investigator Harry Markopolos over eight years before.
It came out that Madoff had not merely stolen from his clients but not conducted any trades at all, simply bilking money in the most primitive conceivable Ponzi scheme. This meant that the SEC would have been able to uncover the fraud with even the most cursory examination at any time during the fund's existence.
Unsurprisingly, by the start of 2009, the SEC was being hammered by members of Congress in both parties – institutionally a terribly troubling development, given that Congress controls the regulator's budget.
So how did the agency respond? After having conducted no "IM cases" at all for years, that NYRO group's next nine cases from January 2009 on were all IAA or ICA cases.
When I contacted the SEC, I made it clear that if they could produce any evidence that Furey's statistics were off, that Stepaniuk's unit had in fact filed IAA or ICA cases during the relevant time period, then I probably wouldn't write about her complaint.
But when I pressed the agency for specifics on that question, they responded with red herrings.
First, they sent a list of 14 IM cases pursued by the SEC's New York Office between 2006 and 2009. When I asked how many of those were pursued by Stepaniuk's group, it turned out that only one of them was – a case against Henry "Hank" Morris, a top fundraiser for New York City Comptroller Alan Hevesi. But that case was charged in March 2009, right after the Madoff story broke. This was completely consistent with what Furey had claimed, that her group had essentially not pursued IM cases until after Madoff.
When I pointed this out, they sent yet another list of cases, two of which appeared to have been filed by Stepaniuk's group prior to the Madoff case. One of those, SEC vs. Kevin Dunn, involved a stockbroker for MetLife who was accused of swindling the widow of a Port Authority policeman who died in 9/11.
While no doubt a worthy matter to pursue, this, too turned out not to be an "IM case." Dunn was exclusively charged with violations under the old-school '33 and '34 Acts. The only references to the IAA in the entire case were two totally extraneous facts.
One was that MetLife, which was not charged in the case at all and merely happened to be Dunn's employer, was a registered Investment Adviser. Two was that Dunn, as a condition of his punishment, agreed to be barred from any affiliations with any registered broker-dealer or investment adviser in the future. This is a common regulatory/punitive throw-in and had nothing to do with what kind of case it was.
Claiming that this was an IM case was not much different than sending on a case involving a stockbroker who had committed insider trading while flying over a registered Investment Company office in a hot air balloon – and claiming that was an "IM case." It was silly.
The other case I was sent was . . . SEC vs. Value Line!
The fact that the SEC would try to discredit Furey and sell its own sterling record of investigating investment management cases by citing the same troubled investigation that had caused Furey to blow the whistle in the first place should tell you a lot about how disorganized the agency now seems to be.
The SEC did note that the Inspector General, years back, could not find corroborating evidence for Furey's claim that Stepaniuk had told her there was a policy against "IM cases." But what was or wasn't said is not of primary relevance to the story.
What is highly relevant is that Furey was unquestionably on record – in emails and other complaints – complaining about the lack of action in this arena even before the Madoff story broke. And there's little doubt that this unit's actual record of pre-Madoff IM cases in the rest of the 2000s is essentially nonexistent.
This being the SEC, the story unfortunately did not end with a key unit of the agency merely failing to regulate an entire sector of the finance world until a $60 billion Ponzi scheme exploded in its face. In this incident they've also continued to show an inability to deal with whistleblowers, a problem that of course has been epidemic in the last two presidential administrations, but has been particularly acute in the SEC.
Noted author William Cohan described Furey's post-whistleblowing struggles within the SEC in great detail in a Bloomberg piece.
As Cohan explains, Furey went through all the usual nonsense after coming forward and complaining about the failure to bring "IM cases": She was shunned by superiors, kept away from sensitive work and taken off the promotion track.
Moreover, when Furey in 2010 asked then-NYRO director George Canellos if her career was being held back by her whistleblowing, he gave an interesting answer. She says he responded by saying that there were people in the New York office who were "not fans" of what she had done.
Canellos today mans one of the SEC's top jobs. Along with Andrew Ceresney, who worked with new chief Mary Jo White as a partner at her old firm Debevoise and Plimpton, he runs the SEC's enforcement division.
Furey contends that for a time, she was being compensated at a level not commensurate with her actual duties – without getting too wonky, Furey believed she was being paid as an "SK-14"-level civil servant while she was in fact handling the duties of an "SK-16." When Canellos and other officials did not respond to her complaints directly, she requested an external "desk audit," a government procedure in which an outside official assesses the duties of an agency employee.
Furey received a perfect score of 1,760 out of 1,760 from the outside auditor, who agreed that she was working at the SK-16 level and recommended that, if she remained in that position, she be promoted.
The SEC and Canellos instead stripped her of her duties, essentially demoting her and not implenting the recommendation of the desk audit, an action rare enough that the agency's human resources department apparently had to do research to see if it was legal (according to Furey's attorney, this checking was done only after the demotion).
The SEC, meanwhile, contends that Furey only temporarily held the higher position, filling a spot vacated by a promoted official, and that the agency hadto demote her. "As a general matter, managers are not permitted to indefinitely assign work above an employee’s grade level," says SEC spokesman John Nester. "If there is not a higher level position that has been approved for filling, managers are required to remove the higher level duties."
Beyond that, neither Stepaniuk nor Canellos has any comment on Furey's allegations.
While a lot of this will seem like a meaningless intramural squabble to outside readers, it points to a larger pattern within the agency. For years, people who come forward and try to press the SEC to pursue important cases have often been treated very poorly, if not with outright hostility.
This has been true of people outside the SEC, like Harry Markopolos or Leyla Wydler, who came forward with information about the Stanford Ponzi scheme, only to be ignored by the SEC. Both the Madoff and Stanford cases, which incidentally were both "IM cases," snowballed into far bigger disasters than was necessary because the agency identically blew off those two whistleblowers.
The agency also has a poor record with whistleblowers within the SEC, like onetime investigator Gary Aguirre, who famously won a $755,000 wrongful termination settlement against the SEC after he was fired for trying to press an insider trading case against future Morgan Stanley chief John Mack.
Aguirre, ironically, now represents Furey, and it sometimes feels like we're re-living the same stories over and over again with this agency. The same kinds of blindly political creatures keep getting promoted to the top jobs, while hardworking line investigators who are just trying to do the work keep running into the same kinds of ludicrous intra-office difficulties. They have to get a clue eventually – don't they?

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