this week i

toured the u.s. capitol..

..and gift shop. huh?

went to a doo-wop show at wolftrap. apparently hate doo-wop.

have been reading the agonist a lot recently, per my boss's suggestion. his rant against ken mehlman is superb.

kind of agree re: economic forecasting.

think spain without portugal looks bizarre.

would follow this guide to self-employment, but i'm happy at kff, tyvm.

read this article about how language shapes thoughts.

the guugu yimithirr rely on cardinal directions..they would warn you to 'look out for that big ant just north of your foot.'

a speaker of tzeltal from southern mexico was blindfolded and spun around more than 20 times in a darkened house. still blindfolded and dizzy, he pointed without hesitation at the geographic directions.


dredged up my favorite paragraph from my old epidemiology textbook, written by the legendary hopkins professor leon gordis. this is verbatim (emphasis mine).

they asked a group of men whether or not they had been circumcised. the men were then examined by a physician. of the 56 men who stated they were circumcised, 19, or 33.9%, were found to be uncircumcised. of the 136 men who stated they were not circumcised, 47, or 34.6% were found to be circumcised. these data demonstrate that the findings from studies using interview data may not always be clear-cut.

9/2

this week i

cracked the survey of income & program participation. successfully ran some estimates of how many people will gain/lose medicaid eligibility over the course of a year.

got together for restaurant week.

caught a didgeridoo presentation at the australian embassy.

drove to oregon ridge park for the hot august blues festival, featuring keb' mo' and, yes, lyle lovett again.

watched a face in the crowd, andy griffith's amazing b&w movie about the eruption of power in america.

read this eye-opening article about labor unrest in the developing world - bangladeshi garment workers are fighting to increase their $43 monthly pay. this is why i consider constant travel vital, lest we forget the struggles of those we share this earth with.

saw the magnificent rodrigo y gabriela.

video

ordered the banana flambé.

wasn't shocked by the statistics and recommendations presented in epidemic of care, co-written by the c.e.o. of kaiser permanente. unabashedly the perspective of an insurer -

premiums are merely the arithmetic sum of the cost of care

providers started acquiring providers..hospitals bought clinics..medical groups merged with one another..a strategic response to the growing negotiating power of local health plans.

the public wants unlimited care

kaiser permanente of ohio has reduced chf death rates to less than half of the state average.

..he had some decent criticisms ..of our absence of standards -

we simply expect millions of independent, overworked caregivers to all somehow 'do it right'.

..of the media -

improving the safety and consistency of care..will not happen as long as the press ignores statistical quality reports and instead politicizes a subset of photogenic, anecdote-based quality issues.

- but he mentioned long waits in single-payer systems, without ever touching the term 'life expectancy' (bosnia and puerto rico have us beat, for fuck's sake) -

in britain, the government spends $1,763 in tax dollars per person per year..our government already directly spends $2,218 per person..for just the old, the poor, the disabled, and the governmentally employed.

- and he kept using the term 'medical miracles' while only briefly touching the bigger (..fatter) problem.

we significantly underpay for prevention and for managing outcomes.

think that at the point you're using robots with lasers to perform octuple-bypass surgical miracles on 400 lb. fifty year olds, the medical system has already failed. by devoting only one chapter to prevention, so has this book.

8/26

this week i

examined out-of-pocket cost sharing and premiums among seniors with different types of insurance to supplement medicare.

perfected more than thirty pages of r code to simulate the population of americans that we expect to enter these new health insurance exchanges in 2014.

saw lyle lovett with my father.
video

have been glued to emma's blog, currently about her experience at a maternity hospital. in somaliland.

have been teaching jenn some r coding. she wrote me the best birthday card note i've ever received -
for (i in 1:4){
print("happy birthday")
print( ifelse(i==3,"dear anthony","to you") )

}

hit the pause button on life.

watched a meteor shower over the atlantic.

grilled. kept hydrated.

enjoyed the moonshine.

sunburned.

drove into town for some wings..

..then further north for the boardwalk..

and kites and volleyball

and sandy jesuses.

miss it already.

wish i understood this real estate market.

opened quantum mechanics and experience, not the best beach read.

"ever since physics first penetrated the atom..it has literally been called into question..whether or not there are always objective matters of fact about the whereabouts of subatomic particles, or about the locations of tables and chairs."

8/19

this week i

published our health affairs article on the state of medicare for disabled (younger) beneficiaries.

trekked up to baltimore to get some advice about part-time phd programs.

rode a speedboat past ft. mchenry. climbed federal hill. watched the city night from a little havana patio. might've snuck a late-night cinnamon sugar pretzel and a breakfast at teavolve in there too.

host enough people in my home that i ought to make some guest information packets.

learned that the funny bone is the funny bone because it's at the end of your humerus. and how to quickly determine the classes / variable type in an r data frame.

am growing alarmed about political compromises re: net neutrality.

rode the elevator to the top of the washington monument..



loved atul gawande's article on end of life care.

"you only live longer when you stop trying to live longer"

"i prefer the more martial view that death is the ultimate enemy - and i find nothing reproachable in those who rage mightily against the dying of the light."

"if i'm able to eat chocolate ice cream and watch football on tv, then i'm willing to stay alive."

"the new health-reform act was to have added medicare coverage for these conversations, until it was deemed funding for 'death panels' and stripped out of the legislation."


8/12