Sunday, July 10, 2011

Open Letter to The North Carolina General Assembly

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Making Hoecakes with Seed Corn

I hope you do not mind if I speak frankly.  I have been teaching at NC State for more than thirty years now, and I have discovered that plain talk is usually best.  Now before those of you who bleed Carolina Blue tune out, let me point out that my older daughter has a degree from Carolina Law and my younger has a double major BA from over there on the Hill.  So I am that common critter here in the Old North State: A Tar-Packer.  If you cut me open you would see one of those illustrations of the human circulatory system: twin pairs of vessels, one red and one blue.  And while in this context I write purely as a private citizen, I believe I could raise some resounding “Amens!” on both campuses.

You are all smart people.  You would not be a member of this august body were that not the case.  It is currently in vogue to assume that all politicians are stupid; otherwise why would we be in this mess?  Folks who allow themselves to espouse that position have never had to run for public office.  Getting elected takes determination, smarts, and money.  You have demonstrated that skill set.  But somewhere along the path to what I assume are your excellent educational credentials, somebody in my job – standing up in front of the class – let you down.  They neglected to teach y’all an important truth: There is no such thing as a free lunch.  You get what you pay for.

You have chosen to pay for a second-rate education for your children.  Well, maybe not for your children, they may be aiming at that darker shade of blue up in Durham or other private schools throughout the nation.  But you are most certainly short-changing the 200,000 plus students who walk the 17 campuses of our four–year institutions and the almost 850,000 students who take classes in our community college system.  And I, for one, do not see the wisdom in turning your back on almost a million people who will determine the future of the state.

I have heard the rhetoric about fiscal responsibility and the “mandate” to cut taxes which has led to the recent drastic cuts in funding to higher education.  It is often quite impressive and sometimes entertaining.  Still none of it trumps a much more rustic expression: Don’t eat your seed corn.

Let me share a story about some of my students; the “seed corn” from which our future will grow.  In one of my courses my students are required to define the career they wish to pursue after graduation.  They must assess the skills necessary to get the job, and define how they will obtain those skills.  Next, they actually apply for the job or internship that marks the next logical step on the path to that career.  For the students who work seriously at the assignment, the assignment always gives them valuable insight into the real world of looking for a job; some actually land the job or internship.  More interesting for the moment though, are the scattering of responses that I think of as “those with delusions of a job.”  These, thankfully few, papers assert that within a few months of graduation the student will have started their own business or “taken over” an existing competitor and be well on their way to dominance in their chosen area.  These papers, which usually skirt the actual requirements, are often late, poorly written, and lack citations.  Yet they are heartfelt.  These students truly believe that they will, without skills or experience, succeed in the global competition that will define their world.

These students will not suffer under the continual erosion in funding that you seem to feel is appropriate support for higher education in North Carolina.  They are clueless, and will remain so even as the quality of their education crumbles around them.  They will continue to believe, as you apparently believe as well, that the simple possession of a degree will suffice for success.  The actual education represented by the degree is secondary.  The “ticket” is all that is important.  They, and you, seem to believe that there will come this magical moment when, despite second-rate skills and questionable dedication, they will rise above the competition.  .  .  .  Sure, and do you want fries with that fantasy?

Unfortunately, it is the others, the seed corn; that you will be sacrificing.  Our best students will soon discover that despite the efforts of their institutions to do more and more with less, and less, and less; they are simply more poorly trained than their competition.  And remember, this is not the ACC tournament we are talking about.  This is not UNC v. NC State; this is not about any of the rich rivalries among our 17 campuses or 58 community colleges.  The issue here is how well the young people of North Carolina are being prepared to compete in a global economy.

China is planning to open 30 new graduate business colleges in the next few years.  My students from India write English better than most of my native North Carolinian students.  Those international students are now getting prime rib in their native lands, and you are asking us to make hoecakes with seed corn here at home.

Surely we taught you better than that.

Respectfully Submitted,

Robert Schrag
Morrisville, NC

Friday, September 24, 2010

Beating the Bushes

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I was watching an NFL game last week.  I must admit I don’t really remember which one. I tend to watch pro football the way my wife watches LMN – it’s wallpaper, a song you have heard over and over, it could be surf, the wind, you know, white noise.  But suddenly there was a glitch, a disruption.  One of the commentators; again, my bad – big white guy, maybe a former player or coach? Anyhow, he said something like, “I don’t think Reggie Bush should give back the Heisman. He won it with his play on the field.” I was momentarily stunned that someone who makes that much money could say something so stupid.  Then, of course, I laughed at myself. So, today I would like to talk with people who earn their living as sports commentators or sports talk show hosts, particularly those who agree with the big white guy quoted above .  .  . 

Ladies and Gentlemen, may I speak frankly? 

Today I would like to talk with you about beating the Bushes.  No, not the George Bushes – that’s so yesterday.  I mean the Reggie Bushes – and I don’t actually mean Reggie himself.  If you overlook the fact that his greatest collegiate demonstration of broken field running was sprinting around all the regulations intended to determine eligibility for student athletes, Reggie is actually doing the right thing.  He is returning a trophy to which he has no right, because he had no right to be on the field.  Hence, I have an issue with all those folks who feel Mr. Bush should get to keep the trophy because “he won it with his performance on the field.”

Let’s do a little time travel exercise – maybe 1980, Lake Placid, NY, the Olympics.  The Miracle on Ice was not just the fact that the USA won the gold medal in hockey – the miracle part was that a bunch of American collegiate amateurs defeated a Soviet team that was by every definition a professional team.  The miracle was that despite the Soviets circumventing the spirit, if not the letter, of Olympic regulations, the American amateurs won the day.  And we were proud.  Allowing Mr. Bush to keep his Heisman would stand that perspective on its head – it would make Soviets of us all – because in doing so we essentially say that only what happens on the field matters.  How you get there is unimportant.  I hope the commentators who argue that perspective realize that by doing so they also stand four-square behind the use of performance enhancing drugs, behind tutors writing papers, behind special degree programs for athletes, because it is “only what happens on the field that matters.”  Shame on you.

In the interest of full disclosure, I need to admit that I am biased on this issue.  I am a college professor.  For more than thirty years I have told my students – and the hundreds of student athletes among them - that you play by the rules, that you do your own work, you become educated and no one can ever take that away from you.  Bush broke the rules of a world to which I have given my professional life.  Bush winning the Heisman was glaring evidence that sometimes cheaters do win, sometimes a person who is ineligible, who has no right to be on the field, gets the glory.  Letting him keep it would be saying, “And that’s OK.” To the extent that you think Bush should keep the Heisman, I repeat, shame on you.
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Wednesday, September 8, 2010

Entitlement Politics

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To whomever may be listening: May I Speak Frankly?

One has to feel for the President. Well, no, I take that back. One obviously doesn't, with the Mad Hatters running all over the country throwing tea parties that blame him for everything from broken oil wells in the Gulf of Mexico to broken families in Kenya. They obviously don't feel for him. But, really, think about it for a moment - he actually wanted the job. And I suppose a lot of people do. Why, I'm not too sure. I mean he's now getting slammed by Mo Rocca for redecorating the Oval Office. Jeeeez.

Even his teabag distractors admit he is a "cerebral" president, though they cast it as a flaw. But, one might question his intellectual "cred" when you realize he still wanted the job even though he knew he was going to inherit two questionable and unpopular wars that were draining the national treasury faster than Paris Hilton on a spending binge. He was also going to get a Congress so petty that they make the folks on Jersey Shore look, well, cute. Republicans and Democrats alike seem to define policy on the basis of vehemently opposing whatever the other holds most dear. We know they started out as lawyers, but you wonder how many of them started out as divorce lawyers?

"I want the Big Isle Potted Orchid!"
"You only want it because I want it!"
"You'll just kill it!"
"You will!"
"You'll send it to a death camp!"
"I'll send you to a death camp!"
"Madam Chairman, I yield my remaining time to the representative from . . . "

What the President, and anyone else seeking public office, needs to realize is that we are living in the age of entitlement politics. No, I don't mean social programs run amok - I mean that the folks making the loudest political noise - and it is mostly noise - are the kids who wouldn't pick up their rooms, who demanded a computer in the bedroom when they were five so they could work on their preschool "homework" and who always blamed the teachers if they got bad grades. Unfortunately, their parents agreed and acquiesced and we got "slacker pols."

The thing that drives me so far away from political issues these days is the unceasing acrimony and truly breathtaking stupidity on display by those "slacker pols" who hold office, are seeking office, attempt to garner huge crowds to oppose those in office on general principles, or blather on endlessly and antisocially via "social media." It is a foregone conclusion that little of import will occur in American politics until the midterm elections are over, because between now and then the "slacker pol wannabees" must demonstrate that they are suitably rabid to appeal to the "lunatic left or right wing fringe" of their party.

Someone who truly sought to bring the calm reason of the middle ground to politics today - anywhere, here, Iran, Israel, France, Columbia, spin the globe - would never be heard. They would not be entertaining enough, they wouldn't be extreme enough, they wouldn't angry enough. They'd be so uncool. They'd be so 20th century. They'd be so missed . . . .
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Sunday, January 31, 2010

The Illusion of Inclusion

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I usually like to pretend that I am talking with people who actually live in the real world.  Today I am going to make an exception, I am going to talk with the guys on the U.S. Supreme Court – and I use the word “guys” intentionally, because I really just want to talk with Chief Justice Roberts and his buddies in black, Justices Kennedy, Thomas, Scalia, and Alito.  My charge that these guys don’t live in the real world usually stems from the fact that they can never be fired, always have a parking place in DC, and spend most of their careers immersed in documents that few people in the world can read – let alone understand.  These five Justices just added another nail in that coffin.  They just clarified that companies and organizations are “people” whose right to express support for political candidates is the same as yours and mine.  And it is that notion that large organizations are “people” that intrigues me.
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So, Gentlemen, May I Speak Frankly?

Your Honors, or Honori, or whomever - may it please the court - having worked for, or studied at, large organizations for almost 40 years, I am fascinated by this notion of companies as “entities” with the right to freedom of expression.  I mean we all realize – I hope – that IBM and AIG and the AFL-CIO aren’t really people.  So I assume that you mean to declare that these collections of buildings, people and databases, these companies, are people in a purely legal sense – a sort of intellectual fantasy like much of the law.  I think it runs deeper than that, which is why most folks stand still for that kind of silliness.  I think that we really do allow ourselves to become part of the metaphor of the organization as organism, and to believe that we are meaningful parts of that organism.

In our early days with the organism we might see ourselves as a small but important element.  Maybe the thumb.  No, it’s not a terribly showy appendage but it does separate our company from others without that valuable, opposable digit.  After a successful decade we may see ourselves as an arm or a “good right hand.”  A couple more decades allow us to feel close to the heart of the organization, eventually even the brains or the soul; and we come to believe that others contemplating our departure or demise do so with fear and trembling.  It is a pleasant fairy tale.

The recent and hopefully receding recession proved the illusion in that feeling of inclusion.  We are neither the heart not the soul of the organizations we serve.  The people who make up an organization are far more analogous to hair or fingernails.  They may help the organization look good, but when the survival of the organization is in peril, they are easily trimmed away.  That does not deny the precious relationships we may craft with our workmates, but the organizations are not those people. Companies and organizations are entities with objectives that transcend, and usually outlive, the needs of the people who attain those organizational goals.  It doesn’t matter if you hawk the free samples at Sam’s Club or plan global strategy for Lehman Brothers – if you get in the way of the organization’s eternal, and inhuman, existence you are expendable.

These “corporate individuals,” your Honors, are the ones you have decided should have a louder voice in electing the individuals responsible for enacting the “will of the people.”  That is more than a tad creepy.  If you are elected to office through the intervention of a non-human entity, who or what is the constituency you are charged to represent?  Do we hope that John Connor shows up in time to prevent the non-humans from taking over, or have the political “machines” already won?

Well, you have made your decision gentleman, but it was hardly Supreme.
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Thursday, November 19, 2009

God at the Goal Line

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When your team - pick a sport, any sport – has dropped out of contention for recognition, you tend to wax philosophical about the entire issue of collegiate athletics. So I thought I would take the opportunity to spend a quiet evening with Dr. Edward Ray from Oregon State University. Dr. Ray is President of Oregon State. He came there after a stint as Provost at Ohio State University. I assume that one of the attractions at Oregon was the ability to keep the monogrammed dinnerware – but I digress. I wanted to talk with him in his “other” role: Chairman of the Executive Committee of the NCAA.

Dr. Ray, Ed, may I speak frankly?

I don’t understand this creeping divinity in the locker room. I was watching a football game last weekend and noticed some interesting body painting. I don’t mean the multi-colored nouveau commedia dell’arte we see on the fans in the stands. Rather, I chanced to glance up during a close-up of one of the players. Within the black patches under his eyes was stenciled 5:32 or 7:28 or something. I doubt it was a bit of code from the playbook or the time when he was to enter the game. I am assuming it was a "chapter:verse" biblical reference. I must further assume that the coaches either approved or allowed it.

The eye inscription apparently takes its place alongside the finger-pointing to the sky and clusters of players on bent knees and heads bowed before or after a game. All these various rituals seem to constitute an obvious religious rally in support of one team or another, or perhaps a specific play or commercial sponsor. I don’t really know, but it bothers me.

I understand, Ed, that a number of NCAA schools are private institutions, perhaps even with a religious affiliation or heritage. Mine isn’t, despite the rumors that a former coach smuggled bibles into the Eastern block and required prayers before games. On paper we are still a state school and separate from any church mandates. So I don’t understand all the religious hoopla. Or Footballa? Or swimmingla?

I don’t have a problem with any student-athlete’s personal religious beliefs. Believe me, it would require divine intervention for me to survive five minutes as a participant in any organized collegiate contest. I guess what bothers me is the implication that God, one, takes sides; and two, cares.

Mark Twain did a far better job addressing the “God takes side” notion than I ever could. He gives voice to the unspoken side of the prayers for victory by creating a scenario where a pastor has just led his flock in a prayer asking God to lead the young soldiers in the congregation to victory. A stranger appears to voice the mandatory, but usually unspoken, corollary:
"O Lord our God, help us to tear their soldiers to bloody shreds with our shells; help us to cover their smiling fields with the pale forms of their patriot dead; help us to drown the thunder of the guns with shrieks of their wounded, writhing in pain; help us to lay waste their humble homes with hurricanes of fire; help us to wring the hearts of their unoffending widows with unavailing grief . . . Lord, blast their hopes, blight their lives, protract their bitter pilgrimage, make heavy their steps, water their way with tears, stain the white snow with the blood of their wounded feet. . ."
Mark goes on and on in that vein, Ed. He was, after all, dying and had lost much of his good humor. But you get the idea. When you ask for God to weigh in on your side, you are also requesting some divine smiting of the foe. Sadly, the practice remains common in warfare – but in football? “Lord, let their awesome quarterback go down . . . nothing career-ending, Lord, just a little torn ligament – maybe a slight concussion.”

The notion that God would smite Duke or Carolina come basketball season is a seductive theology from my position here on poor side of Tobacco Road. Still, the whole idea of God on the hardwood seems to either trivialize the deity or deify the sport. Both are unseemly. Both are poor lessons to parade before student-athletes and their fans. Maybe you could bring this up, Ed, with the rest of the committee? After the benediction? Thanks, I appreciate it. God bless, and y’all come back, y’hear?
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Wednesday, October 7, 2009

A Mind is a Terrible Thing to Lose

I was going to talk with the “gang of six” and other assorted bad actors about the health care debate, but it remains too depressing.  Ideologues on the right raising fearsome "death camp" fantasies worthy of Stephen King while their counterparts on the left still dream of French and Danish-style single-payer system.  I feel for Obama.  I’ve been there.  You stand in front of a class of a couple hundred students and realize that nobody read the assignment.  So instead I’ve decided to talk with a group that we all can agree have lost their minds: The University of Alabama’s Board of Trustees Compensation Committee.

Ladies and Gentlemen, may I speak frankly?  Thank you.

And I mean that, thank you.  We here at NC State have been hard pressed to explain what our Chancellor and Provost were thinking when they decided – in a time of budgetary disaster – to pay the wife of the former governor 185K a year to run a “speakers bureau.”  The gang of three is gone, but the rest of us remain somewhat embarrassed.

You have made us look like pikers, unworthy of public attention and scorn.  So I say again, thank you.  And I want you to understand that I am not here to judge.  Rather, let us say I am simply trying to understand.  Do I have this right?  You have agreed –unanimously – to pay your coach 42 MILLION DOLLARS over the next nine years?  And he doesn’t even coach basketball?  You will understand why we in the ACC have a hard time understanding this.  Your largess does, however, shed some light on why the SEC is rumored to be the “best football conference in the country.”  A rumor started, no doubt, at football coaching conferences during the session on Strategies for Leveraging Obscene Compensation.

But let me ask this as gently as possible: Have you completely lost your minds?  Universities all over the country are facing double digit budget cuts and you are going to pay Nick Saban 42 million dollars to teach large undergraduates to run into each other with maximum mayhem?  Again, have you completely lost your mind?

Oh, I know, we run the same arguments here to pay our coaches less grotesque, but still ridiculous, salaries:  First, it is “different money” raised from fat-cat alums who would never contribute equal sums to “the academic side.”  Second, these are very tenuous jobs – the same alums who foot the bills will toss the coaches to the wolves if they don’t beat Flordia/Texas/USC/Carolina/Yale/YourBiggestRival and get your university to a bowl game in a couple years. 

I don’t want to harp on the old and futile responses of maybe the fat-cats would fund the academic side if the athletic side wasn’t sucking up all their largess with skyboxes and tailgate fanfare.  And, by the by, give me a head coach’s golden parachute and you can throw me to the wolves anytime.  But, those arguments were drowned out by the roar of ESPN College Game Day years ago.  I have another concern: you are embarrassing your university, particularly the faculty who teach there.

Long ago, in a galaxy far away, there was a planet called Ben And Jerry.  It was a frozen planet, run by two beneficent old hipsters not surprisingly known as Ben and Jerry.  They had fled to their frozen orb from the inhospitable outer rings of Maybe Bagel.  Imagine their joy and surprise when they discovered that their planet was host to myriads of icy flavors – some of which still tasted wonderful in the morning.  Ben and Jerry began, with the help of flocks of little ice-cream elves, to market their frozen nectar throughout the galaxy. Even they could sense the potential for significant wealth.  But, perhaps because they were old hipsters, they had an ingrained distrust of greed and disproportionate compensation, so they declared that the highest paid person on Ben And Jerry could make no more than seven times the salary of the lowest paid person.  And so it was for a while. Ben and Jerry are both multimillionaires now, and I doubt that the night watchman or the cookie cruncher is compensated at the “one-seventh of Ben and Jerry’s income” scale.  But that is not the point.

The point is that Ben and Jerry realized that there is an inherent relationship between compensation and the dual perceptions of employee self-worth and corporate mission.  It follows that people who are valued most by the organization are paid the most money and one’s relative importance to the mission of the organization can be measured by comparing your salary to those in the “higher pay grades.”

You are paying your football coach 42 million dollars.

Did I say this before?

Have you completely lost your minds?

Saturday, August 22, 2009

What Paradox?

Although he died shortly after my sixth birthday, it only makes sense that we mess around with SpaceTime so I can talk with renowned physicist Enrico Fermi. There are many topics I would like to talk about with him, but all the recent chatter about the Kepler Mission and the search for “other Earths” prompted me to choose The Fermi Paradox . . .



Enrico, may I speak frankly? Eccellente!

As I understand it, you are bothered by the assertion that the sheer vastness of the universe mandates the existence of a multitude of advanced civilizations right here in the Milky Way galaxy – and “billions and billions" more, as Carl would say, beyond our galaxy. You ask, quite logically, “Why is there no evidence of these innumerable super civilizations? Where are their space probes, their telescopes? Since a vast number of them must be more advanced than we, why, even if we are not bright enough to observe them, have they failed to contact us?” That’s the “paradox” right, Enrico?

Well, obviously, there are folks who assert that the aliens have contacted us, and continue to do so every day. Unfortunately, many in that camp also wear tinfoil hats and underwear to block the evil rays. That’s not where I am going with this.

I am inclined to believe that intelligence is a fairly common commodity – universewise. And I am swayed by the notion that we are not terribly unique in the unimaginable sweep of the heavens. But I would also assert that it is our very similarity to other intergalactic pools of intelligence that accounts for the unseemly interstellar silence that surrounds us. How so? Excellent question, Enrico!

You will notice that I advocate the commonality of intelligence. That says little, if anything, about wisdom. Those are very, very different characteristics. I break it up this way in my classes: Humanity is awash in a flood of data. We are unique, here on earth, in the extent to which we can turn that information into knowledge. More than another other terrestrial species we see patterns in the data, we can establish causality. If I do this, then this will happen. That is the hallmark of intelligence. It has little to do with wisdom.

Wisdom is the ability to choose, from all available options, the course of action that is most harmonic, that does the greatest good. I know, I know – talk about your loaded sentence! Greatest good according to whose criteria, using what measures, to what end? I know, I know – it makes my head hurt just to think about it. Which is why I believe wisdom is far less common in the universe than mere intelligence. “Less common” doesn’t really express it – maybe “incredibly rare” is more accurate.

Let’s use ourselves as an example. I think we can make a pretty good case for "intelligent". E=MC2, democracy, stem cell transplants, The Kepler Mission itself – pretty intelligent stuff. We can also lay claim to creative genius – Michelangelo’s David, Ode to Joy, The Bean in Millennium Park. It’s not that hard to find heart-stopping beauty here on Planet Earth. Ah, but wisdom. That’s another notion altogether.

The same gene pool that spawned those intellectual and artistic achievements continues to self-destruct at the drop of a hat. We kill one another with the same √©lan as we rub wings with the angels. We are born into ancient beliefs – political, religious, and philosophical – and spend much of our lives running from evolving evidence that confronts those “born into” truths. We demonize each other in the name of God, and we may well destroy our own planet before we ever walk on another. Human beings – go figure!

That is why there really is no paradox, Enrico. Intelligence seems firmly bound to arrogance, as hydrogen is bound to oxygen. And that intelligent arrogance keeps our feet of clay earthbound, as our petty antagonisms and hubris focuses our attention well below the stars. Hence, intelligence spread throughout the universe would not mandate a stream of aliens at our doorstep. What? How about wisdom?

Oh, certainly. There are undoubtedly races spread across the heavens that are both intelligent and wise – very wise. It is, I assume, their wisdom that keeps us from finding them.

Friday, August 14, 2009

Prescription for Change

Today’s guest is Julius Genachowski. This guy is Obama’s new Chairman of the Federal Communication Commission. There’s power for meaningful change at the FCC. Here’s one thing I’d like them to look into . . . .


Julius, may I speak frankly?

Maybe it’s because I’m now on the wiser side of sixty, but I’m beginning to see something deeply sinister in all these television ads for prescription medicines. At first, perhaps like you, I was simply stunned by the overt “shell game” production techniques being employed.

Pardon me?

Oh, sure. Let me explain. What is the object in the shell game? Right, the conman wants to get the rube to look where the pea isn’t. You want them to focus somewhere other than where the trick is actually going down. Take the Celebrex commercial for example – it is a masterful bit of shell game production. You know the one with the awesome graphics? White letters on a blue background? You can take a look at it over on YouTube – here’s the URL: http://www.youtube.com/watch?v=7GvYI4VdVEI

Anyhow, we all know by now that the commercial has to include all the medical disclaimers and cautions. And much of the controversy about this ad focuses on its questionable assertion that Celebrex is no more harmful than other NSAIDs – a broad class of pain relievers. That’s an important issue, because if we listen to the actual words being spoken beneath the music and the graphics in the ad, we learn that Celebrex, and all NSAIDs “can increase the risk of heart attacks and strokes that may lead to death.” So Celebrex seems to be saying, “Yeah, we may kill you – but so will those other guys!” That’s the controversy that folks have been raising with Dr. Hamburg over at the FDA.

But I don’t want to talk to her, Julius, I want to talk to you. I think this goes way beyond just Celebrex – it is a whole class of false and deceptive advertising that is not only harmful, but it is also costing us an arm and a leg! How? Ah, yes. More, brandy?

Let me try to clarify. Have you ever loaded software onto your computer, or downloaded a new version of Firefox or iTunes? Sure, right, we all have. Now, before you can actually run the software, what do you have to do? Restart? Maybe, it depends. But what do we always have to do? Bingo! Click on the button that says “I agree.” We click on the button that says we “have read and agree to” the five or ten pages of legalese that we have not read and have no idea if we agree with or not, because if you haven’t gone to law school it is incomprehensible. But we agree because, cognitively, those bits of text on the screen have disappeared, vanished, zip – gone! Not only do we not read them - we don't even see them.

The same is true with the medical warnings and disclaimers that accompany television advertisements for prescription drugs. Any school kid can tell you that a picture is worth a thousand words. What is less widely realized is the fact that cool animations and a soothing soundtrack in a TV ad can cause any spoken words to vanish. So we don’t hear the warnings anymore, we just see the pictures and hear the music. Click. Accept. And that is what used to bother me. Not so much anymore. Well, that’s not really true, it still bothers me – but two other things bother me even more.

First is the fact that the ads are very effective – maybe that floating green Luna moth will help me sleep, maybe that Alli stuff will help me shed a few pounds, maybe Lipitor will let me attend my granddaughter’s wedding. Those very effective shell game ads nudge us down the road to belief. And what am I supposed to do before I take the drug? Oh, that’s right – I’m supposed to talk to my doctor – it’s a prescription drug, I need a prescription. I’ll talk to my doc about that.

Fast forward to the doctor’s office. Their “CEA [cost efficiency analyst]” or the “CCA – [cost containment algorithm]” has determined that they should spend about 7 minutes with each patient. The doc knows it is absurd, but s/he will try to do their best. They walk in the door. “Hi. There are issues on your tests . . . .”

“Dr. Jones, I think I need Celebrex/Lipitor/Alli/Lumina/Cialis/Yadda/Yadda. Can we talk about it?”

Obviously, meaningful conversations between patients and their health care providers are vital for quality healthcare. But these ads co-opt the conversation. They prompt us to waste our valuable time with our doctor by both inclining us to imagine aliments we probably don’t have and to harangue the doc for prescriptions for “shell game” drugs that enrich big pharma and may actually harm us. We need to be talking about our specific medical concerns - not spouting the shell game ad agenda. I mean, Julius, if that’s not false and deceptive what is? Multimedia mega campaigns over-hyping the benefits and masking the risks of unnecessary drugs? Come on Julius, we’re struggling to come to grips with the healthcare crisis - legitimate concerns about the escalating costs of care and coverage. And these greedy ad men and women are pushing pills most folks don’t need.

I wish that were all. But it’s not. I am equally disturbed about the Menactra ads for their vaccine. You’ve probably seen it – but if not you can see it here:
http://www.menactra.com/what_is_menactra_menactra_ads.html

These folks should be ashamed of themselves. We live in a scary world, and raising kids has always been tough. These ads essentially say to parents:
"Be afraid. Be very afraid. If you don’t get our vaccine for your children they may die! Tomorrow! No symptoms, no warning, just a dead kid – and it will be your fault."
So you see, Julius, these folks have no shame. They don’t care about protecting our health. They just want to make money. There’s certainly nothing wrong with making a fair profit for a worthwhile product. That needs to happen for the economy to recover, for crying out loud. But when ads for prescription drugs are intentionally deceptive, when they create a huge drag on healthcare efficiencies, and when they seek to terrify young parents . . . . Well, somebody needs to get these guys. How about you Julius? You can do it! Go get ‘em guy!

Gosh, my aggravation about this issue has lasted for longer than 4 hours. Who am I supposed to call? My doctor, right, I better call my doctor . . . .

Friday, August 7, 2009

And Bigotry for All!

Today I am "speaking" with Mayor Peter J. Cammarano III of Hoboken [D], Assemblyman Daniel M. Van Pelt, a Republican from Ocean County, Anthony R. Suarez, the mayor of Ridgefield, and Rabbi Saul J. Kassin, a leader in New Jersey’s Syrian Sephardic Community. All have been implicated in the recent money laundering, influence peddling, human organs sales, scandal in New Jersey.


Gentlemen, may I speak frankly?

You amaze me. In a world constantly in search of ways to follow its worse instincts, you have made it easier to do so.

Bigots like to point out that every prejudice is based on a kernel of truth – small perhaps, they say, but there. Someone of Italian heritage steals a car – Mafioso. Someone whose name ends in “berg” or “stein” is arrested for embezzlement – cheapskate Jews. Name ends in “arez” busted for grand theft auto? Damn spics are at it again. A Van something or a Windsor, Smith or Alden involved in stock manipulation and “old money” is again ripping off the poor and the middle class. And everyone knows that the DemocratRepublicans are a bunch of thieves. “See? Told you so. You just can’t trust those damn ______s!” Frankly, I’m surprised you guys didn’t pull a few Africans, Asians, and Muslims into the scam. It could have been a clean sweep. Still you did manage to stigmatize all of your own ancestors:

“Hey, you looking for a steal on a Kosher kidney?” “Can I get you a congressman with that taco?” “I dare say, that 50 dollar bill looks a tad tarnished. Shall I send it out to the cleaners?” “Wanna a real deal on a building permit? Here’s an offer you can’t refuse.” Social absurdities pulled from bad movies back into the mainstream of American conversation. If it is within your emotional repertoire, gentlemen – although I doubt it is – you should be ashamed.

You see guys, here’s the problem; I’m not really worried about thoughtful people. They will realize that your criminality has nothing to do with your ethnicity or your religion. You are not Italians or Jews or Latinos or blue blood Christians of one stripe or another – you are thugs. You are all, no doubt, in varying degrees of self-denial, but you are thugs nonetheless; and your ultimate victim - human tolerance - has always been very, very, fragile. That is why I am quite concerned about the “less than thoughtful;” those whose social reality is constructed by the “sneer and shout” journalism that seems to dominate the contemporary media. Your actions filtered through those outlets will do us all harm.

Intolerance and bigotry grow best in the dark soil of fear, watered by storms of hatred, and sheltered by hedges of ignorance. You have abetted that twisted ecology no end. You have given just about everyone in America an excuse to listen to their more fearful and hateful selves and hear a corrupted version of what sounds like truth: “those people” really are “that way.” You have given hope to the bigots and in doing so you have damaged us all.

The Oxford English Dictionary defines “shame” thus:
I. 1. a. The painful emotion arising from the consciousness of something dishonoring, ridiculous, or indecorous in one's own conduct or circumstances (or in those of others whose honour or disgrace one regards as one's own), or of being in a situation which offends one's sense of modesty or decency.

It is somewhat complex I realize. But hopefully you will have a number of years in small rooms to ponder those complexities.

Friday, July 10, 2009

Artistic Intimacy

Dr. Leah Price is Professor of English at Harvard and has an incredibly impressive resume - particularly when you consider that she is still on the shy side of 40. One thing I don't understand though, she got her Ph.D. at Yale. I thought there was a rule that if you got your Ph.D. at Yale you weren't allowed to teach at Harvard. I have chosen to "talk" with her since she was quoted in the story that sparked this post.
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Leah, may I speak frankly?

In life, Leah, certain intimacies should remain private. I am aware that in the age of the Internet that assertion seems quaint at best, at worst, foolish or even stupid. But simply because something can be made public doesn’t mean it should be. Evidence is all around us. Micro-blogs like Twitter and Facebook's “What’s on your mind” are easy targets. Someone I do not know just informed me via my Facebook page that, “Sweden is great. Very interesting, but also clean and friendly people.” And I should care because . . . .? Darker examples also abound. Do a search on any pejorative term and you will encounter thousands of public symptoms of social pathology that should be confined to the privacy of a therapist’s inner sanctum.

But, the current burr under my saddle is somewhat different, even strange. I heard an interesting story on NPR the other day [see below] about a website called BookGlutton. [http://www.bookglutton.com/] You were quoted so you know the site and the story far better than I, but apparently the site is a sort of cyber book club where everybody simultaneously reads a book and discusses it in a semi-social, semi-intellectual gabfest that occurs as a live chat session in the margin of the screen, right? The story quotes teachers who love the site as a teaching tool. I can see the value in that. Given that reading for pleasure has largely tanked among young people, I am in favor of anything that draws people to the joy of reading. However, the article also quotes you as saying:

"There's something frustrating about reading on a Kindle. "The fact that you're reading on a screen makes you expect, 'Oh, I should be able to click through on this. Oh, I should be able to look this word up. I should be able to Google this name.' "

And then they say that you have no doubt that within the next decade, no one will feel that frustration anymore - because, I assume, we'll be reading novels interactively with a bunch of friends?

Leah, I have to admit that that just creeps me out. OK, you're still a thirty-something. I can cut you some slack there. You probably grew up reading on a screen. But the notion of clicking my way through a novel with folks chatting along side in the margin? Come on now.

“OMG! Didn’t see that coming! Did anyone else? I thought she was his sister! LOL!”
“Oh, I knew it had to happen. Total manifestation of the commodification of cultural dominance.”
“The what of what? Who are you?”
“I’m a grad student at Stanford.”
“Well, excuuuuse me!”

OK, I am aware that once an artist puts a work before an audience he or she lets go of the work. The audience can do whatever they want with it. But I always think of that interaction – artist and audience – as one-to-one. Even theater and film, which are often presented to groups, are experienced individually. We – one person – interact through the artwork with another person. For me it doesn’t matter if my role at the moment is artist or audience member, that interaction is more than personal – it is intimate.

This notion of “group think” being brought to bear on novels, on any artform, becomes a problem once we leave the realm of pedagogy. When you teach you have to at least pay lip service to the notion that there are no stupid questions, that every input moves us along the path to learning. That is, of course, a crock. There are incredibly stupid questions that create horrific detours on the road to insight. But in the classroom you often have to walk that road.

Docents walk that road for us in museums, and many do it brilliantly. I remember a woman at the Uffizi Gallery in Florence, Italy. We had signed up for a tour, there were supposed to be seven of us, but five people failed to show up, so my wife and I got a tour for two. It was quite wonderful, we learned a lot. But that was pedagogy. When I am intimately involved with a work of art I am completely unconcerned about what the kid in the back row thinks. I am equally disinterested in an expert point of view. When I am looking at The Birth of Venus, I don’t want anyone else there, thank you. This is between Botticelli and me. This is private. I don’t want to be disturbed.

The good people at Bookglutton, and you Leah, should be quick to point out that their site in no way denies me the privacy to read a book all by myself. You are, of course, right. But I worry that it puts us on a slippery slope. It creates a space that redefines our interaction with art. It is the same slope that leads to babies in strollers parked in front of Michelangelo’s David, to the seven-year-old with the toy musket shooting at the actor portraying George Washington at Colonial Williamsburg, to our seeming inability to distinguish between entertainment, public pedagogy and private artistic intimacy.

There is certainly space for all three in our society – but not in the same room, not on the same screen, not at the same time.

NPR story on Bookglutton:
http://www.npr.org/templates/story/story.php?storyId=106150832

Friday, July 3, 2009

Temporary Sanity

Dr. James H. Bray, is the President of the American Psychological Association. I have not read of his research, but I assume he would be qualified to give me some feedback here.

“Has he lost his mind?” is the question that springs to mind when watching Gov. Mark Sanford explain the last few weeks of his life. One could argue that the opposite is true – that he found it. Bear with me, Dr. Bray, then let me know what you think.

I think of it as the water balloon theory of the self. Imagine – or actually go get – a round balloon. Fill it with water until it is about the size of a softball. It should be able to retain its spherical shape but shouldn’t be in danger of bursting. That is the self at rest, when we are comfortably all alone – no obligations, no roles to play. Now pick up the balloon, hold it between your hands and begin to wiggle your fingers. As each finger exerts pressure on the “balloon-self” the surface distorts as portions of the “self” swell while others recede. The fingers are the expectations, the pressures placed upon us by life. Some fingers we choose – by our jobs, our relationships. Some we are born into - our family, our ethnicity. Some are a blend – our beliefs and values.

Every politician juggles the interests of a variety of constituencies, and is, in turn, squeezed by many fingers. The higher the office, the more insistent the pressure of influential constituents. Gov. Sanford’s constituents brought a rigid social and political orthodoxy to the table. Then he meets a “soul mate”; someone in whose presence his self escapes pressure. Here is the same self usually allowed only in solitude, round, full, comfortable – a water balloon at rest. In that relationship he sees the promise of a synthesized life. No having to select the “reality” of the moment. The chance of a constant self; of a life without lies. How wonderful. He momentarily finds his mind, he finds “temporary sanity.” But it is a sanity that cannot survive in the rest of the world that he has chosen; it is a sanity in opposition to the norms of his previous personal and political constituents. In that world this new self, this new sanity, is lunacy.

He tries to bring that new sanity back into his old world and those powerful old fingers reach out to grab him by the balloons. It remains to be seen if he has the flexibility and the resilience to survive in this reality, or if he will seek another more amenable to recently discovered new facets of his self.

So what do you think, James? Does that balloon hold water?

Plainly Speaking About Finance

Daddy Warbucks was Little Orphan Annie’s adoptive father in the long running comic strip, Broadway show, movie, etc. I have chosen him to chat with because he was depicted as a reasonable – though admittedly fictional – billionaire. The motivation for this posting was a story I heard a couple of times during the day on NPR. June 29th? 30th? I’m not sure and can find no reference to it. Please let me know if you heard it. The gist of the story was that legislation either just passed or pending would require that financial institutions describe their various products and services in a way that could be read and understood by reasonably intelligent adults in the general population. The legislation was being “fiercely opposed” by the banking community on the grounds that the requirements would “severely limit” the products they could offer.

Daddy Warbucks, may I speak frankly?

Didn’t we take care of this a long time ago? 1400s? 1500s? Then it was the Catholic Church asserting that the word of God could only be communicated in Latin. Bad enough that this goldsmith Gutenberg was printing copies of the Bible and selling them to those nouveau riche merchants. Next thing you know people will get the idea that Jesus of Nazareth, a nice Jewish boy, didn’t speak Latin. Adfectus deus! I recall reading that they got rather, well, catholic about the whole issue. My way or the highway – translate the good book into English and we will kill you, dismember you, grind your bones into dust. Princes of the Church acting in behalf of the Prince of Peace, no doubt to guard the common people from holy writ, writ in unholy tongues.

Folks didn’t buy it then and hopefully, we will buy it no longer. It is lunacy when the language that guards or removes our freedom is one we cannot understand. People are reading these words on some type of digital device requiring software. Most likely, they installed that software. During that process they clicked on a link asserting that they had read and agreed to the provisions of the software license or the terms of service. They lied. Nobody reads that stuff unless there is some sort of firestorm over the Facebook or the MySpace terms of service. “Huh?” we then ask, “Wazzat?” We don’t read the lease on our apartment, the mortgage agreement on our house, the service agreement on our rental car, the terms of our credit cards, the patient release forms at the hospital, the entirety of our health or home insurance policies. We don’t read any of that stuff. Are we complete idiots? Yes and no.

Yes, we are idiots because those are important documents; we are signing, clicking, swearing and affirming to agreements that can cost us, literally, life, liberty and the ability to pursue happiness. And, no, we are not idiots because even if we read the documents we could not understand them. My older daughter is a lawyer, and I love her dearly – but her progress through law school taught me a very basic truth. Lawyers do not speak English, they do not write English; I sincerely doubt that they think in English. You may substitute French, German, Russian, Farsi, or Hebrew in that sentence. The truth remains. Here is what happened:

My students will affirm that I am a hardliner when it comes to writing. They will often use other descriptive phrases to describe my insistence that they write according to the formal rules of grammar and style; that words be correctly spelled. When my daughter was an undergraduate I would often proofread her drafts – one of the few perks of being raised by a university professor. She wrote well. Then she went to law school. She sent me a paper to look over. The words were English, the phrases had individual meaning – but the sentences were macabre. There was no discernible meaning in English as it is commonly employed. This is the language of the law. It stands apart from the normal language of the culture. It is the language by which the powerful assert dominion over the powerless. It certainly can be the language through which the powerful can protect the powerless; but it is never the language of the powerless.

As I understand it, this legislation would require financial institutions to define their products – from checking accounts and credit cards to arcane derivatives – in the common language of the culture. Daddy W, it can be done and it should be done.

Something you learn when you teach is that when your students don’t understand you, it isn’t always their fault. Sure, sometimes they aren’t paying attention. Sometimes they don’t care. But sometimes you are not being clear, you are not speaking a language they are capable of understanding. Often in my world junior professors speak graduate school jargon to freshmen. In that case the fault is not in the stars, Daddy, it is in us. Speak plainly, speak clearly. If you cannot communicate the idea behind a financial transaction in the common parlance to a reasonably intelligent adult, then the fault is not theirs, and their suspicion is probably warranted.


You need to tell your billionaire finance cronies that they are going to have a hard time selling this whole “if everyone can understand it we can’t make money from it” gambit. They are without much credibility these days. We used to believe the powerful when they said, “You don’t really need to read all that. Essentially what it means is . . . . .” We now assume they are lying. Besides, they’ll survive, the grandest cons use simple language. “150% return on your investment is guaranteed.” “There is no risk at all.” “I’m going to put a simple pea under one of these three shells. . .” If we fall for that – a con in simple, clear language, then the blame does rest with us. But at least show us the respect of stealing from us in a language we can both understand.

Oops. Excuse me Daddy, I have to take this. “Yeah, Bernie, I heard. 150 years. That’s cold. No, Bernie, I can’t lend you 20 bucks. No, my daughter doesn’t do criminal law . . . Bernie, you know I hate it when you whine like that.”

Monday, June 29, 2009

Reading Twitter in Tehran

Dr. Melissa Hathaway’s title is Acting Senior Director for Cyberspace, National Security and Homeland Security Councils, The National Security Council. That makes her the Acting Cyber Czar in the Obama Administration. Her resume seems geeky and competent. We have not met.


Melissa, may I speak frankly?

I’m not really sure what your role in the administration is – or what it will become. We’ve never had a Cyber Czar before. This whole czar thing is new. I just wanted to bend your ear a bit about the people side of cyber. Too often we think that cyberspace is all about codes and infrastructure. And in a way that’s right. Technology has no ideology. A hammer, a plough, a satellite, a smartphone – it makes no difference. They are just tools. But we employ those tools in the service of humanity and of ideology. I’m hoping you’ll give that side of the equation serious consideration.

Much has been made of the role of Twitter in the recent Iranian elections. I’m sure you kept a close eye on it. Some have cast those events as harbingers of a more amenable Iran, of an Iran more inclined to moderation and dialogue. Still, it seemed to me that the use of Twitter by the urban, reform-minded youth of Iran became so co-mingled with the political agenda of the opposition that Twitter itself came to be seen as a window on a “real Iran” denied by the state-controlled media. The implication was that “new media” were somehow inherently democratic, immune to the distortions that beset mainstream media. That perception is at best incomplete, if not completely erroneous.

Here in the West, our own immersive communication environment lends a feeling of normalcy to a pervasive digital world that is still much the exception. Because we can access the electronic world so easily, it is easy to believe that our reality is the dominant reality. It was equally tempting to read the twittered reality flowing from Tehran as the will of the Iranian people. And it reflected, no doubt, the will of some of the Iranian people. And, perhaps most importantly, it was the reality we preferred. But think for a moment. A few weeks ago, supporters of Adam Lambert were accusing AT&T of swinging the American Idol vote to Kris Allen by providing phones for free text-messaging to Allen’s fans. The trivial may inform us here.

The message in this Idol accusation is that a minority view funneled through a restricted communication channel can masquerade as the majority. I have no doubt that Twitter-journalism reflected the strongly held views of one segment of the Iranian public. We probably did get a unique glimpse at the dreams and aspiration of the young professionals and intellectuals of Tehran. But there is also the real possibility that we saw a minority view artificially magnified by a restricted communication channel. That possibility prompts a consideration of the relationship between contemporary communication technology and ideology.

If you see the world through democratic eyes, the Internet appears the ideal political forum. Majority views can be ascertained while minority perspectives retain a seat at the table. If you see the world from an authoritarian perspective, the Internet is a powerful communication tool that can assure that the dominant perspective remains dominant as long as those pesky “flaws” get “patched.” Simultaneous with the Twitter Revolution in Iran, China launched Green Dam Youth Escort. This initiative includes a demand that every PC sold in China after July 1st have the Green Dam software installed, software that would allow the government to block user access to any “questionable” website.

The point is that we see technology through the eyes of our ideology. Here in America, the Internet is seen as a tool for democracy. The political powers that be in China see it as a tool to maintain the state. We would like to see the Iranian Twitter Revolution as the birth pangs of a western-style democracy. It may be that we just caught a brief, deceptive gleam from the lonely tower of a theocracy.

Give it a thought, Melissa, OK? Thanks.

Friday, June 26, 2009

About Con-Temporary Art?

Simone Lalongo is a young Italian artist whose work was featured at a show titled Emerging Talents: New Italian Artists that I attended this past April at Centro di Cultura Contemporanea Strozzina in Florence, Italy. He may have been among the young very hip people drifting through the gallery, but if so, we were not introduced.

Simone, may I speak frankly? Thank you.


Simone, I suppose you are too young to have read Marshall McLuhan. Canadian media theorist – very big in America in the 1960s? Well, never mind, it doesn’t matter. Trust me, you guys are cut from the same bolt of cloth. Huh? Oh, it’s an American idiom – it means you see the world in the same way. You see it was McLuhan who said, “Art is anything you can get away with.” Seriously, Simone, when I saw your – ah, exhibit? That tiny glass bottle filled with some water and your fingernail clippings? The plexiglass box with the stark lighting? Amazing, amazing, bella, bella bellissimo! I could not believe that you got away with it!


But then, of course, I read the display card, and bada bing, it all made sense! Bada bing? Oh, there is this TV show, The Sopranos, about these Italian-American mafia types . . . ah, it’s not important. Your card though, that was brilliant. No, no really. “The artist’s work becomes an angst filled vortex spinning in on it- and him-self searching for a potential solution, or what we might even call a cure.” I thought I would die! Hilarious! They’re fingernail clippings for god’s sake. You prankster you, I can’t believe they bought it! But wait, there is one part here I don’t understand. Where is it? Oh, yeah here: “His gramme of anxiety is the gramme that each of us consumes every day . . .” The Oxford English Dictionary defines gramme as “a unit of mass equal to 1/1000 of a kilogram.” Are you saying we eat that much in fingernails everyday!? Kinda gross. Simone, hey, Simone, where ya goin’ kid? Come on back! Was it something I said? Gee, kinda touchy. . .


We could, I suppose, blame it all on photography. Before photography art was all about realism. You tried to paint a realistic bison on the cave wall. Maybe you were going to feed a young hunter some mushrooms, spin him around a few times and flash a torch up on the painting so the kid would freak out there and not when the bison was actually charging you. Maybe you wanted to show the god of the hunt what you were after – sort of a magical “call ahead for faster service.” Who knows, but you wanted a real looking bison. Back in the 16th or 17th century you got hired to paint the Burgermeister’s daughter. That’s a little tougher. The idea was not so much to paint exactly what the Burgermeister’s daughter looked like, as it was to paint what the Burgermeister thought his daughter looked like. But it was all about shades of reality. Then in the mid-1800s photography made it’s debut. Point a camera, push a button. There was the Burgermeister’s daughter – as she really looked. Which created other problems that are part of another story.


The point is this; the best artist was no longer simply the person who captured reality most accurately with a brush. The camera did that. The best artist slowly became the one who captured the essence of the moment – the purest impression of the moment. Bada Bing – Monet, Manet and every other way. Now what is on the canvas is only part of art. What is said about the canvas, what is written about the canvas, how the artist explains the canvas – these become increasingly important issues. Which eventually lead to McLuhan’s observation and Simone’s fingernails in a bottle.


So is that such a big deal? A kid cons his way into a temporary exhibit? It may well be. I have two problems. Simone’s exhibit wasn’t the only simplistic construction at that show masquerading as art. Nor is the Centro di Cultura Contemporanea Strozzina the only gallery playing along. I remember being at the Museum of Contemporary Art in Chicago a few years ago, a show featuring the “best young artists in America.” It was equally unimpressive. Large photos mostly out of focus. Rambling erotic journals “framed” as art.


I have no problem with young people taking their adolescent works seriously. I certainly did. When I was a sophomore a buddy of mine and I presented a one-act play in the coffeehouse at college. The first line was “Name names now Norris, near Nancy’s nice nifty new newly named nuisance.” We thought it was deep, meaningful. Go figure. Then after graduation I applied for a job as a photographer with National Geographic magazine – without benefit of portfolio. They gently suggested more experience. Every young artist should take his or her work seriously. That doesn’t mean that major galleries should aid and abet them. There should be more of a leap between the refrigerator door and national venues. It seems however that a generation of indulgent parents now doubles as the art establishment and feels compelled to gush over the works of their real and surrogate children.


Equally problematic is this love affair with the banal. Simone’s fingernails partner easily with a work I saw at the National Gallery in Washington, D.C. several years ago. Three blank white canvases in a corner – each, oh, maybe two feet square. One lay flat on the floor, snugged into the corner. The other two completed the walls so that the three canvases essentially replicated the floor and the two walls behind and beneath them. The title: Exploded Box. Being a Philistine, the inner meaning escaped me. Are we really so blind to the tiny doors on the fascinating that open around us everyday that someone needs to haul them into a gallery?


I walk down the street during a downpour. Flash flood in the gutter. A huge drain at the corner swallows it up and flings it off toward the ocean. Sweet. But should I head out to the junkyard, score a surplus drain and enter it in a major show? Title: Urban Seascape. Maybe. Maybe contemporary art is anything you can get away with.

Thursday, June 25, 2009

About Health Care Reform?

Nancy-Ann DeParle is Counselor to the President and Director of the White House Office of Health Reform. Some call her the Health Reform Czar. We have never met.


Nancy-Ann, may I speak frankly? Thank you.


You just have to realize that there will never be meaningful health care reform in America as long as we see disease as a profit center. It would be nice to think that the whole AIG disaster was an isolated incident. And I realize that their Accident and Health division was small potatoes when compared to the biggies like WellPoint and UnitedHealth Group. But it doesn’t take a rocket scientist to figure out the business model of any insurance company – medical, car, home; they are all the same: revenue comes in when subscribers pay premiums. Money leaves when the company pays out on claims – those are expenses. You increase profits by reducing expenses – by denying claims.



Now, Nancy-Ann, we don’t know each other. And I certainly don’t know your medical history or experiences, but if you are still clinging to the notion that insurances companies place subscriber's well-being above profits . . . Well, I’ve got this bridge up in Brooklyn you might be interested in. Nifty new infrastructure project. More coffee?



Anyhow, let me tell you a story. A few years ago I had some problems with my back. All of my doctors agreed that a kytoplasty was the ideal treatment for me, and BCBS routinely approved the procedure in cases like mine. Only this time they didn’t. Thereafter followed a few months of medical mumbo-jumbo while BCBS tried to explain why a previously excellent procedure was now questionable. I tried to involve both my senators, Dole and Burr, in the dialogue. Their offices sent me nice little notes saying that this wasn’t their job. Finally, my congressional representative, David Price, intervened and miraculously my case was reassessed and the procedure approved. Unfortunately, my back had deteriorated further and a more invasive vertebroplasty had to be done.



I’m assuming you see the irony, Nancy-Ann. The tipping point was political, not medical. BCBS had obviously decided that this very effective procedure was simply too expensive so they made the business decision to deny the claims calling for the procedure despite its medical efficacy. My doc was able to place the time fairly precisely when kytoplasty went from a routine "yes" to a routine "no." I just raised such a fuss that they gave in – in one case. No doubt they still routinely deny the procedure increasing the pain and suffering of subscribers whose health they are supposedly guarding.



So the way I see it is that we are caught between endemic corporate greed and a past history of governmental incompetence. Even I am not wild about putting my health care in the hands of the folks who spend 800.00 dollars for toilet seats, build multi-million dollar bridges to nowhere, and spend billions of dollars and thousands of lives purging the Middle East of “highly illusive” weapons of mass destruction.



A solution? Would that I had one, dear lady. But I can suggest a few starting points. Any system needs to put medical decisions back into the hands of doctors and patients engaged in dialogue. I am blessed with a doctor who is also a friend. We talk about my issues. He then becomes my advocate to the increasingly complex network of providers necessary to affect my care. All my docs spent a lot of effort trying to turn BCBS on my back issue. The fact that only political pressure moved BCBS demonstrates why an insurance company, whose entire profit structure rests on withholding care, should never determine a patient’s course of treatment.



Balancing that rational decision-making process needs to be a method for controlling costs. I’m sure Big Pharma can explain in great detail why two identical pills separated by an imaginary line – let’s call it the US /Canadian border – vary vastly in price. The same “imaginary line phenomenon” can be observed between a bottle of aspirin purchased at WalMart and two aspirin dispensed at a hospital emergency room. Until the smoke and mirrors surrounding cost are banished, consumers will always assumed they are being gouged – even when they aren’t.



Finally, you need to put a plan in place that is user-friendly. Details are admittedly not my strong suit. But I do have a Ph.D and spend much of my life reading and writing with an eye toward clarity. Still, I probably spend 20 to 30 hours a month engaged in filing paperwork directly related to insurance companies. The stress and irritation is incredible as I fax a copy of a doctor’s bill to the administrators of my flexible medical spending account to prove to them that I am not stealing my money from me for purchases that my doctor says I need but are not covered by BCBS. Free Americans from the unpaid drudgery of that mandatory second job and we might well see domestic productivity skyrocket!



So that’s where I am on health care reform, Nancy-Ann. Thanks for listening. Oh, by the way, I love what you’ve done with the place.