A study just published in the prestigious journal Science reveals that new Medicaid patients in Oregon were 40% more likely to use the emergency room than the uninsured were. This finding is not a surprise to me or most physicians — we have known that truth for years.
But it does undermine one of the basic philosophical and practical underpinnings of Obamacare: the notion that expanding insurance will invariably unclog ERs, improve primary and preventive care, prevent diseases and lower costs.
The study underlines the findings of a prior survey by the PricewaterhouseCoopers consulting firm that indicated that Medicaid patients are 35% more likely to use the ER unnecessarily than are the uninsured.
The reason for ER overuse is simple: Medicaid patients (like all insured patients) feel that their insurance card entitles them to health care anytime they want it. When office doctors aren’t available to provide it, they go to the hospital to get it.
Black History month is intended to counteract the historical bias against blacks. The Tulane University Black History Month Web site reads, “Obviously, a White History Month is not needed because the contributions of whites are already acknowledged by society. Black History Month is meant to remedy this inequity of representation.” According to Jacquelyn West-Ford, Drexel’s senior associate dean of students, “Black History Month is simply a time to bring attention to the achievements that black Americans have made to education and society.”
But Black History Month is not meant to remedy inequity of recognition as such — merely inequity of recognition for those who are black. The holiday discriminates against other unrecognized achievers — as if black achievers were the only ones who have been treated unfairly by history. If remedying inequity of recognition were the true purpose of the holiday, it would be called “Month of Unrecognized Achievers.” It would celebrate people like Nikola Tesla, the father of modern electricity, and not just people like Martin Luther King Jr., whose achievements are already more widely recognized than Tesla’s.
Amazon reacted with satisfaction. Mary Osako, an Amazon spokesperson, said, “With today’s vote against third-party representation, our employees have made it clear that they prefer a direct connection with Amazon. This direct connection is the most effective way to understand and respond to the wants and needs of our employees. Amazon’s culture and business model are based on rapid innovation, flexibility, and open lines of direct communication between managers and associates.”
Private sector union representation has dropped precipitously in the United States, and now stands at just 6.6 percent.
Amazon has consistently argued against any sort of union representation for employees.
“We respect the individual rights of our associates and have an open-door policy that allows and encourages associates to bring their comments, questions and concerns directly to their management teams,” said Mary Osako, an Amazon spokeswoman, in an emailed statement.
“We firmly believe this direct connection is the most effective way to understand and respond to the needs of our workforce and do not believe there is a need for third-party representation.”
[…] Ayn Rand removes your insecurity about whether your choices are right and unavoidable or just random and fickle. She provides a philosophical foundation for what most other commentators only present as a utilitarian argument — individualism and capitalism simply work better than collectivism and socialism. Very few advance the moral argument, but that is ultimately the real argument.
That is a very important distinction that has profound consequences. And that begins to reach out for an explanation of The Big Disconnect — why is it that in spite of socialism failing so completely again and again, why is it that in spite of capitalism and freedom improving people’s lives and creating wealth and welfare wherever it is applied, even with that knowledge and experience — we have to fight new attacks on freedom, year after year, decade after decade? The attacks come in different disguises, but always with a moral root — capitalism is evil, it is destructive, it is egoistic, it is anti-nature. We ourselves, on the other hand, fail to advance the moral argument, but the opponents of capitalism always sell their rotten philosophical goods by claiming a higher moral ground, altruism and the need for control of human freedom to protect man against himself by handing over responsibility to collectivists and anti-individualist leaders who know so much better than the rest of us. With enough moral high ground claimed, there is no need for any clear explanation as to why or how they would know better and there is no questioning of why the leadership should necessarily fall to them.
This is an ancient problem and has recurred in different ways throughout the centuries. Right now, we are seeing a solid revival, a significant pushback against all the advances that were made when the Iron Curtain came down and the despotic leaders of the Soviet Union and their satellites were overturned. Some of us foolishly though that this was the final victory for capitalism and freedom and that surely the world would move quickly in a better direction, while the remaining dictatorships would collapse before too long.
Senate Majority Whip Dick Durbin (D-Ill.) asked Republicans to stop reading Ayn Rand books and help Democrats pass legislation aimed to give struggling Americans a hand.
“I say to my conservative friends, put down those Ayn Rand books for a minute and take a look at the real world,” Durbin said on the Senate floor Wednesday. “If we can’t stand behind those who are struggling in life, who are we; what are we?”
Egalitarianism is not the (proper) advocacy of “equality” of rights. It is true that everyone has the same rights, whether a government recognizes them or not, because those rights are based on the nature of man. The same, one standard applies to every human being. What the egalitarians demand is not equality of rights but equality of condition. No one, they say, should be better off than another.
On “equality of opportunity”:
It is pointless to try to distinguish inequality of outcomes from inequality of opportunity. There is no more right to “equal opportunity” than to “equal outcomes.” An American child of wealthy parents has more opportunity than a Cambodian child of destitute parents. Does that mean the American parents must sacrifice their child’s future to increasing the opportunities open to Cambodian children? Yes, say the egalitarians. No, said the Founding Fathers, to the equivalent question in their time. And that “No” is why America is the wealthiest nation in the world. Only the protection of individual rights unleashes the productive energies of the wealth-creators, on every level of ability. That’s the lesson not only of American history, but of the more recent rise of the Pacific Rim countries, and the still more recent amazing growth of India and China, caused by their turn away from communism, socialism, and other forms of statism.
On the communist inspired collectivist “common pot” mentality:
The “gap” in the condition of the rich and the poor, says Obama, has widened. “The top 10 percent no longer takes in one-third of our income–it now takes half.” Note the language. He first describes income as being “taken in” and then slides into describing income as “taken.” The top 10 percent . . . now takes half.” “Half”–of what? The response would be: “Well, of the nation’s income, of course.” And thus what began as a simple statistical calculation comes out the other side as pure communism: collective ownership. The national income is regarded as a common pot. Then some groups “take” from that pot more than their share. In Obama’s world, if farmer Fred harvests 4 pumpkins and farmer John harvests 2, Fred has taken two-thirds of “the harvest” for himself. He should be ashamed. It’s unfair. It’s a crisis. Something must be done: “it challenges the very essence of who we are as a people,” says the President.
…and later he explains why those who are more productive should be admired. imitated and left free to produce:
Productive strength is a value to everyone. Weakness and self-defeat is not in anyone’s interest, neither the weakened one’s, nor that of anyone dealing with him. It is in your interest that other men be smart, healthy, productive, and free–not stupid, sick, lazy, and enslaved. To take a more realistic example, would you be better off if Thomas Edison had been stupid, sick, lazy, or enslaved? Would you be better off if the comer newsdealer were? It’s a man’s actual, non-comparative level of wealth that matters, not the existence of others with more than he. Except that he is better off to the extent those with whom he deals have money to burn.
…and the reason why the moral reason why the egalitarian hates the productive:
Other’s wealth can only benefit one in practical terms, which takes us to the reason why the campaign against inequality is vicious. The egalitarian hates inequality for a non-practical, non-venal reason: the sight of the successful and the happy stands as a reproach to him. It brings him face to face with his own failure and inner emptiness. Psychologically, emotionally, a man who is inferior can seethe with resentment at the sight of his betters.
Egalitarianism is a rationalization for the lowest of human emotions: envy. Not envy for what others have, but something much uglier: hatred of anyone for having achieved anything. Not “I’m upset because you have what I ought to have,” but “Punish those whose success makes me know I’m a loser.”
The Germans call it “Schadenfreude.” The French call it “ressentiment.” Ayn Rand called it: hatred of the good for being the good. The inequality that the egalitarians actually hate and fear is moral inequality. They rebel against the idea that they are responsible for their own acts and for their own moral character–or lack of it. “Inequality is unfair” is the coward’s cry against the brave, the slacker’s cry against the producer, the hypocrite’s cry against integrity, the conformist’s cry against the man of independence. The demand for the wealth they didn’t earn is only the outward symbol. The root is the demand for virtue they didn’t earn.
He then goes on to quote Ayn Rand’s identification of John Rawl’s motive and error:
If you wish to know the actual motive behind the egalitarians’ theories–behind all their maudlin slogans, mawkish pleas, and ponderous volumes of verbal rat-traps–if you wish to grasp the enormity of the smallness of spirit for the sake of which they seek to immolate mankind, it can be presented in a few lines:
“When a man thinks he’s good–that’s when he’s rotten. Pride is the worst of all sins, no matter what he’s done.”
I am appalled by the state of American education. I am appalled not primarily by the crowded classrooms, decrepit buildings, unmotivated, unionized teachers, severed arts programs, drugs, violence, or many-children-left-behind, but by that which should be the central, fundamental, defining element of any school – the education. Even those schools with richly appointed, sprawling campuses, dedicated faculty with PhD’s, and reputations for academic excellence backed by test scores to prove them still suffer from the same basic pedagogical problem. Education, the actual “learning” that goes on within the walls of our schools, has come to consist primarily, almost exclusively, of mindlessmemorization.
From the causes of WWI, to Newton’s laws of motion, to types of literary devices, to the formulas for area, etc., etc. etc., we are asked to memorize, and regurgitate, and study, and memorize, and regurgitate…and forget. Today’s schools are failing utterly to provide children with a real, functional, life-enhancing, lasting education. That is why I sympathize with the widely popular rallying cry well captured in this viral video, of people who “love education” but “hate school,” and the message, “We will not let exam results decide our fate.” They recognize that their education is bankrupt, and they refuse to define themselves by the schools’ standards of success.
But sadly, this rallying cry and most of those like it are not a rejection of education in its current, empty, memorization-driven state – they reject education as such. The idea that school must “change with the times,” that education is fundamentally for “getting a job” or “satisfying society’s needs,” that our “different genes” mean we must be educated by “different means,” that Google, Twitter, and Facebook are as legitimate means of personal development and self expression as any schooling, betray a basic hostility to the very concept of education. This should not be surprising, given that those sounding the call are victims of the very educational system they decry. How could they know any better?
What a real education actually looks like, what basic purpose it serves, what it does to enhance the life of an individual, why it is essential to life as a mature and thriving adult – these are enormously complex issues. But for my own peace of mind, I want at least to offer some food for thought, and a rallying cry of my own: Protest the “education” in today’s schools, but not education in and of itself.
The “secret” of our approach is teaching math conceptually, first starting with a sequential, targeted introduction to concrete manipulatives, then enabling mastery through deliberate, focused, motivated practice, and then allowing the experience of efficacy through the application of skills in increasingly complex, real-life problems.
This is accomplished via a three-step process:
We develop real understanding by using carefully structured manipulatives, and, more generally, by always progressing from concrete to abstract in a deliberate sequence.
We enable each child to attain mastery of math facts, at his or own pace,before we expect him or her to apply those skills to more complex problems.
Once a skill is learned, we explicitly teach mathematical problem solving, and advance, rapidly, to applying the skills learned to complex, real-life, meaningful math problems.