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June 30, 2005

Still afraid of single-payer

Via economist James Hamilton's new blog comes word of yet another new health care plan, this one from Massachusetts Governor Mitt Romney.

Romney's plan would require everyone to purchase health insurance, and would provide financial assistance to those who can't afford to. As Hamilton points out, whether this is a good idea or not comes down to exactly how much government help would be provided, and to whom.

It would be callous and unfair if the plan pegged the level of state assistance to a straightforward assessment of a person's income or assets. Private insurance costs are much higher for people who are sick or who have preexisting conditions, so someone with an expensive disease and a high income might still not be able to afford adequate insurance. On the other hand, though, it would be intrusive and unwieldy for the state to adjust its level of support to all aspects of a person's medical history. The simplest way would simply be to require that everyone submit quotes for private insurance in their applications for state insurance; but even then, the bureaucratic apparatus required to evaluate all the data might be more cumbersome than it's worth -- especially if the state isn't generous with its help. At best, it would be costly and inefficient At worst, it would be unnecessarily intrusive.

My initial reaction to this plan is that it's just another misguided attempt to insure everyone without embracing single-payer. It runs the risk of becoming just another subsidy to the same private insurers that will continue to compete in the marketplace by shifting costs to someone else instead of keeping their insureds healthy by emphasizing preventive care. I'm tempted to think that this plan mistakenly treats the existence of uninsured people as if it were our fundamental health care disease, when in fact it's just one of the worst symptoms of our real problem, which is the lack of single-payer health insurance.

At least Romney is trying something. He should get some credit for that.

June 29, 2005

Kiddie rides

Last weekend I got a huge dose of nostalgia when I climbed aboard the old-fashioned carousel at Chicago's navy pier. As the carousel turned and the horse I was riding went up and down, I could see the Wave Swinger -- Navy Pier's only real "adult" ride -- swinging people up, down, and around much faster and much higher than that old carousel horse ever could.

I suppose the carousel is pretty tame compared to the Wave Swinger. Most people would just call it boring, and they'd be right. We expect so many more thrills and chills from amusement park rides now than we did when the carousel was at the leading edge of ride technology. Even as a kiddie ride, the carousel doesn't seem to have as many fans as it once did. All the little kids want to ride the Wave Swinger, and if they don't it's usually only because they're still too short.

Why, then, did I really like the carousel? Why did I like the Rocking Horse, when all that did was rock back and forth as the attendant shifted her weight? Nostalgia was part of it. It brought back clear memories of when I was so small that climbing up on the carousel horse was a real accomplishment. I went around in circles and remembered how that exact same motion thrilled me when I was little, and how fun it was to watch everything pass by me again and again as I went around and around. It also helped that there was a little boy sitting on a horse in front of me with his father sitting next to him, and the father seemed to be having so much fun watching his little kid have fun. I bet the kid was enjoying the ride even more when he saw his dad enjoying it. The fun was infectious.

So I suppose it wasn't just nostalgia; it was also the feeling of doing a fun thing with other people, and choosing to believe that the thing was fun. I'd bet that when a kid's parents tell him that the carousel or the rocking horse is boring, that that's as much or more of a buzzkill than experiencing more thrilling rides and becoming jaded. Our expectations make a thing exciting or boring. I always tell people that if I ever don't want to look out the window of the airplane when it takes off or lands, then they should just shoot me, because I'm burnt out on life. Maybe that's a bit too zealous, but the point is that you're going to choose whether to get excited or not. I'll choose, if I can, to get as much fun out of life as possible. Even if it's mostly nostalgic.

June 28, 2005

Two Chicago restaurants

I'm not sure what to say about Starfish, a sushi place west of the Loop that I ate at last week. The food was fantastic. I had the chirashi, which was served on a plate instead of a bowl, with the fish piled up on a modest amount of rice and with some tasty greens off to the side. I had a chance to sample the sashimi, maki, and nigiri that my lunch companions ordered, and they were all delicious. If the food was the only thing that mattered, I'd give the Starfish an enthusiastic three stars.

Unfortunately, the food is only about 94 percent of everything that matters about a restaurant. Some combination of service, price, and atmosphere makes up the remaining six percent. The service at the Starfish was bad. Well, not actively bad, but completely nonexistent. We were seated promptly, but after that it was as if we had never shown up.

We waited about fifteen minutes before placing our orders. One of us had a question about vegetarian rolls that the server didn't know the answer to, so she said she'd check with the chef. When she came back ten minutes later, she'd forgotten all about it and had to go back to the kitchen a second time. Finally, she answered the question about what was in the vegetarian rolls with "a lot of different vegetables." Thanks. It felt as if we waited about three hours for our food, even though it was probably only two hours and forty five minutes. We had to ask for dishes to mix our wasabi and soy sauce. We had to ask for spoons, twice. We didn't even bother to ask for regular soy sauce -- low sodium was the only stuff on the table -- so we just grabbed it from the sushi bar. Keep in mind that the dining room was only half full at the most. The worst part was that the staff never apologized for the wait until the very end, and then only because they must have overheard us discussing the pros and cons of leaving no tip.

So it's hard to decide whether or not to recommend the Starfish. I suppose if you want good food, and if you're forewarned that you may have to go on the offensive to pry it out of the people working there, then the Starfish is the place for you.


It's much easier to evaluate Hannah's Bretzel, a new bretzel place on the corner of Washington and Wells. Ok, I know you're probably not tired of all the old bretzel places, but. . . .

A bretzel, apparently, is a big pretzel made with different kinds of soft bread that can be sliced in half and packed with yummies like camembert, organic ham, and fresh cucumbers. You can have a breakfast bretzel with knutella if you want. Hannah's also serves sandwiches on extremely high-quality breads with all-organic ingredients. For dessert they have a fantastic selection of fancy chocolate from all kinds of chocolate makers in the US and europe. Their beverage selection is pretty good too -- teas, coffees, and sodas of all flavors. One little gimmick I think is pretty cute is their delivery service. Everything you order will arrive at your door in a Mini-Cooper.

The only thing about Hannah's Bretzel is they only have about four seats in the restaurant. So plan on doing take-out, and plan to try it before it gets too trendy, popular, and crowded.

June 12, 2005

"Transhumanist" confusion

I'm only about halfway through James Hughes' Citizen Cyborg, but I've read enough to know that the guy is a bit confused.

It isn't that he's a proponent of any and all technology that allows us to manipulate human biology. Manipulation, after all, is one of the things that man does best. Nor is it his enthusiastic use of hideous terminology -- transhumanist, bioLuddite, and futurology are grisly examples. Hughes is much more of a technological optimist than I am, but that's not why I think his book is so confused and awkward.

The real reason I can't wait to heap scorn upon this book is that Hughes doesn't show any sign that he'll recognize any distinctions between "technological pessimism" and "human racism."

Hughes seems to think than anyone who's ever made an argument against the rapid development of cloning, nanotechnology, or germline genetic engineering is also, necessarily, on the wrong side of the debate over whether citizenship should be tied to consciousness and self-awareness, or to some biologically essentialist definition of humanness.

Huh? If you're confused, join the club. What do these two disputes have to do with one another? It's true that Hughes' bete noire Leon Kass sometimes writes as if the reason we should be wary of certain biological technologies is because these technologies might blur the distinctions between the human and the non-human. Because some social conservatives like Kass seem to think that democratic rights of citizenship depend upon one's biological humanness and not upon one's degree of conscious self-awareness, this technological blurring of biological boundaries would present, for some conservatives, some very difficult political choices. But this biological essentialism obviously isn't the only reason why people might be wary of technologies that would make us immortal.

For example, you might disagree with Hughes about how obvious the equivalence between human immortality and human happiness really is. You might be skeptical of Hughes' assumption that enhancing our physical prowess with cybernetic implants and nanotech brain implants will inevitably make us happier. You might even disagree with Hughes' fundamental claim that "control over our lives" is always positively correlated with happiness. Any of these reasons would be enough to make you less optimistic about new technologies than Hughes, regardless of your position on the question of where liberal democratic citizenship rights come from.

But I'm only halfway through this book. I'm willing to keep reading to see if Hughes will finally specify what it is he's arguing against, but I'm not holding my breath.

June 09, 2005

Charlie Trotter's

The first time I went to Charlie Trotter's, the restaurant blew me away. I sat at the justifiably-famed kitchen table, and everything exceeded my (admittedly gourmet-virgin) expectations. Some things were literally awe-some, as in they actually filled me with awe. Eating at Charlie Trotter's for the second time was a risky endeavor -- when you know what to expect, there's just so much more to lose.

Tonight, I went back to Trotter's. It was a different experience.

This time, I sat in the first-floor dining room right off the entry. This time, I wasn't nearly as naive as I'd been the first time I ate there; I'd eaten at Everest a few weeks before, and at Spring only two nights ago. Both of those meals had been fantastic, but I clearly remembered that Trotter's had been, if only subtlely, at a higher level. This time I was sharing dinner with someone whom I'd regaled with stories about how great Trotter's was, and I was actually a bit nervous that the place wouldn't live up to my memories of it. "Come on, Trotter's," I thought, "show me I wasn't wrong! Come through for me!"

And it did. The food, the service, the wine, and the non-alcoholic beverages were every bit as good as I had hoped they would be. It wasn't the same amazing experience as I'd had the first time, when everything was new and surprising. This amazing experience was of a different flavor entirely. There's something enormously gratifying about not being disappointed. It's even better when someone who has chosen to trust your stories about how great the place is, and has gone in with high expectations of her own, is not disappointed either.

Charlie Trotter's impressed me the first time around. Tonight, the restaurant earned my trust.

June 05, 2005

It's done!

George R.R. Martin is done!

He's got some yadda yadda about splitting books in half and pasting them together with Elmer's, but I don't care all that much.

A Feast For Crows is going into production. Hallelujah!

Hospital construction

If someone suddenly asked me why I thought health care costs in this country keep escalating despite all the Medicaid cuts and reductions in employer-provided health benefits, the first thing that would come to my mind is all the new hospital construction.

Who knows if that's even part of the right answer or not. All I know is, I see a ton of money being spent on shiny new hospitals everywhere I look. In Denver, the University of Colorado Health Sciences Center is putting up some very impressive new facilities at the old Fitzsimons army medical base. In Ann Arbor, the University of Michigan is building new hospitals and biomedical research centers like it was their job. In Chicago, the University of Chicago has just finished the new Comer Children's Hospital, and Northwestern is building the new Prentice Women's Hospital.

I wonder how much of the philanthropy that's funding this hospital boom is actually helping people with little to no access to timely medical care...