“Do you feel safe at home?” in Maskachusetts versus Florida health care settings

by philg

One constant feature of health care in Maskachusetts was the provider asking, often as the first question of an encounter, “Do you feel safe at home?” A fit 6’2″ tall 25-year-old who identified as a cisgender heterosexual man would be asked this question just the same as a frail slight person identifying as female.

A memorable example of this was the delay of care being provided to Senior Management after I had taken her to a community hospital in Cambridge, MA at 5 am. Getting to the bottom of the “Do you feel safe at home?” question was more important than asking about the labor pains that had occasioned the hospital visit (the same hospital where she had been receiving prenatal care, so it wasn’t a new-patient situation). In order that she would be free of coercion, the person who got up at 4:30 am to do the hospital drive had to removed into a separate room so that the 9-months-pregnant person could answer this question freely before moving on to whether abortion care (perfectly legal at all stages of pregnancy in Maskachusetts) or delivery was desired.

An example in miscommunication occurred when the question followed me telling the doctor that I had recently returned from a trip to Israel. This was early in the adoption of the “Do you feel safe?” question so I heard it as “Did you feel safe?” and launched in a long explanation of security risks in Israel, the lack of street crime compared to big U.S. cities, etc. The doc then had to explain that she didn’t care about Israel but about whether Senior Management was physically abusing me.

Because I’m in possession of a mostly timed-out body, I’ve had quite a few encounters with physicians here in Florida since August 2021. What did these encounters have in common? Never once was I asked if I felt safe at home. Nor are patients asked to wear masks, even inside the full-service hospitals with operating rooms, etc.

Separately, I’m noticing that a remarkably high percentage of doctors in Florida are private jet charter customers. The specialist who toils for peanuts in MA and pays 5% income tax (9% under the new “millionaires’ tax” if there is a rare good year) will pay 16% estate tax on finally dying. He/she/ze/they can bask in the glory of institutional prestige, e.g., at MGH, even if prestige doesn’t come with a lot of money. The counterpart in FL seems to earn twice as much, pays 0% income and estate tax, and spends the extra on a luxurious lifestyle.

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Atlas Shrugged in Houston (The Woodlands)

by philg

In Atlas Shrugged, the productive and successful Americans retreat to an isolated town in Colorado and stop paying taxes to the massive inefficient bureaucrat U.S. government. Under the pre-Trump tax code, that happened to some extent with American corporations (see this 2015 post (obsolete now due to changes implemented during the Trump dictatorship that forced companies such as Apple to abandon their sham Irish/Dutch tax homes)), but it did not seem to be happening for individuals on a large scale.

I visited Houston, Texas in December 2022, on my way back from Corvette driving school report (Ron Fellows near Las Vegas). A friend invested heavily there in 2009 when everyone else was running away. Specifically, he invested in The Woodlands, a town north of Houston in a Republican-dominated county (Houston is run by Democrats). “The population has tripled since I moved here,” he said. Everything that you see or touch The Woodlands is at most 20 years old and, therefore, in beautiful condition. There is a fake “town center” strip mall with supermarket, restaurants, and stores for the rich: Tesla (showroom only; illegal to sell direct in Texas; #FreeMarketEconomy), Gucci, TUMI, Louis Vuitton, Tiffany, etc. The more successful residents of The Woodlands generally have huge houses, e.g., 10,000 square feet or more. One guy built a replica of a White House wing, complete with Oval Office, and lets charities use it for fundraising events. (“For maximum authenticity, they should get a guy from the local memory care unit to sit in the big chair,” was my response to seeing a photo of this.) Houses are cheap by Florida standards, with an older (1988) 10,507 square foot lakefront place on the market now at $3.25 million and a 1997 house available at $4 million (Zestimate: $3.6 million). Here’s a 2012 house offered at $6.5 million:

Consistent with “Big Nonprofit Hospitals Expand in Wealthier Areas, Shun Poorer Ones” (Wall Street Journal, 12/26/2022), the superb hospitals for which Houston is known have chased after the customers and opened up branches in The Woodlands. Hewlett Packard Enterprise’s corporate headquarters, relocated from Gavin Newsom’s Managed-by-Science (TM) California (announced in the 9th month of the California lockdowns), is just on the edge of The Woodlands.

Maybe this can’t work in other states because it is too difficult and expensive to build infrastructure in most parts of the U.S., but it should be a cautionary tale for city governments. Nobody who was on welfare in Houston moved to The Woodlands, but lots of people who had been paying huge amounts of sales and property taxes moved. So the ratio between the takers and makers went up as The Woodlands grew… “Houston Finance Head Warns of Massive Budget Deficit After Federal COVID-19 Funds Expire” (The Texas, March 31, 2022): “The state’s largest city has been using federal COVID relief dollars to plug budget holes and provide raises, but is lurching towards a fiscal cliff once the federal funds expire.”

A couple of iPhone images taken from a Robinson R66 (no photo window, sadly):

I happened to visit “Market Street” on a rainy day:

There is still a lot to love about Houston per se, but maybe you don’t need to live there. My favorite part of the museum district (note the Tesla 3 from Hertz):

Where better to see the ritual of masks outdoors than in a big city full of Democrats?

Let’s hear it for Matt Mullenweg, the creator of WordPress:

From the fine arts museum, a timely reminder for Ron DeSantis about racism in the classroom:

An image ruined by motion blur in the main subject, worth big $$ and suitable for display because the failed attempt was made by Cartier-Bresson:

Masks of color:

I learned about Gyula Kosice. He built the following installation from 1946-1972:

From James Turrell, inspired by being up in the air:

Some stuff that I desperately want for our house:

The museum is home to a substantial Louise Nevelson (NYT: “a few years [after the birth of a son] Nevelson broke up her marriage. She refused any alimony, however, on the ground that to accept it would be immoral”).

Concerned that you don’t have what it takes to produce a $1 million artwork? The Cy Twombly Gallery might boost your confidence:

Conclusion: If you don’t have to commute into work in downtown Houston, The Woodlands is close enough to access everything great about Houston, but doesn’t suffer from any of the bad stuff.

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Farewell to Black History Month from ChatGPT

by philg

A February 5, 2023 exchange with ChatGPT:

What if we change the question slightly?

Let’s get away from skin color:

I’m sick with envy every time I see a Gulfstream on the ramp. Maybe ChatGPT can help.

(Does the above answer make sense? Melinda Gates and MacKenzie Scott are billionaires, but they did not get rich by employing workers or engaging in business. Why are they told to “implement responsible and sustainable business practices” and to support workers?)

How about our corporate overlords?

I would love to see a corporation “engage in … self-reflection”! ChatGPT demands “fair wages”. Suppose that a corporation accepts ChatGPT’s demand.

(ChatGPT implies that employers are paying $8.65/hr, but a quick search reveals that entry level at McDonald’s is $13.75 to $15/hr in Palm Beach County.)

Is there room for improvement among those who walk across the southern border?

In short, “No.”

Is there room for improvement among those who are already U.S. residents?

(Item #3 seems consistent with the others. If migration is good for the U.S., why would we strive to reduce the flow of valuable migrants?)

Combining all of the above… If you identify as white and native-born, I hope that you’re spending today acknowledging your privilege and making sure that you pay sufficient taxes to buy all migrants free access to the healthcare services that you’re unable to use (because out of network).

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Book review: Walking the Americas

by philg

To prepare for our own adventurous journey to Colombia, a friend and I listened to Walking the Americas, by Levison Wood, a British Army veteran. Mr. Wood starts farther south than we did, but is handicapped by not having any assistance from Royal Caribbean. Without a boat, Mr. Wood will have to push through the notoriously challenging Darien Gap. Today we tend to think that this term refers to a “gap” in the highway that would otherwise connect Alaska to Argentina. One of the locals interviewed in the book says that the name refers to a gap in the mountains that made it easier to travel through from Atlantic to Pacific than through other parts of Panama.

Mr. Wood’s companion is Alberto, a 42-year-old Mexican fashion photographer who often says “chinga”. Alberto was ready for a distraction in 2016 because he’d recently been targeted in Mexican family court by his wife of one year, availing herself of the then-new no-fault divorce law to obtain a free house after a one-year marriage. From “Do changes in divorce legislation have an impact on divorce rates? The case of unilateral divorce in Mexico” (Aguirre 2019; Latin American Economic Review):

In 2008, Mexico City was the first entity to approve unilateral divorce in Mexico. Since then, 17 states out of 31 have also moved to eliminate fault-based divorce. … The results indicate that divorce on no grounds accounts for a 26.4% increase in the total number of divorces in the adopting states during the period 2009–2015. … Unilateral legislation has proved to be an effective tool in modifying family structures in Mexico…

Alberto’s achievement in walking from Merida, Yucatan to Colombia is more impressive than the author’s. Alberto was not writing a book and was not a former paratrooper.

The Darien Gap turns out not to be all that challenging for our heroes. They have enough connections to get the Panamanian authorities to bless the expedition. They hire Emberá and Kuna Indians as porters and guides (I visited these folks about 20 years ago via Robinson R22 helicopter from the local flight school). But the rest of the book features plenty of challenges, e.g., hiking to 12,536′ to the top of Cerro Chirripó, Costa Rica’s highest peak and walking through gang-held areas of San Pedro Sula, Honduras.

The author points out that Central America’s population is 4X what it was a few decades ago and, in his opinion, this is the principal explanation for the region’s poverty.

The migrants whom the walkers encounter are from Africa, Haiti, Nepal, and Pakistan and have typically entered the Americas by flying to Brazil. The Panamanian authorities explain that, after arresting migrants, they will typically assist them in reaching the United States by transporting them to the border with Costa Rica. This gets the migrants out of Panama, which does not want them, and is cheaper than deportation (Panama pays for some bus rides instead of paying for plane tickets back across the Atlantic).

Here are some of the animals that we saw while walking through the Colombian jungle (at the cruise port in Cartagena). Warning: the toucans are friendly, but one of them likes to bite sneakers and it hurts!

The book lends itself well to the audio format and the narrator is convincingly British. I recommend Walking the Americas to anyone planning a journey to or through Central America. Separately, if you want to see a restored Spanish colonial town and a lot of beautiful nature, I recommend the UNESCO World Heritage site of the old city within Panama City and then do your nature excursions in Panama, which is much wealthier and better developed than other nations in the region. They don’t promote tourism as much as the Costa Ricans do because any time they need $1 million they can let a big container ship through the new locks. Cartagena is jammed with tourists, locals trying to sell things to the tourists, car traffic, massive holes in the sidewalks, etc.

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Where is the population-wide evidence that COVID vaccines reduce COVID-tagged death rates?

by philg

Continuing to explore a topic raised in February (Did vaccines or any other intervention slow down COVID?)…

Cochrane has shown that the correlation between forced masking and coronaplague is minimal (i.e., general public masking does not reduce the spread of a respiratory virus, just as Science, including the WHO, said for 100 years prior to June 2020). We’ve had a good natural experiment on COVID-19 vaccines in that countries vary dramatically in their vaccination rate. Where is the study that shows, from these data, that population-wide COVID-19 vaccination, as aggressively promoted by the CDC (down to age 6 months!), reduces COVID-tagged death rate?

The New York Times offers a map and table of countries and their “fully vaccinated” rate. We can see that Chile is 93% fully vaccinated and Spain is virtuously at 87%. Compare to just 34% in Ukraine and 30% in Nigeria.

The correct approach to an analysis would almost certainly include adjusting by share of population over whatever we can agree is the COVID-vulnerable age (CDC says 6 months; European public health officials say 50 (age of vaccine eligibility); previous attempts have used 65; median age of a COVID death is about 80). But what if we do a rough cut by looking at the raw (not age-adjusted) COVID-tagged death rates?

CountryVaccination RateCovid-tagged deaths/million
Chile93%3,080
Spain87%2,301
Switzerland70%1,603
Turkey64%1,175
Ukraine34%2,565
Nigeria30%15(!)

Is it obvious from the above that #VaccinesSave?

(We could also look at excess deaths by country during three years of coronapanic. Vaccinated Chile is at 18%; Spain at 11%; packed-with-filthy-unvaccinated-disgusting-people Switzerland at 8% (no data for Turkey, Ukraine, and Nigeria).)

Why does this matter? Let’s look at a post-Cochrane tweet from a person who might be described as a moderate believer in public health interventions. With her MD and MPH, certainly, she cannot just throw in the towel on the idea that humans, at least with sufficient credentials, can be masters of their own destiny. In light of the Cochrane review, she says that we will master our destiny with vaccines and Paxlovid:

But if the Followers of Science fooled themselves for 3 years on masks, why can’t the Followers of Science also be wrong about the effectiveness of vaccines and Paxlovid? Is it worth looking at age-adjusted country-to-country comparisons to make sure that we aren’t wasting a lot of time, energy, and money that could be better spent on, e.g., fighting obesity (first step under Philip’s dictatorship: no more Buy 2 Get 3 candy sales at CVS!)?

Fighting COVID with ineffective tools is not cost-free because humans have limited time, energy, and money. Closing schools, for example, will ultimately cost more lives than SARS-CoV-2 infection because people with less education live statistically shorter lives. Dollars printed to pay people to sit at home for 2 years are dollars that can’t be used to pay people to lose weight (imagine what you could do for public health if you gave Americans $600/week on condition that they lose 1 lb. per week! (maybe people would game the system by bulking up in the week prior to the first weigh-in?)).

(Speaking of Paxlovid, my friends in California seem to be Pfizer’s best customers. They said that they would never get COVID because (a) they had 4 or 5 Pfizer shots, (b) they mostly stayed home for 2+ years, and (c) they wore their N95 masks on the rare occasions when they left home. Then they got COVID (once or twice) and, despite being reasonably young (60ish) and not obese or chronically sick, they would guzzle Paxlovid within hours of an at-home test yielding the sacred magenta line. (How did they get it so fast when the rest of us have to wait 2 months to see a primary care doc? Telehealth!))

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Life lessons from the Queen of Versailles

by philg

Extremely loyal blog readers may recall that I wrote about The Queen of Versailles in 2013:

the protagonist talks about her days as an engineer at IBM. One day she asked her manager why he had a clock counting down. The manager said that it was showing him the days, hours, minutes, and seconds until he could retire. Why did he care? “Because that is the moment when I can start living,” was what the guy said. As a result of this conversation, the Queen of Versailles quit her engineering job and took up fashion modeling in Manhattan. Then she devoted herself to being the wife of a rich guy and mother to seven children.

The funniest line in the movie was Jackie Siegel talking about the setbacks during the Collapse of 2008 forcing the family to travel to Upstate New York via commercial airline. One of the younger kids, accustomed to the Gulfstream life, asked “Mommy, what are all of these people doing on our plane?”

Jackie Siegel is back, finishing Versailles, her huge Orlando house, in front of an TV audience (Queen of Versailles Reigns Again; streaming on HBO). (In the 2012 documentary, I remember she and her husband saying that the inspiration for the house was the Paris casino in Vegas and not Louis XIV’s bungalow in Frogland, but in this new TV series they talk about the French original as the inspiration.)

The saddest event between the two documentaries is that one of the Siegels’ daughters was addicted to Xanax and was entrusted to rehab. She formed an alliance with a fellow patient, ultimately pronounced cured by the psychologists. As soon as they were out of rehab, he introduced her to heroin. She was dead of a methadone overdose at age 18 (New York Post):

Victoria, who was a big part of the documentary, had gone to rehab to deal with a Xanax addiction. It was there she met her 26-year-old boyfriend.

“The day she got out, she tried her first heroin … a month later she was dead,” Jackie said. The boyfriend later died of a drug overdose as well.

(About 20 years ago, a friend paid handsomely for his childhood best friend to go to the Betty Ford Clinic for treatment of alcoholism. At Betty Ford, he met Hollywood heroin addicts and, upon being cured and released, began to party with them. He overdosed and died.)

The HBO show is a mixture of lifestyle and construction challenge, but I think it is worth watching to see what happens when half of the fine craftspeople of Florida come together in one place. I learned about the High Point Market, a furniture trade show that takes up 10 million square feet. Also, that the decorator chose red as a pool table felt, not tournament blue. Sometimes style is more important than function!

Sadly, the house was built right next to a big lake and not too many feet above the lake. It’s not within a FEMA flood zone, but the lake itself and shores are flagged as “Zone AE” with a 1 percent annual flood risk. Hurricane Ian was purportedly a 500-year flood event and Versailles flooded (TMZ).

Fired Googlers: How about a system that returns the FEMA flood zone, not just a map, in response to an address? ChatGPT is useless:

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Do the Jews who support open borders for the U.S. also support open borders for Israel?

by philg

Here’s a typical perspective from an American Jewish Democrat:

The guy who gets a paycheck from the Anti-Defamation League wants to fill the United States and other countries “around the world” with any person on Planet Earth who is capable of spinning an asylum yarn, e.g., “I was afraid of my spouse” or “there was a criminal gang in my neighborhood” or “I identify as 2SLGBTQQIA+ and my native country does not support Rainbow Flagism.”

But how is this perspective consistent with the State of Israel continuing as a Jewish state? There are 5.3 million Palestinians living in the West Bank and Gaza. All of them could make credible asylum claims, e.g., “I am 2SLGBTQQIA+ and Wikipedia says that therefore my situation is ‘precarious’.” (“Gaza, however, still follows the British Mandate Criminal Code Ordinance, No.74 of 1936, which outlaws same-sex acts between men, with the current punishment being up to 10 years in prison.”) Or “I am fearful that the Israeli military will blow up my apartment building in case they suspect that Hamas is using it for offensive purposes.”

Arabs are already 20 percent of Israelis. After the 5 million Palestinians settle in Israel as asylees, plus additional asylum-seekers from other Muslim countries as necessary, the Muslim population will outnumber the Jewish population and Muslim Israelis can vote to establish an Islamic government within Israel, either expelling the Jews or keeping them around as tax-paying Dhimmi.

There must be mental gymnastics that I am missing that enable these migrant-supporting Jews to, without being obvious hypocrites, oppose the migration of Muslims, including Palestinians, into Israel. But I can’t figure out what it would be! If a person says that any Muslim is entitled to cross the U.S. border and apply for asylum, how can he/she/ze/they be opposed to a Muslim crossing the Israeli border and applying for asylum?

In case the above tweet is memory-holed, a screen shot is below. Separately, note that the Hebrew Immigrant Aid Society is mentioned. Anger regarding this taxpayer-supported enterprise was cited by Gregory Bowers as his motivation for shooting Jews at a Pittsburgh synagogue in 2018 (“HIAS likes to bring invaders in that kill our people. I can’t sit by and watch my people get slaughtered. Screw your optics, I’m going in.”). This was predicted years earlier by a friend who is an Orthodox Jew (working class white males in the U.S. becoming Jew-haters as a consequence of HIAS and other prominent Jewish-led efforts to increase low-skill migration into the U.S.).

Related:

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Elite nation-building thought process

by philg

One reason the New York Times subscription is worth it is for the window into the thought processes of the elites. “Over 75,000 Job Openings in Iowa Alone. Millions of Refugees Seeking Work. Make the Connection.” (NYT, 2/2/2023) is a great example. Excerpts:

Across the globe, 32.5 million refugees are seeking safety, many of them adults in search of work. At the same time, severe labor shortages in the United States and many other high-income countries have left businesses clamoring for workers.

The United States can help address both problems (and more) through bipartisan immigration reform — and states can be part of new solutions with innovative ideas that could act as the foundation for immigration federalism.

Creating a pathway for individuals to live and work in Iowa and other states would ease the burden on America’s asylum system.

One of the pillars of modern elite thinking is that, instead of being organized by cultural affinity, a cohesive human society can be built by assembling people who did not like wherever it was that they were previously. That’s the basis of open borders for asylum-seekers. Native-born American taxpayers will fund apartments (in a building owned by a member of the elite!) for (1) person who says that he/she/ze/they was at risk of being killed by a gang in El Salvador and speaks only Spanish, (2) someone who says that he/she/ze/they was a domestic violence victim in Haiti and speaks only Creole, (3) a migrant who says that he/she/ze/they was a victim in Syria and speaks only Arabic, and (4) a former police officer from Somalia (based on occupation, automatically eligible for asylum?) who speaks only Somali. Though they share no common language, these four folks can bond over… something. Thus, a thriving neighborhood is born. (Maybe they bond over their shared hatred for life in the respective countries of their birth?)

What’s new from the New York Times is the suggestion that these migrants get allocated by a central bureaucracy of elites to states in which there are (elite-owned) businesses whose offered wages are insufficient to attract native-born workers and existing immigrants. So not only will an asylum-seeker be in a country that he/she/ze/they may not have wanted to live in, but the asylum-seeker will be in a state that he/she/ze/they did not want to live in. (Remember that asylum-seekers are “fleeing” from somewhere. They’re involuntarily in the U.S. because this is the only place that they can be safe. It may be that the asylum-seeker dislikes and disagrees with everything about American culture and values, but the alternative was death.)

From Amana, Iowa: 75 years of communal living, a couple of photos of what awaits welfare-dependent migrants from a conservative Islamic society:

(Why will they be welfare-dependent? If they’re in a low-skill low-wage job, especially if they have children, even working 40 hours per week they will be eligible for means-tested programs such as public housing, Medicaid, food stamps (SNAP/EBT), and Obamaphone.)

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What’s new with Sam Bankman-Fried?

by philg

It’s been two months since Sam Bankman-Fried returned to the U.S. (BBC). How is my prediction that Joe Biden will appoint him as U.S. Treasury Secretary and that he will be confirmed by Senate Democrats looking? Any other news from this cryptocurrency trailblazer?

Most of the $121 million in real estate that Mr. Bankman-Fried and his Stanford professor parents owned is within gated communities, according to my friends in Nassau, but they did drive me, in January, to see the police station and courthouse:

The locals say that the prison where our future Treasury Secretary was held is not worth the 20-minute drive for a photo. “All that you can see is a wall with a sign.”

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A Maskachusetts Immigration Success Story

by philg

A story from our former suburb of Boston… (not quoting it because it would be tough to read in italics)

Sally is the mother of four kids – lives in Chelsea.
She is beautiful and speaks well but cannot read and has a 2nd grade education.
Her husband, small gentleman with a major speech issues, hit her over the head with a hammer when her boyfriend came over to the house. The father went to jail.
There was a lot of stress in the house. Both parents during the pandemic lost one of two jobs. The father was experiencing major mental health issues. The kids were “learning at home” The kids at the time where 3, 8, 10 and 11…..learning? How? Both parents were working their one job and desperately trying to find a second job.
The father worked for 18 years at Bed Bath and Beyond making $15.50 an hour. The mother continues to work at Whole Foods making $17 an hour.
Because the father is in jail the mother is responsible for all the bills which she cannot handle. Feb 1 she was evicted and went to stay in a hotel because all shelters were filled. She and the kids will stay there until housing becomes available- maybe 2 years? There is nowhere to cook or do laundry.
The father is in jail and has been for three years without bail or a trial.
Just another day at work.
What is [South Sudanese Enrichment for Families]’s response?
We are writing letters to the fathers’ public defender to try to get him a trial and bail in March. We have facilitated the father instead of the Nashua Street Jail to be at the Recovery Center in Worcester. He gets therapy and tutoring.
A volunteer is working with the mother to try to have some stability in their life. Many Sudanese are helping getting the kids to school etc.
We have another woman with two kids going into a shelter in March and we have one child taken away from her mother. Very very sad. Two Sudanese families are going to take the child in.
….
We have 8 families that are in our Financial Fitness Program where we assess where they are financially and what they need to do to meet their financial goals. There is a waiting list.
We are getting there ……all with your help. Thank you…the need is huge.

(Although my heart is warmed by the above, I’m confused by the story. The mom of 4 had a boyfriend (perfect adaption of a migrant to the American lifestyle, despite having only a 2nd grade education!) and the father went to jail. But also the story implies that the father was at home during the coronapanic lockdowns in Maskachusetts. Yet he has been “in jail” for three years and the lockdown began three years ago. Maybe the boyfriend is the new “father” who has the Bed Bath & Beyond job and was at home during the lockdowns and pretend-learn-from-home-scheme? Also, why do the nonprofit say-gooders (maybe even do-gooders?) want to get the hammer-wielding father out of jail? So that he can attack the mom with a hammer again? So that he can copy the undocumented immigrant David DePape and attack Paul Pelosi? Isn’t jail the safest place for anyone who cannot be trusted with a hammer?)

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