Old Folks At Home . . . And Abroad

November 22, 2014
Posted by Jay Livingston

“We need to get rid of Obamacare,” says Ed Gillispie in a NYT op-ed yesterday (here). The reason: Obamacare’s “gravitational pull toward a single-payer system that would essentially supplant private insurance with a government program.”

Gillespie, who lays out his credentials at the start of the article – he ran for Senate in Virginia and lost – notes that Obamacare is unpopular. But he omits all mention of a government-run single-payer system that happens to be very popular – Medicare. No Republican dare run on a platform of doing away with it. Gillespie himself accused Obamacare of cutting Medicare, a statement that Politifact found “Mostly False.”

So how are seniors doing? Compared to their pre-Medicare counterparts, they are  probably healthier, and they’re probably shelling out less for health care. But compared to seniors in other countries, not so well. A Commonwealth Fund survey in eleven countries finds that seniors (age 65 and older) in the US are the least healthy – the most likely to suffer from chronic illnesses.*

Over half the the US seniors say that they are taking four or more prescription drugs. (All the other countries were below 50%.)

And despite Medicare, money was a problem. Nearly one in five said that in the past year they “did not visit a doctor, skipped a medical test or treatment that a doctor recommended, or did not fill a prescription or skipped doses because of cost.” A slightly higher percent had been hit with $2000 or more in out-of-pocket expenses.

In those other countries, with their more socialistic health care systems, seniors seem to be doing better, physically and financially.  One reason that American seniors are less healthy is that our universal, socialized medical care doesn’t kick in until age 65. Americans’ health problems may have started long before that. People in those other countries have affordable health care starting in the womb.

Critics of more socialized systems claim that patients must wait longer to see a doctor. The survey found some support for that. Does it take more than four weeks to get to see a specialist? US seniors had the highest percentage of those who waited less than that. But when it came to getting an ordinary doctor’s appointment, the US lagged behind seven of the other ten countries.

There was one bright spot for US seniors. They were the most likely to have developed a treatment plan that they could carry out in daily life. And their doctors  “discussed their main goals and gave instructions on symptoms to watch for” and talked with them about diet and exercise.

Gillespie and many other Republicans want to scrap Obamacare and substitute something else. That’s progress I suppose. Not too long ago, they were quite happy with the pre-Obamacare status quo, even though the US healthcare spending was double that of other countries with little difference in health outcomes.  That didn’t stop George Bush from insisting throughout his years in the White House that “America has the best health care system in the world.”  But at least now, the Republicans want to do something different.  Unfortunately, their Republican ideology precludes them from learning from other countries. As Marco Rubio put it, we must avoid “ideas that threaten to make America more like the rest of the world, instead of helping the world become more like America.”

But maybe Republicans might learn from their own country by taking a second look at Medicare, a program many of them publicly support. They’ll just have to avoid letting anyone know that for nearly a half-century it has done what Gillespie says should not be done: “supplant private insurance with a government program.”

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* Includes hypertension or high blood pressure, heart disease, diabetes, lung problems, mental health problems, cancer, and joint pain/arthritis.

Sexting and Gender

November 18, 2014.
Posted by Jay Livingston

I.

Much of Hanna Rosin’s recent Atlantic article “Why Kids Sext” plays on the generational divide. Parents get understandably upset about something that kids see as just another part of social life. Cops and prosecutors have an even more difficult time since a high schooler’s sexy cellphone selfie is a felony in most states.

The media too aren’t sure how to play it. “Massive teen sexting ring,” gasped the headline in a local paper  in Louisa County, Virginia. A couple of high school kids had created an Instagram page with about 100 photos of girls from the local high school and middle school. They hadn’t taken the pictures; they had merely consolidated the photos that were already circulating on kids’ phones. When Rosin asked kids in the local high school how many people they knew who had sexted, the “ring” turned out to be “everyone.”  (The kids overestimated. I think that surveys find that about a third of kids have sexted.)

Rosin’s article reveals differences not just of age but of gender, for despite the newest iPhone and Instagram technology, the ideas and attitudes, especially those of the boys, seem like something out of the 1950s.  The “maddening, ancient, crude double standard” is, unfortunately, alive and well. So is the idea of sex as conquest. Boys describe how they would sweetly cajole girls to sext. When the photo arrived, the boys felt a kind of egotistical pride (“I’m the man”) –  not much different from high school boys of sixty or seventy years ago bragging about “getting to second base” or farther.  (I guess a sext is somewhere between second and third – a sort of .jpeg shortstop.)  On college campuses, as Lisa Wade has said,  the order of the bases has changed. Maybe that’s true in high school too, but the game mentality – with all its attendant attitudes and assumptions – remains the same.

If a girl refused, the boys dismissed her as “stuck up” or a “prude.” And if she did send the photo . . .

How do you feel about the girl after she sends it?, I asked.     “Super thots.” [THOT - “that ho over there”]     “You can't love those thots!”     “That's right, you can't love those hos.”

Whichever the girl does – sext or refuse – the boys find a reason to be contemptuous.

For the boys, the  pictures were not about sex or stimulation; they were purely for narcissistic satisfaction and social status.

They gloat inwardly or brag to friends; they store them in special apps or count them. . . . “Guys would pile them up,” one girl who had graduated a year earlier told me, referring to sexts they’d gotten. “It was more of a baseball-card, showing-off kind of thing.” Olivia described it as “like when they were little boys, playing with Pokémon cards.”

The boys saw the sexts as a universalistic and utilitarian currency – something they could trade and use for other goals. That’s why the boys’ promises not to show the picture to anyone else can evaporate so quickly.  The picture has use value only if others see it.  It has meaning as an object; that meaning is not connected with the particular person in the picture.  She could just as easily be Charmander or Snorlax.

The girls, by contrast, were more particularistic. A picture was important for what it said about the relationship between her and a particular boy.  Girls have the relationship in mind also in those rarer instances when they ask a boy for a picture

It is kind of a marker that you have reached a certain point in a relationship or you are about to reach a certain point in a relationship. So it can be foreplay. It can be a kind of intimacy.[Rosin in a Fresh Air interview here.]

That “marker” comment suggests that the girls too had a “base” system in mind, but if so, the bases were the stages in the relationship, the level of intimacy with another person. They did not share the boys’ view of the sext as a bit of capital added to their individual holdings and separate from the person in the photo.

II.

Sex – universal commodity or special relationship?  Many years ago, long before cell phones and sexts, I thought I might demonstrate this difference by asking students to imagine a dream date. I was a genii, I said, and I will grant your wish. You can have a date with any person you choose. You can spend an evening doing whatever you want, and if you like, the evening can extend till morning.
But you must choose one of two conditions.
    A.  You actually have the date, but nobody will ever know about.
    B.  You don’t have the date, but everybody thinks you did.

I had them mark their ballots anonymously but asked them to indicate their gender. Then, as an afterthought – mostly because I wanted to keep up with popular culture – I also asked them to write down who they were thinking of.

I thought that more boys would choose B – the date as utilitarian currency.  I was wrong. Everybody wanted the actual date. But gender did make a difference on the second question. Most of the boys chose women from the media (as I recall, Heather Locklear got several votes – I told you this was a long time ago).  The girls’ choices were more along the lines of “this guy I knew in high school” or “this guy I went out with last year but we broke up.”

The boys did not want the date as a tradeable commodity. Instead it was an abstracted ideal, a fantasy. They had no idea what it would actually be like to spend a few hours with Heather Locklear the real person.  What the girls wanted was a real relationship with a real person.

Hope and Bugs, Of Course

November 15, 2014
Posted by Jay Livingston

Ever since I read Andrew Gelman’s list of words to avoid, I’ve been more conscious of the simple “of course.”  I still use it, but more sparingly and cautiously.  (Gelman’s list, here, includes obviously, clearly, interestingly, note that, and their variants like “it is interesting to note that.”)

But then there’s the ironic “of course,” the one that points to some gem that is far from obvious. Done correctly, the casually tossed in “of course” makes us admire the author for spotting this sparkling insight. Maybe it makes us feel a bit inadequate for not seeing it ourselves, especially since the author is saying, “Aw shucks, anybody would have seen that.”

Adam Gopnik’s essay on Bob Hope in a recent New Yorker  shows you how it’s done:

The real parallel to Hope—the great American comedian whose career most closely resembles his—is, of course, Bugs Bunny.

Of course. 

Even if you’re old enough to remember the “Road” movies with Bing Crosby and the Oscars, the USO tours and  the decades of TV appearances, you would not have come up with the Bugs-Bob parallel. Gopnik goes on to explain.

Like Hope, he arrived in Hollywood in the late thirties and became a huge star with the war. Like Hope, he was usually paired with a more inward character who loves to sing (Daffy Duck is Bugs’s Bing [Crosby], though blustery rather than cool), and, like Hope, his appeal rises entirely from the limitless brashness and self-confidence with which he approaches even the most threatening circumstances. Together, they are the highest expression of the smart-aleck sensibility in American laughter. Their fame in wartime may have something to do with the way that, as A. J. Liebling documents, the American Army itself was essentially an urban creature dispatched to deserts and jungles: Bugs, with his Bronx-Brooklyn accent, has somehow been sent out there in the countryside, among the hunters, as Hope ends up in the sands of Morocco with no weapon but street-corner sass.

Once Gopnik clears away the rough, we see the previously unnoticed diamond. Hope, Bugs – of course. 

But I wanna tell ya’, the entire essay is worth reading, both for Gopnik’s aperçus and Hope’s funnier lines.

Peter Freund

November 11, 2014
Posted by Jay Livingston

Last weekend we honored our colleague Peter Freund, who died in June. Peter and George Martin were the co-founders, in the 1970s, of our New York Walk – an unofficial, informal, and very loosely planned event for faculty, students, friends, anyone who wanted to join us.  It started as a one-off in the 1970s but became a semi-annual event. Our route usually took us to places like Grand Central Station (Peter loved showing students the whispering gallery there) and downtown sites (Lower East Side, Chinatown). But for Saturday’s reunion, we walked the High Line.  George Martin and Laura Kramer, both retired, were there.

Faye Allard, our colleague till last year, came in from Philadelphia. Here she is with Sangeeta Parashar.

On Sunday, there was a memorial service.  More former Montclair colleagues came – Gil Klajman, Barbara Chasin – and spoke. 

Anecdotes, admiration, and appreciation were offered also by Peter’s wife Miriam, his sisters and nephews, and several friends and colleagues who collaborated with him on his research and activism, all with the goal of reducing the dominance of automobiles, especially in our cities.  (Peter was a founding member of Auto-Free New York, and he never learned to drive a car – a decision that was both ideological and prudent.)

Food and beer, travel and cities, generosity and humor – these were the recurrent themes in people’s reminiscences. That plus a deliberate unconventionality, often as a gambit to get others to question their usually unquestioned assumptions. Like tearing up a dollar bill or two on the first day of class, and when students got upset, asking them why. Peter had a wonderful golden retriever. He had named her Igor. He said it was in tribute to Dr. Frankenstein’s assistant, but I think it was also so he could delight in the reactions of those who insisted that this male name was just wrong for a female pup or, better yet, that the dog would wind up with a confused gender-identity.  In a way I cannot quite articulate, this fits with something else Peter loved – British entertainments like The Goon Show, Monty Python, and Gilbert and Sullivan.  A female dog named Igor – Peter’s own Python sketch.

Peter Freund
November 14, 1940 - June 12, 2014

The ASA Footnotes obituary for Peter is here.