7 Quick Takes (6/29/12)

— 1 —

Yesterday, the big controversy on the blog was Tau Day, not the Supreme Court ruling. But I’d be lying if I didn’t admit I spent the day glued to SCOTUSblog, and, when I got home, I had to celebrate. So I made broccoli parmesan fritters, using the recipe from Smitten Kitchen. Fellow Patheos blogger Eve recently posted her own variation on this recipe, but I kept it simple (except for doubling the garlic).

I heart health care

This was my second cooking project for the week, as I had my first Spawn of Sourdough Starter in the form of small sourdough pretzels.

— 2 —

But that wasn’t the only fun legal story this week!  Law and the Multiverse (a blog that analyzes law through the lens of comic books and superhero movies) got military lawyers to weigh in on whether a certain plot development near the end of Avengers is a war crime, and how much license a soldier has to follow her conscience and shoot down a fellow soldier engaged in an ambiguously illegal act.

— 3 —

It’s practically a crime that The New Yorkers article on the University of Chicago Scavenger Hunt is restricted to subscribers.  But I guess it’s kind of appropriate that after you read this excerpt, you’ll be compelled to quest for a copy online?

Christopher Straus, University of Chicago class of ’88, created the school’s first scavenger hunt, in 1987, envisioning a modest diversion, limited to his dorm, whose purpose was to instill a sense of camaraderie. These days, many of the items on that first list seem like easy pickings—a hula hoop (10 points), a training bra (25 points), a painting on velvet (20 points). Each year, the Hunt begins long before its official start date. “One kid on our team has been growing his beard for weeks in case there was a beard-related item,” said Erin Simpson, a member of the MacPierce team—two dorms playing together. This year’s list, the longest in the twenty-six-year history of the Hunt, consisted of three hundred and fifty-one items. It filled nineteen pages and contained such challenges as: Build a ten-foot bridge across Botany Pond using nothing but balsa wood and glue (60 points). Revamp a Xerox machine for office warfare (12 points). Secure a meeting with the mayor of Chicago (25 points). Produce a scale model of the Great Lakes out of fire (15 points).

— 4 —

This week I got CPR certified (the heel of my hand is still sore from practice!), and that all the excuse I need to repose this hilarious British primer on the technique.

— 5 —

Now I know how to deal with heart attacks, but I am no match for the spectre of Death in his more dapper guises, as in these anti-tippling PSAs from the early 1900s (via io9).

— 6 —

Turns out there were more interesting Turing posts than I linked on his birthday:

11Gizmodo has a first person account of judging a conventional Turing Test

“What are your favourite Sci Fi movies?” “I like Star Wars and The Matrix,” comes the typed reply.

“Can we agree that the prequels sucked?” I continue. “Absolutely! Lucas should be shot!”

That settled it – only a flesh-and-blood movie buff could be so enraged by The Phantom Menace.

10Bruce Sterling gave a speech on Turing (Wired has the transcript)

In the original Turing imitation game, you’ve got three entities: a judge, a woman, and a machine pretending to be a woman. Alan Turing says he can’t answer the question “can machines think” because he doesn’t want to waste time with the popular definitions of “machinery” and “thinking.” He wants a simpler, more rigorous test that’s more objective and reliable. So what he actually comes up with is a test for a machine with a woman’s sensibility…

I really wish this aspect of Turing’s puzzle had been relentlessly played up from the very beginning. It’s just like Turing says: it’s useless to ask the indefinite question “can a machine think.” Why not ask the specific and weird question, “can a computational system be a woman?”

01Charles Q Choi on modern day implementations of the Turing Test (we got a shout-out)


— 7 —

Finally: omg revolving crossbow!!!

My birthday’s in less than a month, btw.

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  • SO cool that you made sourdough pretzels! How did they turn out? Also, what wheat did you use? I have tried sourdough making but wasn’t too successful. I can’t wait to try again!

    • leahlibresco

      I just used my all purpose flour. I thought they turned out well. They seemed much harder coming out of the oven than they were when I ate them. The surface was more bready or biscuity than pretzely, so on the next go round, I’ll try boiling them before I bake.

      • Charles

        You need to quickly blanch them in boiling water that has a strong base added. I use food grade LYE, but common household baking soda produces similar, if not totally authentic results as well. Without this step I am sorryto say you made bread shaped like pretzels, NOT pretzels.

        • Charles
        • Charles, you are my hero! No one knows how to make real pretzels in the US. Also, let me add that it’s not necessary to have the lye-water boiling when you dunk your pretzels in it. But either way, I imagine Leah will find the science-y rubber cloves and safety goggles element exciting. Nothing beats real pretzels.

  • Hey Leah: Talking about celebrating the SCOTUS ruling on Obamacare, can you share your thoughts on the coercive funding of abortion in this bill that’s just been ruled constitutional? I know this aspect of the law has not received much attention, but the Catholic Bishops have had a lot to say about it:
    best, John

    • leahlibresco

      Not an expert on health care law, but this seems to be the result of the gov’t trying not to do too much in the health care market. You get your subsidy and then you can use that money to buy the health care plan of your choice. Just like a school voucher program gives you a subsidy to take to the school of your choice, regardless of its pedagogical approach.

      • math_geek

        From what I understand (and in this case, I should), it’s even less than that. Insurance companies can’t bundle abortion coverage with the rest of their insurance plans to qualify for the subsidy. They have to make it a separate add-on.

        In any case, it’s unlikely too many insurance companies will want to add any kind of coverage that will attract women. Women cost significantly more to insure than men do (I’d guess around 30% more). Here’s an older study that says 40%, but these numbers are often overstated because women live longer, and are therefore older on average.
        PPACA forbids gender-rating (charging different rates based on gender), meaning that men will be far more attractive customers than women to every insurance company. As such, insurance companies won’t offer any benefit to women that they don’t have to. Health insurance “tailored” to women will simply be much pricier.

        The only reason this might not happen is that the law also sets a minimum loss ratio of 85%. This means that the company has to find some way to guarantee that 85% of their premiums go towards benefits. I expect insurance companies to cheat this rule heavily using reinsurance, but maybe they come up with something else. If that’s the case, then women are better to insure because they can make more money per woman.

        • deiseach

          So why on earth did the HHS not use this argument to defend their requirement that all organisations provide coverage for women, instead of saying “the amendment is about women’s access to contraception and sterilisation and we get to define what is and is not a religious organisation”?

          The ‘war on women’ rhetoric made me roll my eyes (particularly Nancy Pelosi’s fraught and overwrought “women will be left dying on hospital floors!” line), but if the government had made their case that women’s access to healthcare in general, not strictly to contraception, was limited by insurance companies’ unwillingness to insure them, then things would have panned out differently, I imagine.

          Or is it the case that the government did not want to challenge health insurance companies? I know over here, when our government of the time in 2007 tried to require new companies in the private health insurance market to make risk-equalisation payments to the VHI (up to then, the only private health insurance company in the state) to compensate it for its older and less profitable customer base (because the new companies coming into the Irish market were cherry-picking young people and families), one of them – BUPA, the large English insurance company – just pulled out of the market altogether and sold off its Irish operation. So I imagine no American government wants to take on large, powerful vested interests like that.

          • math_geek

            I wouldn’t like to try to ascribe motives to the HHS Mandate. The whole thing seems particularly senseless for a lot of reasons. And I am saying that as a liberal Catholic with some serious reservations about Church teaching on contraception.

            However, I am pretty sure that the government wants to avoid the topic of insurance company profit maximizing and how that relates to gender discrimination entirely. It’s a messy messy topic. I think there is some reluctance to take on the insurance companies, but really I think that’s barking up the wrong tree. If you want to have privately run health care (and there are a lot of reasons to want this), then you have to accept that it’s going to be run by people whose main motivation is to make money. Insurance companies are going to act in whatever way makes them the most money by definition.

            I think that in America there is this basic idea that discrimination on the basis of gender (or at least in a way that adversely affects women) is a moral wrong, and this extends to health insurance despite the fact that health is one of the few areas where gender plays a significant independent role. So outlawing gender discrimination and trying to fix it through law has a lot of support, but the moral outrage stops us from asking the question of why companies would discriminate in the first place. It doesn’t help that sexism was and is a major aspect of our culture, and it is therefore easy to ascribe these actions to sexism.

          • deiseach

            Speaking as someone living in a country with a national health system, I never could see why America didn’t have the likes of it. I’m not sure ‘Obamacare’ is that system, though. From the little sense I can make of it, the necessary reforms got bogged down in a morass of everyone deciding to stick their special interest cases in, so that it got bloated beyond belief and nobody is really sure what it means or how it will work out, plus – as you say – the costs built into the private insurance health schemes were not tackled in a meaningful way. And then the whole economic downturn hit, which didn’t help any.

            There can be – heck, there will be inefficiency and huge cost in a national insurance scheme. It happens in England, it happens here in Ireland – costs and spending go up and there are constant budget shortfalls. Then successive governments fiddle around with the system, trying to reduce the cost on the national budget while not losing votes by closing down people’s local hospital, and it never ends well. You end up with extra layers of management while they lay off nurses and close wards. I don’t think anyone has devised a perfect system.

            And besides the cost, there are waiting lists. It’s not uncommon to have waiting lists of three years for people to be seen for a procedure in an outpatient clinic, whereas private health insurance would get them seen immediately or within weeks. This is why governments are trying to persuade those who possibly can pay for it to take out private insurance, but the whole social care aspect means that things like “risk equalisation” (that is, insurance companies only taking the young and healthy while leaving the sick and old to public health or to former semi-state bodies) are written in, which means that the insurance companies in turn crank up the premiums (they have been raising them each year for the last four years, due mainly to the economic downturn, which means people can’t afford private policies so they let them lapse, which means the companies have fewer customers to spread the costs over, so they raise the premiums – in a vicious circle).

            So if America does get a national health system, it is going to cost. There is no way around it. And there will be the worries about a ‘two-tier’ system, with better and faster care available to those who can pay for it. But the system you have at present seems to be the worst of both worlds.

          • The ‘war on women’ rhetoric made me roll my eyes (particularly Nancy Pelosi’s fraught and overwrought “women will be left dying on hospital floors!” line)…

            I don’t know why you think that line is “overwrought”, deiseach, since that actually happens. There have been many cases of women coming into Catholic hospitals suffering life-threatening pregnancy complications – ectopic pregnancy, placental abruption, preeclampsia, hemorrhage, sepsis – where the only appropriate intervention is induced abortion (which will kill the fetus, as opposed to doing nothing, which will kill both the fetus and the woman), but the hospital ethics committees refuse to give the doctors permission to act.

            As I wrote in a previous post, quoting accounts from doctors who found themselves in that situation: “In another case where a woman was septic and hemorrhaging, the doctor was told by a colleague to put her in a bed and try to keep her alive with blood transfusions until the fetus died. Another doctor sent her critically ill patient to the nearest secular hospital, a 90-mile ambulance ride, because she judged that this long and hazardous journey would result in her getting a needed abortion more quickly than waiting for the ethics committee at her own hospital to give permission.”

        • Ted Seeber

          “Insurance companies can’t bundle abortion coverage with the rest of their insurance plans to qualify for the subsidy. They have to make it a separate add-on.”

          That was the Stupak Amendment. It was abandoned in a deal with Obama to enact this by Executive Order. The Executive Order turned out to do the opposite.

    • Ted Seeber

      I have been following the case closely- and you need to know that Obamacare faces more than one challenge. THIS one dealt ONLY with the requirement to purchase health insurance, which in a bit of a comic twist, Obama won the battle but lost the war: He tried to claim it wasn’t a tax when it was, and the federal government has now LOST all ability to EVER force you to buy anything under the name of interstate commerce.

      The issue you are approaching- the lie Obama told to Burt Stupak to get his votes and then reversed entirely on an HHS enforcement plan requiring employers to pay for contraception and abortion and violate the religious liberty of Catholics- is still winding it’s way through the lower courts, and will not likely reach SCOTUS before the election. 47 Catholic organizations that serve the public and/or hire non-Catholics have filed lawsuits, oddly enough not about funding abortion per se, but about the new definition of a religious organization being ONLY one that serves people of the same religion (no feeding the hungry, no caring for the sick, no housing the homeless, unless they’re already a member of your church) and who only hire people of the same religion (that atheist down the street trying to feed his family needs a job, any job? Can’t even hire him to be the janitor because doing so means your church will be subject to the HHS mandate).

      • Ted Seeber

        Crossposted from Mark Shea’s blog (for parts 1-3, you need to go there, they’re irrelevant here):
        4. The real problem with the HHS Mandate has nothing to do with the ACA- and everything to do with the definition of what a Church is allowed to do in our society and still be a church. If the HHS Mandate stands, then every soup kitchen, hospital, food bank, and clothes closet will have to be restricted to the membership of that particular parish, both in terms of donations and who can be served. In addition to that, if the atheist down the street needs a job, you won’t be able to hire him to be the janitor without endangering your status under the HHS Mandate.

        THAT is the real issue- that the HHS Mandate includes a definition of Church that violates the Free Exercise Clause of the 1st Amendment. Has nothing at all to do with the commerce clause, abortion, or taxes, and everything to do with how the Catholic Church can interact with it’s immediate neighbors.

      • ratnerstar

        “…Obama won the battle but lost the war: He tried to claim it wasn’t a tax when it was, and the federal government has now LOST all ability to EVER force you to buy anything under the name of interstate commerce.”

        He lost the war because … the Obama administration had ambitious plans to require people to purchase all sorts of stuff? I think you may have been taking the “broccoli argument” a bit too literally.

        • Ted Seeber

          Not specifically, but he did try to expand the power of the federal government a little too far. I could easily see Romney getting elected and using the same argument to privatize Social Security and require all of us to gamble in the Stock Market instead of FICA taxes. Under the Roberts Decision, that is no longer possible- the IRS still has to be involved, and it still has to be a tax, it can’t magically turn into everybody being required to buy IRAs.

      • deiseach

        I didn’t understand the whole “forcing people to buy” aspect; there are such people as the working poor, who would fall between two stools – not badly enough off to qualify for government schemes but paying for private insurance would take a huge chunk out of their income, so they would have to choose between paying rent, buying food, or paying for the insurance they were legally required to have.

        How on earth does that make any sense?

        • Ted Seeber

          Exactly the reason why this was a lawsuit that went all the way to SCOTUS. Turns out now you have to choose health insurance *first* over food, clothing, and shelter.

          • ratnerstar

            “Turns out now you have to choose health insurance *first* over food, clothing, and shelter.”

            It does not “turn out” that way at all. Please stop saying blatantly untrue things.

        • ratnerstar

          The answer to your question, in one word: subsidies. Under the ACA, the government will kick in money to cover some or most of the costs of health care up to an income of $88,000 for a family of four ($44,000 for a single individual). The poorest of the poor (up to 133% of the poverty level) will have health care provided free of charge by expanded Medicare. After that, the government sets a percentage target for how much of a person’s income should go towards health care: 3-5% for folks barely above the poverty line up to 10% for those near the 88 thousand dollar level.

          Is this a kludge? Absolutely. A far more elegant way to do this would be single payer, like we see in Canada. Similarly, a private helicopter flown by a gang of supermodels would be a more much elegant way for me to commute to work. Neither is going to happen. Besides, single payer would require higher taxes, which would also squeeze the working poor, in pretty much exactly the same way.

          • deiseach

            ratnerstar, having a small bit of experience in working in a local government capacity regarding education, and therefore dealing with the bureaucracy of who is eligible for what grant, this sounds to me like an absolute recipe for disaster.

            People will be able to game the system (there are always people who get more than they deserve because they can play the rules like a fiddle) while others will be stuck – “Sorry, you make ten dollars more than the limit allows, so you can’t claim”. Or hooky employers who are paying cash-under-the-table will not provide payslips so that the claimant can prove their earnings, leaving someone to choose between losing the black economy job they need or go without health care.

            Also, it sounds like a whole new mess of regulations will be crowbarred into the existing system and that will require layers of middle management to implement (they never hire on more staff on the coalface dealing with the public, because that’s way too easy for the opposition to score political points about taking more from the taxpayer to increase the bloated civil service, but there is always room for a new Deputy Assistant Junior Principal Officer in charge of new policy implementation).

            At the very least, doing something to cut back on the amounts charged for private medical treatment might help – but it sounds instead like hospitals will have to work out new codes for claimants under this while the insurance companies increase the amount the user has to pay themselves and reduce what can be claimed back as reimbursement.

          • ratnerstar

            Deiseach, the issues you bring up are indeed concerns, but they are not unsolvable problems nor was the bill designed without awareness of them. These are the same problems that go into any large program, the same problems faced by the US tax code, the social security system, and many others. There are methods of mitigating the risks, although, of course, the fraud will always be with us.

            People will be able to game the system – Yes, just like people are able to game the tax system. This has not lead to a “recipe for disaster.” Subsidies go directly to the insurance companies, so there is much less incentive to work the system.

            others will be stuck – “Sorry, you make ten dollars more than the limit allows, so you can’t claim” – This is the easiest problem to solve, and you do it by phasing out benefits gradually. If you make $79,990 a year, you get a $10 subsidy. If you make $88,000, that subsidy disappears. (These numbers are for example purposes.)

            Or hooky employers who are paying cash-under-the-table will not provide payslips so that the claimant can prove their earnings, leaving someone to choose between losing the black economy job they need or go without health care. – You have this backwards. If your employer pays cash under the table, then the government thinks you are unemployed, and you get subsidies you don’t deserve, you don’t lose your health care benefits. And what you’re missing here is that THOSE PEOPLE DON’T HAVE HEALTH CARE NOW. This seems to be the essential issue that many people here are missing. Millions of Americans, RIGHT NOW, do not have access to basic medical care. Anyone working unofficially is certainly in that category.

            Is there a potential for a new bureaucracy? Sure, perhaps. Frankly, that’s something I’m willing to trade for near universal health care coverage.

            At the very least, doing something to cut back on the amounts charged for private medical treatment might help – This is precisely what the bill aims to do. It’s too complex to summarize here, but there is plenty of information available, as they say, on the Internet.

            but it sounds instead like hospitals will have to work out new codes for claimants under this while the insurance companies increase the amount the user has to pay themselves and reduce what can be claimed back as reimbursement. – No, that will be illegal under the law.

          • ratnerstar

            Also, I should point out that we aren’t flying into this blind. We have a good example of how this works, somewhat ironically thanks to Mitt Romney. The MA program has not been an unqualified success, but it has been a vast improvement over the status quo ante.

    • ThomasW

      While I haven’t read the full decision, I don’t think the court considered abortion funding. The court ruling is was only on two aspects of the law — the individual mandate and Medicaid expansion. The rest of the bill is still open to court challenge.

  • Ted Seeber

    One of the sins I struggle with is anger- sometimes bordering on the homicidal. I *really* want a revolving crossbow, but I’m pretty sure I can’t be trusted with one.

  • Liam

    The darker firemen among us use “Another One Bites the Dust” instead of “Staying Alive” to time our compressions. Thanks for getting the hands-only message out there. A couple weeks ago I showed up to a homeless guy who OD’d on heroin getting rescue breaths by a bystander. We revived him and found out he had Hep. B.

    • Oregon Catholic

      As an RN with almost 40 years experience of taking of CPR classes I can tell you that the Red Cross changes it’s recommendations pretty consistently every 2 years – not coincidentally imho to justify the 2 year certification renewal requirement and fee of course. The new chest compression-only CPR will go by the wayside soon. It contradicts basic cardiopulmonary physiology and I predict we will see an increase in deaths. I have in my car at all times a disposable plastic barrier for giving mouth to mouth safely along with gloves and several clean disposable diapers to use to control bleeding in case I come upon an accident. It’s a simple kit anyone can carry that could save a life.

      • Liam

        King County Medic One leads the nation in saves. We have a 49% save rate. Most places hover around 10%. Our save rate has increased since we focused on minimizing the intervals between compressions. When you pause to give breaths, the pump drains and it takes as many as 30 compressions to get back to good cpr. Last year we even began administering 30 compressions while the AED is spooling up for a shock. We are in trouble with medical control if we aren’t compressing at least 90% of the time. What basic physiology concerns you?

        • Oregon Catholic

          Lack of oxygen. What good does it do to circulate unoxygenated blood for more than just the first few minutes? After that it’s depleted and acidosis keeps increasing without any Co2 exchange. Without seeing your data I couldn’t speculate on your save rate.
          If people are refusing to do mouth-to-mouth out of fear of disease, then compressions are better than nothing.

          • Liam

            Pausing compressions to administer breaths dramatically reduce blood flow and perfusion. There’s a bit of O2 exchange from compressions, and blood has a fair amount to begin with. The best thing to do is keep pumping until a crew with a BVM shows up that can dedicate a member to ventilation. The save rate is from our 2011 annual report. You can download the pdf at:

  • jenesaispas

    It’s a shame they don’t show that advert more often 🙂

  • calahalexander

    I love io9. I have to set the timer when I pull it up because otherwise I would seriously spend all day reading it. It’s probably my favorite site on the internet. And I cannot WAIT to see Looper. (Please tell me you think that looks amazing too.)

  • Hermann

    Not joining the HHS debate – II´m a German

    BUT the slingshot channel is just AWESOME!!!