Democratizing the workplace

I came across this article from the BBC the other day and it absolutely fascinated me. The article focuses on a Swedish software firm , Crisp, and their rather innovative approach to how their business is structured.

Crisp doesn’t have a CEO.

Yassal Sundman, a developer at the firm, explains: “We said, ‘what if we had nobody as our next CEO – what would that look like?’ And then we went through an exercise and listed down the things that the CEO does.” The staff decided that many of the chief executive’s responsibilities overlapped with those of the board, while other roles could be shared among other employees. “When we looked at it we had nothing left in the CEO column, and we said, ‘all right, why don’t we try it out?'” says Ms Sundman.

This is something that I have long suspected about the business world–that in many cases, the boss is completely superfluous. More on that in a bit. So what does a workplace without a designated leader look like?

Crisp holds four-day meetings for all staff two to three times a year. They are used to making decisions on issues that affect everyone, such as an office move, but workers are encouraged to make decisions themselves at other times. It also still has a board – a legal requirement – and this can be used as a last resort to resolve issues if something is not working.

Imagine that, the people who are actually doing the work are making the decisions! Together!

Henrik Kniberg, an organisational coach at the firm, argues that not having to ask a boss for decisions on projects or budgets means the firm can respond faster. “If you want to get something done, you stand up and start driving that,” he says. Yet Mr Kniberg stresses that not having to ask permission does not remove the need for staff to discuss issues or bounce ideas off each other. Because they are all in charge, workers are more motivated, he argues. Crisp regularly measures staff satisfaction, and the average is about 4.1 out of five.

Who would have guessed that giving the worker bees more freedom and self-determination would lead to a happier and more agile workforce? Truly shocking.

What I like about this article is that, for me at least, it dispels some long held myths that people have about business that they apply to their politics. There’s this idea that business is always better at everything than government. I’ve said for years that this patently false for a variety of reasons, but I think this article really drive home on central point:

Businesses can be just as bloated, top-heavy, and overly-administrative as the worst government you can think of. The equivalent of bureaucracy is alive and well in the private sector, and it’s just as detrimental.

I’m not sure how many presidents, vice presidents, junior vice presidents, CFOs and CEOs a company needs, but I’m willing to bet that, as this article from the BBC suggests, the answer is probably “None of them.”

The average CEO in 2014 made $22.6 million dollars per year. That’s a pretty tidy sum for a position, that, if Crisp’s example is any indication of, is essentially worthless. What’s more, that year CEO salaries increased almost 9%–way ahead of the 2.4% that the rest of the economy grew. And a 2000 study found that performance is a weak indicator of CEO compensation. The best predictor of CEO salary was the size of the company–no matter how terrible of a job they did. I’m sure everyone remembers all of those Wall St. folks that gave themselves huge bonuses after they collapsed the economy? The numbers are all here for you to take a look at.

And then there’s the lovely ‘golden parachute’ that we all hear about so much, which sounds like something Donald Trump would pay Russian hookers for, but is really just a giant check they give the top brass upon retirement. Here’s a list of the top 20 golden parachutes according to Bloomberg. I’ll recreate the top five for you here:

  1. Steve Wynn (Wynn Resorts): $358,134,747
  2. David Simon (Simon Property Group): $302,425,834
  3. John Hammergren (McKesson): $198,150,788
  4. David Zaslav (Discovery Communications): $161,119,864
  5. Brent Saunders (Allergan): $140,672,343

Man, what a great deal: getting paid tens of millions of dollars a year no matter how poorly you perform…and then they give you HUNDREDS OF MILLIONS when you retire!

What a fucking joke.

How many billions of dollars are wasted every year on executives that don’t do shit? Billions that could be reinvested in the company or the employees. While everyone else’s hours and benefits are slashed because of taxes or Obamacare or whatever bullshit line they throw out, the CEO gets to retire with hundreds of millions of dollars in his pocket. Notice how it’s never the top earners that are asked to tighten their belts during the lean times?

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But why is it this bad? How do these salaries get set? Well, in many companies, executive compensation is set by the board of directors. And who’s on the board? You guessed it–all of the executives. Executive salaries are out of control and keep going up despite poor job performance because they’re the ones giving themselves the raises and the golden parachutes. Pretty convenient, huh? This article in Forbes covers some of the insane catch-22s that allow this kind of unfettered greed and inefficiency to continue.

And then people wonder why a candidate like Bernie Sanders is so popular with people. Because people are tired of being bullshitted by business leaders and conservative politicians about how dire everything is while they keep making more and more money. They tell us all that they’ll need to get rid of social security and medicare while lowering the tax rates on the guy who just made $358,134,747 simply for retiring.

Because for all the ways they paint the private sector as noble, something for government to aspire to, the same bullshit happens there, too. The same bloating, the same excess, the same waste, the same frivolity. The same lack of accountability for the people at the top. Human greed and ignorance permeates all aspects of society, something that is often lost on conservatives. 

But it doesn’t have to be that way. Companies like Crisp are showing that. They’re just starting to show that there’s a different way to do things. You can essentially democratize the workplace–give the employees the reigns. Give the employees more of a stake in things. Give the employees the freedom they don’t get with a top-down organizational structure.

Because the same is is true in the workplace as it is in politics: the people have the power. Unions used to be how workers flexed that muscle. And then the bullshit started. “Well, you know, those unions, they just ensure that bad workers can’t be fired.” You hear this bullshit all the time, like with teachers. The teachers union just protects bad teachers!

An argument that seems especially ironic given that of the top 25 paid CEOs in ANY GIVEN YEAR from 1993-2012, one quarter of them worked for firms that took federal bailout money. In other words, these incompetent assholes fucked up, then used your tax money to stay in business and continue to give themselves a massive raise and an even more massive golden parachute. But hey, it’s the unions that are greedy, right?

It’s all bullshit, folks. Did you know that there are countries that don’t have a minimum wage? Doesn’t the sounds like a conservative republican’s idea of paradise!? Well, not so fast. Places like Iceland and Sweden have no minimum wage because workers have the right to collectively bargain. A lot of those evil socialist countries follow that model.

Oh, I get it: when the CEO gets to determine their own outrageous salary, it’s capitalism and moxie, but when the workers try to have a say in how much they’re paid it’s evil socialism. Again, how convenient.

So the next time someone tries to tell you that the government is wasteful and stupid, count for them the many ways the the private sector is also full of corrupt hypocrites.

 

What happened to those bootstraps?

Does anyone else find it supremely ironic that republican and conservative voters elected Donald Trump on the promise that his government would bring jobs back? Because I certainly find this sentiment to be the epitome of hypocrisy.

For decades now, all we’ve heard from the GOP and other conservatives is that the government is horrible and meddlesome, and everything would be better if there was less government interference and everyone took more personal responsibility for their lives.

Conservatives 2008/2012: “The government just makes things worse. Get rid of the government and everything will be fine–it’s not the function of government to create jobs, you libtards.”

Conservatives 2016: “PLEASE BRING BACK MY JOB, GOVERNMENT!”

It’s galling to me that the party of moxie and rugged individualism is now the party that applauds a government that directly gets involved in business and trade negotiations–the very things conservatives were crying the government should stay out of for the past 30 years.

How many times have we seen conservative politicians and voters say the following about welfare or the minimum wage: “We don’t believe in handouts. If you want to make more money, improve your situation, work harder, etc. Pull yourself up by your bootstraps like a real American.”

Well apparently conservatives in 2016 have thrown out their old bootstraps.

This article on CNN interviews people in a Kentucky town, “the poorest city in America,” that overwhelmingly voted for Donald Trump. Here are some snippets:

Beattyville residents want jobs, especially ones that pay more than the minimum wage of $7.25 an hour. They think if anyone can bring jobs back, it’s Trump.

Yeah, of course. The guy whose Trump brand suits and ties are made in Chinese factories is going to bring your job back. The same guy who immediately nominated the CEO of a fast food company who hates the minimum wage, Andy Puzder, as labor secretary.

Here’s what one of the men Kentucky elected to the senate, Mitch McConnell, had to say about the minimum wage: He cited a Congressional Budget Office study that he claimed said raising the minimum wage to $10.10 an hour would “destroy half a million to 1 million jobs. […] That’s not the way to grow our economy,” he added.

And here’s what Kentucky’s other senator, Rand Paul, had to say about raising the minimum wage: ‘The minimum wage is a temporary’ thing, Paul said. ‘It’s a chance to get started. I see my son come home with his tips. And he’s got cash in his hand and he’s proud of himself. I don’t want him to stop there. But he’s working and he’s understanding the value of work. We shouldn’t disparage that.’”

Good luck getting jobs that pay beyond the minimum wage, Beattyville. You elected people who propose the very opposite of that, who think, in Paul’s case, that trying to raise a family on a minimum wage job is great because it’ll build your character and teach you the value of hard work!

“If you got a job here in Beattyville, you’re lucky,” says Amber Hayes, a bubbly 25-year-old mom of two, who also voted for Trump. She works at the county courthouse, but is paid by the Kentucky Transitional Assistance Program (K-TAP), a form of welfare.
The vast majority of Beattyville residents get some form of government aid — 57% of households receive food stamps and 58% get disability payments from Social Security.

But I thought that welfare was just for the takers? Isn’t that what all the conservative politicians campaign on? Haven’t we all heard some iteration of that from conservative friends and relatives? Isn’t that what Mitt Romney said just 4 years ago, that 47% of the country votes to just get free stuff?

Here’s what Kentucky’s own Mitch McConnell said about food stamps as recently as last September: Asked about the improving economy, McConnell scoffed: Business leaders tell him they have “a hard time finding people to do the work because they’re doing too good with food stamps, Social Security and all the rest.”

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Residents of Beatyville would apparently beg to differ with Mr. McConnell.

From the outside, it’s easy to wonder why people in Beattyville don’t just move somewhere else. But out of all the people CNNMoney met in Beattyville, only one wanted to leave. The rest are drawn to the beauty of the place and the friendly community. “I’m country to the core,” laughs Puckett. He husband of 39 years nods beside her. Judge executive Mays puts it this way: “We’re perceived as a hillbilly, backwoods, all this and that. But we’re a good people.”

Again, whatever happened to those bootstraps, hmm? That’s what Paul Ryan or Rand Paul would tell you to do–work to improve your own situation and don’t depend on the government to save you. If you lose your job, find another, even if it means moving. Retrain yourself. Oh, you can’t pay for that? Well, you just need more gumption and definitely less of that darned government in your life, always making things worse.

Look, I have lots of sympathy for the people of Beatyville. They’re certainly in a bad place. Yet at the same time, they and the rest of their state have repeatedly voted for people who have told them that the government will make their life worse. That getting rid of food stamps will create an incentive for people to get a real job. That social security and medicaid should be cut or outright privatized. That the problem with America in general is too much reliance on the government.

In the end, Beatyville and other red cities in red states that are suffering are the victims of their own voting. It’s particularly tragic that they now expect the same government that believes that the government shouldn’t be engaged in safety net programs or other forms of public assistance to save them. If the democrats were smart, they’d get out grassroots campaigns to go to towns like Beatyville and help explain this to residents.

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I guess we’ll see what happens in 2018.

In defense of socialized medicine

Socialized or government run healthcare is often derided by its capitalist critics here in America. But does it really deserve all of the hate and mistrust that it gets from us? So many times I’ve heard people claim that such systems are inefficient, even tyrannical because they limit choices. More recently, I’ve heard and read many people talking about how even people in the Scandinavian countries are turning their backs on socialist principles.

However, much of these claims remain to be proven. Strangely, nobody ever offers evidence that increased choice leads to better health outcomes. As for inefficiency, most people who demonize socialized medicine cry about increased wait times for procedures. And what about citizens themselves turning their backs on socialized medicine? I’m willing to bet that the majority of the people who make this claim have never been to any of these other countries and have never bothered to ask its citizens what they actually think–they’re simply parroting economic and political rhetoric and propaganda.

In reality, it’s actually pretty easy to take a magnifying glass to socialized medicine and hold it up to scrutiny. There are a lot of data one can analyze and compare to determine whether socialized medicine is really the evil and inefficient scourge that people claim. There’s even a way to find out what the people in places like Sweden actually think about their healthcare: by–shockingly–asking them point blank and not relying on American politicians and conservative economists to spoon feed you their own biases.

There are two primary resources that we’re going to be looking at in this post. The first is here. That link will take you to the complete 2014 International Profiles of Health Care Systems released by The Commonwealth Fund. The majority of the information I will be providing comes directly from the report. It’s an excellent read, albeit a long one. The report compares the healthcare systems of Australia, Canada, Denmark, England, France, Germany, Italy, Japan, The Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the US. That’s a pretty broad base to compare, and I feel it’s an adequate sample to really show genuine reflections in outcomes and costs.

First, it’s worth noting exactly how all of these systems work in terms of how they cover healthcare. Australia, Canada, Denmark, England, Italy, New Zealand, Norway, Singapore, and Sweden all have national health systems that cover all citizens, run by the government, and funded through taxpayers. France, Germany, and Switzerland have a statutory insurance mandate, similar to Obamacare, wherein all citizens are required to purchase insurance; funding largely comes from employee/employer contributions. And finally the US, where 56% of people have private insurance, 13% are uninsured, and the remaining 31% are covered under government run programs (Medicare, Medicaid).

Now, the first thing we can do is look at cost, since that’s currently what we are bemoaning here in the US. Per capita, here is what healthcare spending looks like in each of those countries. I will highlight the highest and lowest numbers.

  • Australia: $3,997
  • Canada: $4,602
  • Denmark: $4,698
  • France: $4,288
  • Germany: $4,811
  • Italy: $3,209
  • Japan: $3,649
  • Netherlands: $5,219
  • New Zealand: $3,172
  • Norway: $6,140
  • Singapore: $2,881
  • Sweden:$4,106
  • Switzerland: $6,080
  • UK: $3,289
  • US:$8,745

The US pays the most, almost double the average of $4592. Now, what about spending as a part of GDP?

  • Australia: 9.1%
  • Canada: 10.90%
  • Denmark: 11.00%
  • France: 11.60%
  • Germany: 11.30%
  • Italy: 9.2%
  • Japan: 10.30%
  • Netherlands: 12.1%
  • New Zealand: 10.00%
  • Norway: 9.30%
  • Singapore: 4.7%
  • Sweden: 9.6%
  • Switzerland: 11.40%
  • UK: 9.3%
  • US: 16.90%

Again, the US spends the most. We get an average here of around 11%, and the US is a good 50% higher than that.

So we spend the most of all of those countries. Surely, then, we get better outcomes for that, right? Well, let’s look at some healthcare quality indicators listed in the survey. The first one is: “Diabetes lower extremity amputation rates per 100,000.”

  • Australia: 4.6
  • Canada: 10
  • France: 7.1
  • Germany: 18.4
  • Netherlands: 13.5
  • New Zealand: 6.7
  • Norway: 8.7
  • Sweden: 3.3
  • Switzerland: 7.1
  • UK: 5.1
  • US: 17.1

Hey, look! The US wasn’t #1! That honor goes to Germany. But just barely, we’re a close second. It’s still worth pointing out that we’re still nearly double the average rate (9.2). So I don’t really know if I would qualify that as a victory.

What about lifespan?

  • Australia: 82.8
  • Canada: 82.2
  • Denmark: 80.6
  • France: 82.4
  • Germany: 81.0
  • Italy: 82.7
  • Japan: 83.7
  • Netherlands: 81.9
  • New Zealand: 81.6
  • Norway: 81.8
  • Singapore: 83.1
  • Sweden: 82.4
  • Switzerland: 83.4
  • UK: 81.2
  • US: 79.3

(Data from the WHO).

We don’t seem to live the longest, which is odd considering how much we pay compared to everyone else. Okay, well what about deaths due to the healthcare system? In other words, how many avoidable deaths in the healthcare system were there (per 100,000)?

  • Australia: 57
  • Canada: n/a
  • France: 55
  • Germany: 76
  • Netherlands: 66
  • New Zealand:79
  • Norway: 64
  • Sweden:61
  • Switzerland: n/a
  • UK: 83
  • US: 96

Yikes. Looks like our healthcare system kills more people.

Now it wasn’t all bad news for the US. We had the highest 5 year breast cancer survival rate (barely) and we were somewhere in the middle of the pack when it came to mortality after admission to a hospital for a heart attack. And that seemed to be the general trend, that the US was either the worst offender or somewhere in the middle.

Okay, what about the long waits and rationing? There were several markers here. The first was “Able to get same or next day appointment when sick.”

  • Australia: 58%
  • Canada:41%
  • France: 57%
  • Germany: 76%
  • Netherlands: 63%
  • New Zealand: 72%
  • Norway: 52%
  • Sweden: 58%
  • Switzerland:n/a
  • UK: 52%
  • US: 48%

Everywhere else but Canada it’s easier to get a same/next day appointment. The next measure was “Very or somewhat easy getting care after hours.”

  • Australia: 46%
  • Canada: 38%
  • France: 36%
  • Germany: 56%
  • Netherlands: 56%
  • New Zealand: 54%
  • Norway: 58%
  • Sweden: 35%
  • Switzerland: 49%
  • UK: 69%
  • US: 39%

Again, the US isn’t the worst, but it’s far below the average (48.7%). Okay, now the one I’m sure you’ve all been waiting for: “Waited 2 months or more for a specialist appointment.”

  • Australia: 18%
  • Canada: 29%
  • France: 18%
  • Germany: 10%
  • Netherlands: 3%
  • New Zealand: 19%
  • Norway: 26%
  • Sweden: 17%
  • Switzerland: 3%
  • UK: 7%
  • US: 6%

Well, well, well. While it’s true that other people have to wait longer to see a specialist, we weren’t necessarily the fastest. And it isn’t as if people those other countries are dying in the streets because they can’t see a doctor. Indeed, it would seem as if this whole issue is really a nonissue–clearly it doesn’t affect mortality, as every other country on the list had a higher average lifespan than America. Also, “waiting” depends on what we’re talking about: we might get people into specialists faster, but other countries do primary care faster than we do. However, there’s one more piece of this issue to look at: “Experienced access barrier because of cost in the past year.”

  • Australia: 16%
  • Canada: 13%
  • France: 18%
  • Germany: 15%
  • Netherlands: 22%
  • New Zealand: 21%
  • Norway: 10%
  • Sweden:6%
  • Switzerland: 13%
  • UK:4%
  • US: 37%

While it’s true we do get people seen faster in some instances, we certainly make them pay through the nose for it. So much so that some people can’t or don’t access healthcare at all. I wrote awhile back about stress in America and the role that Americans said money played: 20% said they put off medical appoints because of cost. That’s worth noting.

Also worth noting before we move on is how much people pay for drugs per capita in each country:

  • Australia: $588
  • Canada: $771
  • Denmark: $295
  • France: $651
  • Germany: $668
  • Italy: $514
  • Japan: $718
  • Netherlands: $450
  • New Zealand: $297
  • Norway: $414
  • Singapore: n/a
  • Sweden: $478
  • Switzerland: $562
  • UK: n/a
  • US: $1,010

Look at that, ours is the only number with a comma in it.

Okay. So we’ve looked at efficiency and outcomes. But what about popularity? You often hear that criticism. “Well yeah, it’s cheaper in Sweden, but the people over there hate it!” Is that really true? Well, luckily for us, we have some sources.

Public views of the health system: “Works well, minor changes needed.”

  • Australia: 48%
  • Canada: 42%
  • France:  40%
  • Germany:42%
  • Netherlands: 51%
  • New Zealand: 47%
  • Norway: 46%
  • Sweden: 44%
  • Switzerland: 54%
  • UK: 63%
  • US: 25%

You can ask the converse, too: “Needs to be completely rebuilt.”

  • Australia: 9%
  • Canada: 8%
  • France: 11%
  • Germany: 10%
  • Netherlands: 5%
  • New Zealand: 8%
  • Norway: 12%
  • Sweden: 10%
  • Switzerland: 7%
  • UK: 4%
  • US: 27%

Well it looks to me like socialized medicine is pretty popular. Meanwhile, a much higher percentage of people don’t like the American healthcare system. In fact, very few people in countries with socialized medicine feel it needs to be completely abandoned. That’s not exactly a stinging rebuke of socialism. As an example, I find it interesting that Canada, the nation with the worst scores when it came to access, had numbers in the single digits with regard to completely scrapping their system. And we can look at other sources, as well.

Eurobarometer conducts public polling in the EU. When asked about the overall safety and quality of their healthcare, almost 3/4 of EU citizens responded that it’s good (71%).

While it’s true that in many other countries people can purchase private or supplemental insurance, those numbers are generally low, with some exceptions. In England, only 11% of people buy supplemental coverage. That number plummets to 7% and 5% in Norway and Sweden. Again, hardly a shunning or abandonment of socialist principles. And where those numbers are much higher (between 50-70% of people) that coverage mostly allows for things like private hospital rooms, elective surgery, optometry, etc–it doesn’t necessarily buy access to better basic care (although in some cases it certainly can buy you access to faster private hospitals and doctors).

Alright, so what can we conclude from all of this? Well, for one, we can say that when politicians call US healthcare the greatest on earth, they’re talking out their asses. It’s not. The data clearly demonstrate that it isn’t. It doesn’t manage to make us live longer, and it puts us in the middle of the pack when it comes to industrialized nations as far as most other health outcomes. We pay the highest prices for mediocre results, basically.

At this point, I don’t really know how anyone can completely bash socialized medicine. It produces better outcomes for less money. That isn’t up for debate, that’s what the numbers indicate. There are some aspects that don’t measure up to the needs of some Americans, like the amount of time one waits to see a specialist. Although, that might be one reason why they pay so much less than we do: they don’t refer people to specialists at the drop of a hat. That probably saves a lot of money in the long run.

These data also seem to speak against the idea that “When the government gets involved everything goes wrong.” On the contrary, we see that the countries where the government is most involved have the lowest costs, the best outcomes, and the highest rate of approval among their citizens.

And as far as the “they’re all fleeing socialism to embrace the free market” lines go, that’s a bunch of baloney. By and large, people are satisfied with socialized medicine, and people are turning to private industry mostly for niche care. And even if more people are embracing some aspects of the free market, they aren’t doing so while abandoning socialism: it seems most countries agree that basic healthcare is a human right, and all citizens should have access to it.

I suspect that the American fear and hatred of socialized medicine is due to several factors. One, for many generations we’ve simply been taught by our government that socialism and communism are dire enemies. Two, here in American we’re used to a corrupt and inefficient government, so we naturally don’t see how centrally planned healthcare can work. But just because our government is inept doesn’t mean that all others are; indeed, it would seem that every other government has found a way to produce better outcomes with less money, which doesn’t exactly prove the “government is inept” theory. Admittedly, socialized medicine wouldn’t work in the current American government. Mostly because the government is bought and paid for in America, where overseas that isn’t the case (or at least not to the same extent as here). Which brings us to three: healthcare, to most of the world, is a human right, while in the United States it remains mostly a privilege.

Most countries see the health of their citizens as something that shouldn’t be considered a for profit venture. We can’t really say the same for the US. We provide healthcare for the elderly, but even that’s questionable now that republicans control all three branches of the government here. There’s a very real possibility that Medicare will be dismantled and replaced with a voucher system where our seniors will purchase private insurance. The problem with that is that insurance companies are in it to make money, and if a senior can’t afford what the insurance companies are charging, tough luck. I guess grandma doesn’t get healthcare.

In reality, having the government run everything allows them to stand up to the pharmaceutical companies and insurance companies (where applicable) and set price ceilings and negotiate. In our American system, we pretty much let private companies write the laws, literally. And now we have a group of people in power who want less government involved, because for some reason the same people who were going to drop you like a brick when you got sick are magically going to have a change of heart once Uncle Sam isn’t looking.

In summation: socialized medicine works. It’s cheaper and it’s more effective. It’s nothing to be afraid of, unless you own stock in an insurance or pharmaceutical company. Anyone who tells you different just isn’t living in a world of facts (or ethics, if you ask me).

I leave you with a meme.

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The marijuana condundrum

Well, election night wasn’t all bad news. More states legalized either recreational or medicinal marijuana! Woo-hoo! Take a look at the map now:

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However, no sooner than all this new legislation was passed did I read an article on Medscape about the dangers of marijuana use by a Dr. Melissa Walton-Shirley. The article is here if you’d like to read it, but I’ll be pulling out bits and pieces for the remainder of this post.

The crux of the article is this: there is some evidence that links marijuana to increased risk of certain cardiovascular diseases. The doctor who wrote the article cites a presentation that, “described an association between cannabis use and a twofold increase in the diagnosis of takotsubo cardiomyopathy.”

First of all, association isn’t causation. Walton-Shirley goes on to say,

“Seeing this uptick in apical ballooning in the young (and males to boot) is proof that manipulating the sympathetic and parasympathetic nervous systems is probably not a good thing for any age or gender unless those systems are producing pathology. Surely it’s predictable that inhaling substances never meant for human consumption doesn’t bode well for us, but it’s not the first time we’ve heard of pot’s potentially deleterious cardiovascular effects.”

There are a lot of things wrong here. First of all, a trend is not proof of anything. Second of all, and more importantly, the sample sizes of some of these studies are atrocious. Walton-Shirley even says in the article, “This article was lampooned due to its small sample size, but one must admit, where there is smoke, there can be fire (pun intended).” Hardy har, but you can’t just ignore the flaws and limitations of research to make a point or a pun.

I also find it very suspect that we’re never really given solid numbers about this “uptick.” Dr. Walton-Shirley gives some clues about it, saying that the rate of this cardiomyopathy is increased twofold by smoking pot. Well that’s all well and fine, but what does that mean in terms of naturally occurring cases? In other words, how many people are we talking about if we double the rate?

Well, we’ll have to do some detective work. Surfing the internet, I found an article from Circulation that states: “On the basis of recent analyses reported from several countries, this condition probably accounts for ≈1% to 2% of all cases of suspected acute myocardial infarction.” I think it’s also worth noting that the subtitle of the article is A New Form of Acute, Reversible Heart Failure. Turns out most people make a COMPLETE recovery. Anyway, the math.

 According to the American College of Cardiology, about 785,000 Americans have an MI every year. So we can say that in an average year, about 7,850-15,700 people suffer from TCM. But we also know what the prognosis for someone with TCM is: very good.  According to another Medscape article: “The prognosis in takotsubo cardiomyopathy (TCM) is typically excellent, with nearly 95% of patients experiencing complete recovery within 4-8 weeks.”

Well, let’s take those figures an apply them to our math above. We’re looking at a baseline mortality rate of 78.5-502.4 people per year. That’s it, folks. So let’s go with the worst case scenario, and say that smoking pot really does double the number of people who develop this. We’re talking about 1004 deaths per year due to marijuana. 

ARE YOU KIDDING ME?

Alcohol use kills 88,000 people per year.

Tobacco products kill 480,000 people per year.

Both perfectly legal. But heaven forbid we legalize pot, or 1000 people might get a rare form of cardiomyopathy. Do the people who make these arguments against pot not realize how insanely inconsistent their logic is? I mean, are we going to put people in jail because they use tobacco? Consumption of sugary drinks leads to diabetes, which affects 29 MILLION people in America. Should we jail anyone who drinks a big gulp?

And really, that’s what I think pisses me off the most about all this uproar over legalization. It’s not about health. Health is important, but legalizing pot isn’t a referendum on whether or not it’s bad for you, or whether or not you should use it. legalizing pot is about one thing:

NOT SENDING PEOPLE TO JAIL FOR USING IT.

That’s what decriminalization is about. It’s saying hey, maybe you shouldn’t go to jail for using a substance that’s less harmful than alcohol and tobacco, two perfectly legal products. 8.2 million people are arrested every year for pot-related offenses. Sure seems like we’re ruining more lives than we’re saving with anti-pot laws and policy. And we’re disproportionately ruining the lives of minorities, too, considering that white people use pot at the same rates of blacks and Latinos, yet are far less likely to be arrested for it. Not to mention the billions of dollars wasted every year enforcing these stupid laws:

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There’s no sensible reason to keep marijuana use illegal. There’s very poor evidence that it adversely affects health, at least compared to other perfectly legal substances. Anti-pot laws just waste everyone’s time and money. And people like Dr. Walton-Shirley are cherry picking data with very poor sample sizes to paint marijuana as some health menace, when there’s really no compelling body of evidence to support the stance.

Just make it legal everywhere and put those resources to better use.

Stupid political memes

As much as I hate to say it, internet memes are important now. They’re as much a source for news and information as any other social media outlet now. Indeed, memes are not only a way to transmit information, they’re also representations of ideas and beliefs held by people. There are literally entire generations and groups of people who get all of their news and information and ideas from social media and memes. So it’s important to call out bad memes that represent bad ideas, because they’re a very common way that misinformation and bad ideas spread. So without further ado, here are some popular political memes and my refutation of them.

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I’ve seen this one on Twitter and Instagram a lot lately, and it’s very disappointing. Right off the bat, anyone who paid attention in 8th grade history class should know something that casts suspicion upon this meme. Abraham Lincoln was assassinated in 1865. Now, does anyone know when the Federal Reserve was created? 1913! A whole 48 years after Lincoln was assassinated. I guess old Honest Abe had a time machine that he didn’t tell anyone about.

Really, what we’re talking about with this meme is the idea of conspiracy. Because if there’s ever turmoil in this country, it has to be a conspiracy, right? And if it’s conspiracy we’re talking about, then obviously it’s the Federal Reserve’s fault, because why not. After all, everyone’s favorite crazy grandpa, Ron Paul, is always screaming about the Fed and how it’s the cause of all of the world’s problems. Except that it isn’t, clearly.

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I saw this one just today and got into a bit of an exchange with someone about it. First of all, let’s take the two sentences at the top. “Never arrested. Never convicted.” Well fucking duh, because again, history. Obviously Hitler was never arrested and convicted of any of his war crimes because he fucking shot himself before we could capture him. Now, let’s take the last sentence. “Just as innocent as Hillary.”

Look, I’ll be the first to admit that Clinton isn’t some angelic figure. But Hitler? Come on. There’s no comparison. Nothing Hillary Clinton has ever done even remotely compares to straight up genocide and literally trying to take over the world. This is false equivalency or dichotomy at its absolute finest. By the way, the person I debated about this meme kept calling Clinton a despot, which is what makes her as guilty as Hitler, apparently. Her despotism according to this individual? Voting for the war in Iraq and the no-fly zone in Syria. Because obviously those are just as bad as the holocaust, guys.

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This was pretty popular when Bernie was still in the race, but I still occasionally see it making the rounds, or other memes that are similar to it. The only problem with it is that it’s total and absolute crap. Taxes are not collected at gunpoint. Similarly, nobody is going to shoot you if you don’t pay your taxes. And do you know why? BECAUSE YOU CAN’T COLLECT TAXES FROM A DEAD PERSON. And despite all that, your economic value is still greater even if you don’t pay taxes than if you were dead. So knock this bullshit off, the government doesn’t go door to door with soldiers to collect taxes.

At the very worst, tax evasion will land you in jail. But most likely it’ll result in a garnishment or lien of some kind.

But let’s take this moment to look at countries who do practice socialist principles. People in Denmark, Sweden, Norway, etc. gladly and proudly pay taxes. Their systems are sources of national pride. Some of the very things that Paul and his ilk believe are privileges are considered human rights over in parts of Europe. And while we’re on the topic…

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No, taxation is not theft, goddamnit. For anyone who believes this drivel, please kindly give me an example of one modern society that functions without taxation of some kind. Go ahead, I’ll wait. I’ve been waiting, because nobody that I’ve ever posed that question to has ever been able to provide an answer, because the whole premise that taxation is tantamount to theft is absolute horse shit.

And comparing the government to the mafia is also horse shit. The mafia doesn’t produce anything. The government, on the other hand, and contrary to popular belief, DOES produce things with your taxes.

Taxation is roads. It’s bridges. It’s schools. It’s the fire department. It’s the police department. It’s the trash collectors. It’s the military that defends us. It’s drinking water. It’s all of the things that are promised to us by the social contract. But if you really think that taxation is theft and you shouldn’t ever have to pay any taxes, then go right the fuck ahead and leave society. You’ll see real fast how far no taxes and no social contract gets you, you twats. I also find it hypocritical that these same assholes probably use all of the public goods that the taxes they hate so much paid for.

And before anyone says it, saying that you’re being taxed too much or that your tax dollars are being used inefficiently is not the same thing as saying that all taxation is armed theft. So don’t even try making the argument that it’s all really the same thing.

What all these memes have in common is that they show a breathtaking ignorance of history and fact. And yet there are millions of people out there who see stuff like this and just accept it as fact. And they all vote. Every last ignorant one of them.

The jobs are never coming back

If you listen to Donald Trump, he can bring back all of the jobs that we’ve lost in the last several decades. Yes, Donald Trump, all by himself, is going to reverse three decades of globalization. It’ll be a thing of beauty, believe him. It was all he could talk about at the first presidential debate.

Except that those jobs aren’t coming back, ever. Those jobs and the US are just like Taylor Swift and any of her exes–they are never, ever getting back together.

To think otherwise is just plain ignorant. Those jobs are gone, it’s impossible for them to come back, and they probably would have left no matter what. I say this based on several things:

Automation. All of the jobs that Trump talks about bringing back are based in the manufacturing area. We lost a lot of those jobs because foreign labor is cheaper (more on that in a bit). But we also lost a lot of those jobs because technology started making workers obsolete. And guess what? That threat continues today. Technology will continue to replace workers for years to come, in all sorts of industries, not just manufacturing. In fact, some estimates show that by the next time we’re ready to elect another president, the world’s biggest economies will have lost a little over 5 million jobs to automation. And this time that extends to business and administrative work.

It’s no secret that workers are more productive than ever, but wages and employment haven’t kept up. The reason for that is technology, as laid out here by these fine folks from MIT. I’ll let the infographic do the talking:

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Those jobs that Trump likes to talk about were destined to be lost one way or another. If it wasn’t because of trade deals, it would be because of technology.

Wages and Benefits. Those jobs also left because companies suddenly found themselves in a position to pay a whole lot less for labor by outsourcing it to countries where they could pay employees pennies on the dollar. Why would a corporation bring back jobs to the US if it means having to pay higher wages and provide benefits like healthcare, sick days, etc? No American worker would settle for less than minimum wage and benefits, and many companies wouldn’t provide them for employees if they didn’t have to. It’s a pipe dream to think that someone could bring those jobs back. In order to do so, they’d have to essentially make the American worker equivalent to the overseas worker, and that wouldn’t fly.

No, taxes aren’t the problem. That’s the problem if you listen to Trump and other conservatives. The taxes here are just too high! How can anyone do business at a rate of 35%? First of all, that’s a rich argument coming from someone who probably hasn’t paid one red cent in taxes for the last twenty years. But two things come to mind whenever I hear this argument. First, American businesses and individuals have paid a lot more in the past, and the economy did just fine. Great, in fact. As evidence that this tax business is a red herring, Exhibit A:

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Corporations have never contributed less to the economy than they do now. Companies like Apple proudly boast that they stash billions or dollars overseas. Which bring me to Exhibit B:

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Many companies don’t actually pay 35%. What they’re taxed on paper and what they actually pay is quite different thanks to lots of loopholes, legal maneuvering, and offshore funny business. In fact, many companies end up paying pretty much 0% in taxes, like these assholes. So unless Trump plans to drop the tax rate to 0%, I don’t think there’s really anything else he could do.

But more to the point, how does Trump plan to increase military spending after he’s lowered the nation’s income? How does he plan to pay down the debt if he’s reduced the nation’s income? He could slash other programs, but that would mean either cutting or eliminating popular programs like social security, which wouldn’t go over well with voters and politicians.

It’s all empty rhetoric. I get why it resonates for people in the rust belt, who did lose out thanks to globalization and automation. But to believe that Trump can somehow “bring jobs back” is absolutely not true. The best thing to do would be to put forth a policy that created new high paying jobs in sectors where automation and globalization weren’t as influential. And right now, that probably means infrastructure building and rebuilding, because the last time I checked robots still didn’t repair bridges or roads. And it isn’t like our country isn’t in dire need of such repairs.

But I’m sick and tired of political seasons where we continually have this debate about a fictional economy. Conservatives love to talk about an economy that doesn’t exist, and Donald Trump has just upped this game by a factor of a thousand. In this fictional economy, employment never rises, the economy never grows, and stimulus packages never work. However, all of those things are demonstrably false. It’s great to have a robust debate about the state of our economy and the direction that we’re headed in, but it’s impossible to do when one candidate is essentially basing his entire campaign on an economy that only exists in the halls of Fox News.

Stressed out? You’re not alone.

In a previous post about healthcare in the United States, I talked a little bit about stress and its role in health. With this post, I’d like to delve a little bit more into its prevalence in American society. In order to do this, I’ll be summarizing and analyzing the latest stress report from the APA–the American Psychological Association–entitled, “Stress in America: Paying with our health.” You can find the full report here. It’s a fascinating read, and I highly encourage everyone to read it. I’ll then provide my own insight into the matter. First, a little background.

The APA has been conducting this study since 2007. That’s not a terribly long time for any long term trends to emerge, but I think the data is still valid and relevant for a short term snapshot of the American psyche. This last survey was conducted in February of 2015. 3,068 adults were included in the survey, which was conducted by Harris Poll. There were 1,204 men and 1,864 women across all generations and all regions of the US. Now, to the results.

The top causes of stress

The top four things that cause us stress are:

  1.  Money (64% of respondents)
  2. Work  (60%)
  3. Family responsibilities (47%)
  4. Health concerns (46%)

Money, not surprisingly, is the top concern of most people and the biggest cause of stress. 54% of those surveyed reported having “just enough or not enough money to make ends meet at the end of the month.” Specifically, Americans worry about paying for unexpected expenses, essentials, and saving for retirement. Unexpected expenses are a big one, considering the plight of the average American.

62% of Americans have less than $1,000 in their savings accounts, and 21% don’t even have a savings account at all. That means that, in the big picture, a whopping 83% of Americans don’t have enough money to pay for something big that happens out of the blue: an injury, a car repair, etc. It’s no wonder that the average American has $4,717 in credit card debt, and US credit card debt currently totals close to one TRILLION dollars.

The financial picture is just as bleak when it comes to retirement. I’ll let the pictures do the talking for me:

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Clearly, the average American is not prepared to retire. This means that they have to work longer, which is a source of stress. However, the impact of not being able to retire goes beyond simple stress. Aging workers are more likely to suffer injuries on the job. They’re also more likely to have chronic health problems, which means they use their insurance more than younger workers. Ultimately this means that employers wind up paying more for an aging workforce.

But how does money specifically impact individual health? Well, according to the survey, nearly 20% of American report skipping or thinking about delaying visits to the doctor. 32% of Americans say that they don’t have enough money to live a healthy lifestyle. It also affects relationships. 41% of respondents with a spouse or partner reported that stress had caused problems in their relationship.

But perhaps the biggest effect on our health is how we manage stress. Spoiler alert, it’s very poorly. In order to deal with stress, the Average American will 1) Watch television, 2) Surf the internet, 3) Sleep/nap, 4) eat, 5) Drink, 6) Smoke. The order of those things changes depending on which generation you’re surveying, but you’ll notice two general things about all of those activities: they’re either sedentary or they’re actively bad for you. And about 20% of Americans say they don’t engage in any sort of activity at all to manage stress.

Now, let’s talk about some of the good things to come out of the survey.

First, self-reported stress is down. Yay! On a scale of 0-10, Americans in 2015 had an average stress level of 4.9 , which is down from 6.2 in 2007. However, that’s still far short of the level of stress that Americans think is a healthy level–3.7. Also, the number of Americans who say that stress has a “very strong or strong” impact on their physical and mental health appears to be decreasing as well.

Okay, now for some thoughtful analysis. First off, I think it’s very tempting for some people and pundits to look at this data and say, “Well if those lower income people would stop spending their money on fancy phones and tattoos and all that garbage they’d have more money left over!” It’s a new variation on the old “Welfare Queen” trope and quite frankly it’s pitifully stupid. The data clearly show that this isn’t the case. 53% of Americans reported using coupons or shopping during sales this year, 52% are cooking more at home, and 51% are cutting back on non-essentials. In short, people are tightening their belts, contrary to the conservative narrative. Now, does that mean that there aren’t people out their who spend and manage their money poorly? Of course those people exist. But they’re the exception, not the standard. And they even include wealthy people–actors and professional athletes can go broke making stupid purchases, too.

Second, there have been lots of reports about how, “The middle class is shrinking because more of them moved into a higher class!” Well, that’s certainly a nice talking point, as you can see in this article. And there’s even recent data that shows that median household income has nudged upward. However, let’s keep several things in mind.

“Middle class” is a relative term. It’s simply a multiplier of the poverty level. Also, it’s not a reflection of purchasing power. It’s not a statement on inflation. I can make more money, but if the price of goods increases at a rate greater than my income, the extra income means nothing. Similarly, if my debt increases, the extra income also means less. My newfound income may also push me into a higher tax bracket. In short, it’s entirely possible to make more money but be worse off than you were before. Being “middle class” or “upper middle class” is a purely linguistic term, and it’s very subjective. And if this report is any indication, any new income gained by the average American has not done much to impact the level of stress they feel regarding money. Which leads me to my last point, which is more philosophical in nature.

People who regularly read this blog know that I’m not a big fan of money. I hate it. I hate the way it’s used, I hate the way it’s idolized. At the same time, I recognize that in our society money is obviously necessary. I have to eat, put a roof over my head, etc. But the problem with money isn’t a conceptual one. I have no qualms with the idea of creating a system wherein we have a currency that represents labor. The problem is a cultural one, how we promote and utilize such a system.

In American culture, money has become synonymous with success. The more money you have, the more successful you are. The more material objects you own, the more successful you are. Indeed, it’s ingrained into the American psyche that spending money is tantamount to patriotism. Remember W imploring everyone to go out to mall or the terrorists will win? In the grand scheme of things, our society promotes money over all else.

It promotes money over science: the fossil fuel industry spends millions of dollars every year trying to discredit climate science and buy legislation.

It promotes money over public policy: The NRA and gun control. Lobbying by the food industry (hello soda and corn products!)

It promotes money over family: We spend much more time working than we do with our family and in our relationships.

It promotes money over the environment: Who cares about pollution if it provides us with cheap goods?

And it promotes money over health as the survey here shows.

But even if money is necessary, is it really important? And more crucially, is it really the metric we should all be using for success? Who lived the richer life: the man who died wealthy but never knew his kids or the person who lived a modest life and spent more time with their family? I realize that’s a subjective call, but my point is that culturally, we as a society only view one of them as being successful.

As a final thought about money, stress, and society, I would encourage everyone to read this article. It’s about a book written by a palliative care nurse who recorded the regrets of the dying patients that she took care of. Here’s the list of what people reported regretting on their deathbeds the most according to this nurse’s experiences:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.

“This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. Health brings a freedom very few realize, until they no longer have it.”

 

2. I wish I hadn’t worked so hard.

“This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret, but as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.”

 

3. I wish I’d had the courage to express my feelings.

“Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.”

 

4. I wish I had stayed in touch with my friends.

“Often they would not truly realize the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.”

 

5. I wish that I had let myself be happier.

”This is a surprisingly common one. Many did not realize until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again.”

I would argue that what society tells us we should value really isn’t what we inherently want to value. And that disconnect more than anything is probably the biggest cause of stress in our lives.