Month: May 2014

German Lopez outlines the scandal that saw Secretary of Veterans Affairs Eric Shinseki questioned before Congress yesterday:

The controversy really began after CNN reported in April that at least 40 US veterans died while waiting for appointments at the Phoenix VA hospital. According to internal emails and CNN’s sources, VA managers in Phoenix created a secret wait list in an attempt to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor. Even worse, top-level management supposedly knew of and defended the practice.

Besides the secret list, the Phoenix VA hospital already provided a different, official wait list to DC that allowed VA higher-ups to verify that patients are being treated in a timely manner (within 14 to 30 days). But Phoenix’s secret wait list supposedly avoided federal oversight with an elaborate scheme in which officials shredded evidence that some patients were taking months to be seen. What’s worse, if someone died while waiting for an appointment due to the secret wait list, Phoenix officials would allegedly discard the name as if the fatal error never happened.

He adds that “there’s also been issues with scheduling practices in at least three other locations.” Shinseki’s testimony didn’t impress veterans groups:

After the hearing, the Iraq and Afghanistan Veterans of America, which has a broad membership base among younger veterans, released a statement that read, “Secretary Shinseki did not restore confidence that VA senior leadership is responding with action and not just concern. Our members are outraged. And we need to see a bold plan to address these allegations.”

None of the veterans’ groups, including the conservative American Legion, which has called for Shinseki to resign, endorsed the idea of replacing centralized, VA-provided care with a private option. Republican senators have repeatedly floated the idea of privatizing the VA’s healthcare system. Veterans’ organizations on the panel endorsed a limited private care option but warned that it shouldn’t take away from the VA’s budget or its mandate to be the primary healthcare provider for veterans. Carl Blake of the Paralyzed Veterans of America argued that veterans with certain chronic injuries and demanding physical condition who now receive care might not be able to find private specialists outside the VA to treat them. The problem, he stressed, was getting the veterans into the VA’s healthcare system.

So will the general get the axe? Mark Thompson wonders:

[Shinseki] has already said he won’t resign. What’s critical is how Congress and veterans react to what he says, and what a VA-wide inspector general’s probe into the problem turns up. Shinseki will survive if he convinces them he was ignorant of such wrongdoing—he has denounced it as “absolutely unacceptable”—and shouldn’t have been expected to detect it on his own.

But anyone who has paid attention to VA data is aware that there have been persistent efforts inside the agency to make vets’ wait times seem shorter than they actually are. One 14-day limit for getting an appointment was ripe for abuse, and critics say such abuse should have been anticipated and eliminated. Shinseki’s defense becomes weaker with every corroborated story of his subordinates gaming the system. If there’s evidence that the problems are systemic, Shinseki’s days are numbered.

Michael Astrue points out that this is not the VA’s only problem:

There is also a risk that the recent focus on breakdowns in the VA hospital system will cause President Obama and Congress to overlook the other huge failing at the VA—a sluggish, error-prone disability system that will never work until it moves completely from paper processes to a state-of-the-art electronic system. VA disability paperwork is so voluminous that the General Services Administration became concerned a few years ago that a building in Virginia would collapse from the sheer weight of its stored VA disability paperwork. Predictably, waiting times for review have slowed to historically sluggish levels; a former soldier, whether injured in Afghanistan or Vietnam, should not have to wait years for a decision on his or her claim.

Jordain Carney and Stacey Kaper explain how the VA has gotten so overloaded in recent years:

The VA is dealing with a sudden influx of Afghanistan and Iraq veterans as the U.S. draws down its troop levels. Nearly 970,000 Iraq and Afghanistan war veterans deployed overseas since 9/11 have filed a disability claim, according to a Freedom of Information Act request released to Veterans for Common Sense this month by the Veterans Benefits Administration.

And due to medical advances, many service members who would have died from their injuries in past wars are now being saved, but they are returning home with more numerous and more complicated injuries. Vietnam veterans typically claimed three or four injuries. Now a single veteran from Iraq or Afghanistan routinely submits a claim with the number of injuries in the double digits. Meanwhile, the Obama administration has also changed the rules to give more benefits to veterans.

This embed is invalid

Yesterday, Buzzfeed obtained an NYT internal report (embedded above):

A 96-page internal New York Times report, sent to top executives last month by a committee led by the publisher’s son and obtained by BuzzFeed, paints a dark picture of a newsroom struggling more dramatically than is immediately visible to adjust to the digital world, a newsroom that is hampered primarily by its own storied culture.

Joshua Benton is impressed by the document:

I’ve spoken with multiple digital-savvy Times staffers in recent days who described the report with words like “transformative” and “incredibly important” and “a big big moment for the future of the Times.” One admitted crying while reading it because it surfaced so many issues about Times culture that digital types have been struggling to overcome for years.

I confess I didn’t feel anything quite so revelatory when I read last week’s leaked version — which read like an indoor-voice summary, expected and designed to be leaked to the broader world. This fuller version is quite different — it’s raw. (Or at least as raw as digital strategy documents can get.) You can sense the frayed nerves and the frustration at a newsroom that is, for all its digital successes, still in many ways oriented toward an old model. It’s journalists turning their own reporting skills on themselves.

Zachary M. Seward focuses on the NYT’s declining homepage traffic:

Traffic to the New York Times homepage fell by half in the last two years, according to the newspaper’s internal review of its digital strategy … That’s not necessarily a reflection of any problems at the Times but the reality of how news is now distributed on the internet. Homepage traffic is declining at most news sites as readers increasingly find links to news articles from social media, email, and other sources.

He adds that overall “traffic to the Times isn’t falling; it’s just coming in through the ‘side door’ more often.” Ezra complicates this analysis:

Someone has to post an article to Twitter or Facebook. That can be the media brand. It can even be the journalists. But when articles work it’s really coming from the readers. Social media is wonderfully, frustratingly organic. Oftentimes the biggest hits are the ones you never even thought to share.

So the next question is where do those readers — the ones seeding your content, and finding your gems — come from? That turns out to be a very, very hard question to answer. It’s tough to track the chains of social shares. But my experience — and that may not be worth much — is that many of them are coming to your home page.

Both Derek Thompson and Tyler Cowen add their two cents.

Kent Sepkowitz unpacks the news that scientists at the Mayo Clinic “had treated two adults with the blood cancer, multiple myeloma, by injecting them with mega-doses of genetically modified measles virus”:

Both patients had failed all other available therapies; with the new “oncolytic virus” treatment, each responded and one remains in remission nine months later.

In this study, the patients—neither with existing antibody to measles virus—received enormous doses of live measles virus infused directly into their vein—not given as a shot like a vaccine. Both became feverish and ill with the infusion, as expected, and both recovered. The measles virus was derived from the strain used in routine measles vaccine but had been carefully altered by scientists to enhance its tumor killing effects. It was still, however, a measles virus, capable of giving a person a measles-like illness. The choice of measles for the cancer was quite deliberate—this virus is known to seek out and attack a type of white blood cell that myeloma arises from. The investigators simply harnessed measles virus’ natural born killer tendency.

Adrianna McIntyre has more:

Measles isn’t the only virus used for this kind of therapy; different cancers will be more susceptible to different viruses. Usually when this therapy is attempted, the virus is injected at the tumor site. Myeloma isn’t isolated to tumors, though; the cancer also infects bone marrow itself. In this study, the vaccine was injected into the bloodstream, instead of directly into the tumor.

And this isn’t your garden-variety measles vaccine. The vaccine formulation used in this study contained 100 billion infectious units — 10,000 times the standard dose. And compared to cancer treatments that last months, this measles vaccine therapy only requires a one-time dose. “What we’re really excited about with this particular approach is that we believe it can become a single-shot cure,” said Dr. Stephen J. Russell, lead author on the study.

Readers can relate:

So you lost your gay wedding ring?  How virtually normal. Sorry for the loss. Hope it turns up, and welcome to the club.

Another member:

I lost my wedding ring too. It was a very cool, custom ring, kind of tubular, 18 karats. Cost quite a bit of money. I think I was eating Taco Bell, and it was cold out, making my fingers slimmer, and when I threw the wrappers in the trash, it just flew off into the trash can. That’s my best theory. What an undignified ending for a wedding ring.

Having blown my shot at a cool custom ring, my wife and I went to the pawn shop, where I bought a goofy, old-school, 14 karat art-carved band for $49. I love that 2nd ring, and it reminds me of a time in my life and the place that I lived in then, when I was a little more careless, but still me. I have had it for 14 years, and it has only grown more meaningful with time.

I guess I am saying that you can love your next ring too. It will remind you of this moment with your husband, him being by your side, recovering from the hospital, and all the warp and woof of life, including the messy, annoying bullshit, like going to a hospital and losing a ring. A new ring for yet another stage of marriage and living. All perfectly, perfectly normal.

A near-member:

I was newly married and newly ringed while enjoying some lap-swimming with a friend.  Shrinkage does occur in other places in a cold pool.  One freestyle stroke later and the ring just slipped off into the large and deep Olympic-sized pool.  I was devastated as I frantically flagged down my friend in the other lane who probably thought I was having a heart attack (somewhat true).  We searched for what seemed a half-hour as we tried to avoid other swimmers who thought we were complete dicks.  As we were about to give up and get out, I noticed a shiny thing in the catchment on the side of the pool.  Eureka.  I was so relieved.

Well, this will make you feel worse perhaps, but I thought we could start a new thread.

The thread continues with many more stories:

If it makes you feel any better, I am on my third ring in four years.

The first was lost on the second day of our honeymoon (the Pacific is cold with strong currents).  The second was lost during a friend’s bachelor party (to this day it’ a mystery, along with most of that night).  And I now have a spare fourth ring after losing and later finding my current one (I wisely go with the $40 plain silver band every time).  Needless to say, I have a very understanding wife. Sounds like Aaron is just as considerate, but if you need a favorable comparison, feel free to show him this email.

Perhaps the most wrenching tale:

My wife and I had one of those crazed screaming matches that ended with me storming out of the house and walking about a mile to cool off. I came to a local school building and sat down on a bench to rest. I took off my wedding ring, pondering my marriage while I fiddled with it.

And then I dropped my wedding ring. And it rolled about 10 feet. Into the sewer. Gone. Forever.

Holy shit, I thought. My wife’s gonna think I threw my wedding ring away in a fit of rage and divorce me! There was only one thing I could do: Tell truth truth, however stupid it may be. I literally ran home and apologized in tears. She was annoyed, but believed me. That was about 10 years ago and we’re on our way to 18th anniversary.

Cheer up, Andrew. You’ll find over time that the pain of losing your wedding ring lessens. It doesn’t fully go away, but you learn to deal with it.

Another sends the above photo:

While snorkeling in the Caribbean, I thrust my left hand down at just the right angle and speed to basically slingshot my ring off of my finger.  I can still see it silently, gently, floating about 20 feet down into the corals, glinting in the sunlight before settling into some dark crevice. It reminded me of a scene from Lord of the Rings (though more tropical). I had no hope of retrieving it (especially after I took my eye off the landing spot to tell everyone what happened).  But, my sister was at least able to take the attached photo of me diving down after it, so I could tell my wife back at the hotel that I made some effort to get it back.  Luckily we were poor when we got married, so the financial hit wasn’t too bad.  And it is a bummer to not have the ring from our wedding, but I did gain a story.

Another photo:

Two days ago I cleaned house, worked in the yard, did laundry and dishes, went grocery shopping, had lunch at Audrey’s school, and discovered that somewhere along the way I had lost the diamond from my wedding ring. Yesterday I found it on the pavement under our outdoor faucet, where I had detached the hose. A miracle!

Two sentences you’ll only find on the Dish:

Very sorry about the loss of your wedding ring. It brings back a memory of my first colonoscopy.

I was on the table just slipping into unconsciousness when I heard the doctor announce that I had a nipple ring. Then I heard a bb bouncing on the floor. One of the nurses said that she’d get it, and that’s the last I remembered. When I awoke, the ring had been saved for me, but since I had been pierced fairly recently, the hole closed. Getting it done the first time was excruciating. I had to wait months before I could have it redone, and the pain was worse the second time around because I actually knew what to expect.

Not to minimize your loss, but if given a choice, I’d lose my wedding ring over the nipple ring any day. Now you can go shopping, and Aaron will get to place it on your finger all over again. Sounds sweet to me, especially since you’ll most likely get a “happy ending” afterwards.

Another reader:

Years ago we were in a hotel room when my mother realized she had accidentally thrown out her engagement ring.  She had wrapped it in tissue for protection in her suitcase (so, never do this) and then placed the tissue on a counter, later thinking it was trash. It had been my father’s mother’s ring and after a frantic search it became clear it had gone out with the trash and was gone for good. I remember my mother’s devastation.

Years later, after my father died, my mother told me about how my father had not gotten angry or upset, he had simply said “It’s OK. These things happen. I’ll buy you a new one.” It was his family heirloom, and his calmness, his complete absence of blame, did a great deal to calm my mother and alleviate her guilt.  He bought her a new ring and when my mother died I took possession of it.  This new ring says much more to me about love, about my parents’ commitment to each, than the original ring ever could have. I treasure it.

It’s a thing.  It’s not your husband’s love, which will endure regardless of how many rings you go through.

One more:

I am sorry about your wedding ring. But Aaron is right, it is a thing. It is a symbol of your relationship. You don’t lose his love with the ring.

In 1982, I was 39.5 weeks pregnant, 40% dilated, and not in labor. My two year old was having a rough time with our rough time. My husband took her apple picking with his boss and children. He lost his wedding ring in the orchard. Extremely pregnant woman are rather volatile, and I was no exception. A few days later, the baby was born. We replaced the ring. The feisty toddler is herself 34 weeks pregnant now and on medicine to try to keep her from delivering for another two weeks.

Steve and I are still happily married. He collapsed at work yesterday from otherwise silent stomach bleeding. Last night they found a significant tumor, probably a low grade malignancy. He had many CT scans last night to look for true size of the tumor and any sign of spread. We are awaiting a meeting of the experts to formulate a plan. That wedding ring is so unimportant today.

Bouncing off the Abramson story, Salmon speaks out against keeping salaries confidential:

Very few people like to talk about how much money they make — especially not people who earn a lot of money. Since companies tend to be run by people who earn a lot of money, the result is a culture of silence and secrecy when it comes to pay. Such a culture clearly served the NYT ill in this case. If the salaries of senior NYT management had not been a closely-guarded secret, then Abramson would not have been shocked when she found out how much Bill Keller made before her, and Arthur Sulzberger would not have reacted badly to Abramson’s questions about pay.

Indeed, secrecy surrounding pay is generally a bad idea for any organization. Ben Horowitz has the best explanation of why that is:

it can’t help but foment poisonous internal politics. But there are other reasons, too. For one thing, secrecy about pay is bad for women, who are worse at asking for raises than men are. If men secretly ask for raises and secretly get them, while women don’t, then that helps to explain, at least in part, why men end up earning more than women.

Matt Bruenig thinks this secrecy “is only true for people who earn a lot of money, as well as those who may not make that much money but still find themselves in that high socioeconomic status milieu (e.g lesser-paid writers)”:

In conversations among those in upper class professions, I’ve noticed that once the job and employer are identified, the next questions are about how they like it and what kinds of things they do. In conversations among those in lower class professions, after the job and employer is identified, most of the time the next question is about what the pay and benefits are. When jobs aren’t self-actualizing and don’t confer status, that’s all they are about.

Jeremy Stahl watched ESPN’s E:60 documentary on Qatar’s World Cup preparations and is appropriately outraged. According to one source in the documentary:

Sharan Burrow, the general secretary of the International Trade Union Confederation, is quoted in the ESPN documentary as saying that at current rates, 4,000 people will die to make the 2022 World Cup a reality. A March ITUC report said that 1,200 migrants have already died in the four years since the tiny, oil-rich Gulf State was awarded the World Cup in a shady and stunning decision …

All of these abuses are possible because of the nation’s kafala employment system, which has been aptly described as modern-day slavery. Through kafala, employers are allowed to confiscate a migrant’s passport and withhold exit visas, effectively preventing that person from leaving the country.

Qatar claimed as recently as this Tuesday that not a single person had died while doing work for the World Cup. The contention rests on the fact that the hundreds who have died on infrastructure and construction efforts were working on “non-World Cup projects.” Despite these assertions, Qatar and FIFA seem to have realized that a humanitarian crisis of this scale is disastrous, at the very least from a publicity standpoint. On Wednesday, Qatar announced reforms intended to abolish the worst provision of kafala, specifically the one tying workers’ exit visas to employers.

Christa Case Bryant takes a closer look at the reforms announced this week:

Because the new worker guidelines apply only to World Cup sites, and stadium work is still in the very beginning stages, less than 200 workers are governed by those standards. But Farah al-Muftah, chairwoman of the Supreme Committee’s Workers’ Welfare Committee, says meetings are now under way to establish common standards that would be more broadly applied. “By us going for unified worker welfare standards, you’re covering a huge majority of workers involved in the building of World Cup sites and the country’s infrastructure,” she says.

The Qatar Foundation, which is building another one of the stadiums and was previously involved in major projects such as Georgetown’s campus here, has also been pioneering new standards and inspection regimens. “There’s an acceleration of evidence that this is being taken very seriously,” says Gerd Nonneman, dean of Georgetown University’s School of Foreign Service in Qatar, whose campus was built without a single casualty.

Nathalie Olah notes that the entire oil-fueled Gulf construction boom has had a tremendous human cost, borne mainly by these South Asian laborers:

Saudi Arabia’s human-rights record is notoriously lousy. Since November of last year, it’s been reported that 250,000 migrant workers in the country have been arrested and deported under the violation of labor and residency laws, even though “these restrictive laws are part of a labor system that leads to rampant human rights abuses.” In February, Human Rights Watch wrote a letter to President Obama urging him to address the issue with King Abdullah during his March visit. Nobody seems to have heard anything since, so I’m assuming he ignored that envelope.

In a series of interviews that the NGO carried out with those who’d been detained and forced to leave the country, they discovered that migrant workers—consisting, in the most part, of Indian, Pakistani, Bangladeshi, and Nepalese people—had also been deprived of food and water. However, due to limits imposed by the government, it is almost impossible to access those living and working inside the country.

Tori Marlan discovered that “the rules that determine what babies can become citizens seem to be butting up against the modern circumstances under which Americans are having babies.” One example:

In Montreal, no official asked if my daughter came from my own egg because for heterosexual couples a genetic connection is usually presumed. That doesn’t hold true for same-sex couples.

After Laura Fielden, a U.S. citizen who lives in Spain, applied for citizenship for her daughter, an official asked for a hospital report to determine who was the mother. “I’m one of the mothers,” Fielden told the official. But her Spanish wife had been the one to give birth. Early in February, Fielden’s daughter was denied U.S. citizenship because the child didn’t have a genetic or gestational connection to her American parent.

Lisa Lynch, an American who lives in Montreal, also had to account for the circumstances of her daughter’s birth. But Lynch had a different outcome: After receiving an embryo transplant, Lynch’s Israeli wife gave birth to their daughter in Montreal. When Lynch applied for citizenship she was told her child had to be genetically American. “But my child is genetically American!” she told them. As it happened, an American couple had donated leftover embryos to the couple, and Lynch had the records to prove it, including receipts from the California clinic that had shipped the embryo to Montreal. “The consulate was sort of taken aback,” she says. Officials told Lynch they might need DNA proof from her donors; the couple was ready to comply.