08.19.09 :: On A Rational Discussion of Health Care Reform

Fresh Air on NPR is one of my favorite programs, and host Terri Gross has been doing a series of interviews with knowledgeable, intelligent people on all sides of the debate on health care reform and, more specifically, the actual legislation being proposed. One part of the series in particular struck me as one of the most informed, rational, and even-handed discussions of what is actually being discussed and worked on by the legislation: an interview with Jonathan Cohn, author of Sick.

Every media outlet has its bias and NPR is no exception, but if the site goes against your political grain and you can get past that you'll be rewarded with a broadcast that said more about the proposed health care legislation than all of the town halls combined, and with none of the distasteful and shameful theatrics that townhall attendees and political talking heads on both sides of the spectrum seem bent on engaging in.

Cohn's own bias is stated pretty clearly, and it wouldn't take you long to suss it out anyway since, as the author of a book titled Sick: The Untold Story of America's Health Care Crisis -- and the People Who Pay the Price, it's pretty clear how he feels about America's current health care system. But he says that he knows his own desires in health care are far more liberal than the average American, and certainly even more liberal than Congress. In this interview he isn't tasked with talking about what he would do if he were in charge -- although Terri Gross does ask him this question and he does answer it, but she's asked that of every person she's had on in this series -- he's tasked with discussing each player in the health care debate, from the AMA to hospitals to insurance companies, what's at stake for them, and what the legislation being proposed would mean for them and for Americans. He does a great job of allaying some of the rational fears that can be found if you're willing to pick through the chaff of the shouting matches at townhalls. Here are some of the more interesting bits I found in the broadcast.

There will be no single payer system.
No matter how loudly people rail on about Obama being a communist or a Nazi (oddly, two polar opposite ends of the spectrum) or how we're going to turn into Canada -- which apparently is even worse to most people than turning into Stalinist Russia if you listen to the townhall attendees -- the US will likely never see a single payer system. While polls show that the American public overwhelmingly wants health care reform, Congress is typically more conservative, even controlled by the Democrats, than the American public. A single payer system is too far out and idea for the US to see as a reality any time soon, if ever.

The public option raises issues that Congress is perfectly aware of and is in the process of trying to address.
The public option isn't being thrown into the bill without massive debate and consideration. The main consideration is that of competition; if a public health plan has what tends to be seen as an infinite well of money to draw on, private insurance can't possibly hope to compete against it. This is a very valid concern and many of the parties involved have different needs and desires when it comes to the public option, all of which Cohn discusses, and you can be sure that each one of the groups -- which runs the political gamut -- has a lobbyist working on Congress to make sure their needs are addressed. Rather than shout "Nazi" or "down with socialism" or any number of ridiculous phrases that don't contribute to the debate at all, people should pay special attention to this segment of the broadcast so that we can have an intelligent national conversation about the very real and rational pros and cons of a public option (if it ever makes it into the bill -- at the time of this broadcast it was still in consideration).

There are parts of this reform being proposed that no one is discussing that are really interesting.
Take doctors and their stake in this, for instance. When most people picture doctors they picture a wealthy guy getting rich off of as many procedures that he can make his patient go through. But the truth of the matter is, Cohn says, doctors graduate from many years of schooling with massive amounts of student loans to pay off. Their practices need to pay off these loans, and it's far more profitable for them to go into a specialty line of medicine than to go into family care since family care pays so little relative to the rest of the medical profession. One of the ideas being bandied about in this health care reform is the idea of giving doctors more incentive to go into family care by offering some kind of student loan forgiveness. Having more qualified doctors in family care can only be better for our health care system overall. And this was only one aspect of how doctors may be directly affected by the proposed health care reform that Cohn discussed.

The best part of the broadcast is when Gross brings up each player in the debate -- hospitals, doctors, the AMA, and more -- and asks Cohn to discuss what that group wants in health care reform, what they don't want, and how the proposed legislation will affect them. It's a fascinating look at all sides of the issue.

The rest of the series is spread out over different time periods, but you can easily find them if you browse the August and July Fresh Air archives. In another engrossing episode, Gross talks to two economists, one on the left side of the spectrum and one on the right, and both discuss the economics of the proposed health care in a rational way.

So please, take a listen. Especially if you're one of those awful townhall attendees. But I personally don't know any of those people. Thank God for that.

08.03.09 :: our alpacas: their personalities

I've always enjoyed being a student of animal behavior. To me, having two cats in the house is more than having a couple of companions who like to shed and get underfoot, it's also having a mini animal behavioral lab right there to study every day. I'm fascinated with Cesar Milan's books and his astute observations of the canine condition. So in addition to the main reasons, having alpacas is yet another way to study the myriad ways that animals behave with both us and with one another.

Now that our boys have been here at their new home for just under a month we've had a chance to really observe them and see how they're getting used to the new digs, and also how their relationships with both us and each other are playing out. That's been really fun and there have been some interesting developments compared to our expectations of how they'd behave.

At their previous home, Cinnamon and Benz were quite used to each other having grown up together and having spent a lot of time in the pasture together. Silverton, on the other hand, had been relegated to the goat pasture -- despite having been gelded, he still wanted to bed all the ladies and fight all the boys, so he simply couldn't get along with anyone (well, I'm sure he thought he was getting along with the ladies, but it sounded like they were getting just a little tired of his constant advances).

When we decided which alpacas we were most interested in, we knew that Cinnamon and Benz would be the easy choice: as 4-H animals they were highly socialized with people as well as with each other. But we were also interested in Silverton -- his fleece was just lovely and he was so unique-looking to me. But we worried about whether or not he'd be able to get along with the other two boys given his bad boy reputation. So we asked Don and Jody about it and they decided to put the three boys with each other to see how they'd do. And it turned out they did just fine. Apparently Silverton's time with the goats had curbed his bad boy ways and he was learning to get along with his fellow alpacas.

Being that he's the oldest and had the reputation of being the pushiest, we assumed on bringing them home that Silverton was the natural herd leader. And mostly that has been the case: where he goes, the other boys follow. Silverton was also the first to do his alarm call when he saw something suspicious, and Don had told us that that's the herd leader's job.

To our amusement, however, Cinnamon has shown a tendency to be the bossier one and appears to be sharing herd leader duties with -- or stealing them from -- Silverton. We've noticed that about fifty percent of the time Cinnamon will decide to head off to a different part of the pasture and the other boys will follow. Benz appears to always be the swing vote, however. He's the most docile of the boys but appears to be the one who picks who to follow first. If Silverton walks off and Benz follows, the Cinnamon goes. If Cinnamon walks off and Benz follows, Silverton will follow. If Benz chooses to stay with the other one in either case, the first alpaca doesn't seem to go very far. Occasionally it will be Cinnamon who does the alarm call if there's something to be concerned about (like the housecat that they're absolutely sure is going to eat them, although they haven't been alarm-calling in several days for that).

At first Silverton was clearly the loner of the group, probably because he'd been so used to being with the goats before. Cinnamon and Benz frequently spent their time close to each other while Silverton was content to be several feet away. Initially at feeding time Cinnamon and Benz crowded each other while Silverton kept his distance, having to be enticed to come any closer for food. Whenever people came into the pasture Cinnamon and Benz naturally walked up but Silverton would stay away, his head up with extra alertness.

But since they've been here the dynamic has gradually changed in interesting ways. With only three of them I'm guessing that the small herd size has forced them to become closer socially. Benz and Silverton appear to be better buddies now: during their belly baths the other day the two of them stood side by side for a moment and then looked each other and then, to my surprise, touched noses in what seemed like a sweet gesture of social bonding. Being that I know very little about alpaca social dynamics I honestly don't know if that was the case -- it could very well have been a toe-to-toe stand off for all I know or it could have meant absolutely nothing, but it really didn't seem like that, especially since only a week or so before Silverton seemed genuinely concerned at Benz's well-being after Benz laid down in the sun and gently poked his nose into the side of Benz's face while humming. (Benz, however, was quite annoyed at Silverton for disrupting his nap.) Benz also seems to spend equal time sitting with both Silverton and Cinnamon now.

While Silverton has become sort of the hidden sweetheart of the group, Cinnamon has become bossier at feeding time. We've been feeding the three of them by hand so they can get used to us (rather than out of troughs in the barn) and Cinnamon is usually so busy lifting his head and making his pre-spit bossy face, moving back and forth between Silverton and Benz in an attempt to keep them both from eating what he clearly considers to be his food, that he forgets to eat himself. It's clearly all talk and no walk, however, as most days Benz and Silverton simply ignore him and keep eating. Some days Cinnamon gets a little spitty here (not the green cud spit that means he means business in keeping you away, but the puff-of-air spit that comes first as a warning) but we're told some alpacas are simply bossy. It's not genuine aggression -- that would mean biting and attempts at jumping on us, and these boys clearly aren't going to be doing any of that. Cinnamon strikes us more as the playground bully trying to steal your lunch out of your hand. Unsuccessfully, really. He only really shows this bossiness at feeding time and it's always directed at the other two boys, never at us. Occasionally I see him lifting his head and making his bossy face at the boys in the pasture when they're eating closely together or when they're standing close together during belly bath time, but it always looks pretty half-hearted. They don't even wrestle each other, really.

We do find we need to gently push back on Cinnamon occasionally during feeding time. Sometimes I feed them by myself and sometimes I wait until Matt gets home, and if I'm by myself it can be hard to feed three alpacas with only two hands. I usually grab a scoopful of food and get two handfuls first for Benz and Cinnamon since every time they eat those two act as if they'll never see the feed again. Cinnamon does his bossy face, occasionally spitting air, and then finally figures out that Benz is still eating and so, hey, he'd better eat, too. He's willful enough that he tends to crowd me if I feed them by myself -- the other day I found myself backed up against the barn wall with Cinnamon showing no signs of backing up. So I've started to take a firm but gentle hand with him at feeding time: I take my arm and slowly push back against his neck, forcing him to back up, when he crowds me a little too much. It seems to work for at least a few seconds, then he's back again, making his bossy face. It's pretty funny.

Silverton, showing his emerging sweetheart side, is frequently content to wait his turn. Up until recently I usually had to reach past the other boys to try and get him to eat out of my hand, at which point he'd very cautiously crane his neck, grab some food, and then scuttle back again. If I had to push Cinnamon out of the way Silverton used to get a little spooked and jump back. Lately, though, this no longer fazes him and he uses it as a chance to get closer so he can actually eat. And the other day he even took a bolder step: I crooked the scoop in my right armpit and fed Benz and Cinnamon out of my hands, and then turned to look and saw Silverton with his face buried in the scoop right in my armpit. The little bugger. It's been really fun seeing Silverton get more comfortable with us as he's been the most skittish. He's certainly not going to be letting us manhandle him easily any time soon, but it's been rewarding seeing him -- and really all three boys -- get more used to us being near them and touching them.

Benz is the biggest softie of the group. He's clearly the sweetest and most social, always coming up when new people show up. He frequently lets me walk up to him and stretch my hand out to scratch his chin, mainly because he's hoping there's food in my hand so he'll only let me do that for as long as he needs to determine that there is, in fact, no food in my hand and I have cruelly duped him. (Then he looks at me with those big, black-rimmed cow eyes as if to say, "why must you tease?") But at feeding time he'll usually stick around for a minute or two after the food's gone -- surely hoping for more -- and will tolerate a quick rub of his neck, always looking at us with those huge brown eyes as if to say, "you...wouldn't have any more food hidden in your pockets, would you?"

Because we don't have as much direct reason to physically handle our alpacas -- haltering them and leading them -- as larger operations would, we figure we should take time to do it occasionally for the sake of doing it for a couple of reasons: first, so that we ourselves get more comfortable haltering them for them times we do need it, like vet visits, toenail trimming time, etc., and secondly so that they get more comfortable with us handling them. So later today (when Matt's home to help me) I plan to start with Cinnamon and get him in the barn so I can halter him, check his toenails (they won't need trimming yet but I want to look), and walk him for a little bit on the lead around the pasture. Maybe that will help curb some of his bossy ways. Let's hope I don't get spit on.