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Steve Herzfeld managed an admirably inventive end-run around high healthcare costs for his Parkinson's- and Alzheimer's-afflicted parents. After in-home care was no longer possible, he priced American nursing homes, but found that the cheapest acceptable option was still $6,000. So he sent them to India. Quality elderly care in Puducherry cost less than his father's fixed income. According to the Guardian:

[In India, Herzfeld] could give his parents a much higher standard of care than would have been possible in the US for his father's income of $2,000 (£1,200) a month. In India that paid for their rent, a team of carers—a cook, a valet for his father, nurses to be with his mother 12 hours a day, six days a week, a physiotherapist and a masseuse—and drugs (costing a fifth of US prices), and also allowed them to put some money away...."In India, they really like older people," says Herzfeld, describing how the staff seemed to regard his parents as their own family.

Of course, the care was inexpensive because a couple thousand bucks goes further in Puducherry than it might in, say, Fort Lauderdale. Herzfeld, though, apparently believes that it was cheap because elderly care in America is greedily overpriced by providers. He vents about about healthcare and the profit motive: 

[Herzfeld] believes that India could teach the US and UK a lot about care of the elderly. "In America, healthcare is done for profit, so that skews the whole thing and makes it very inhuman in its values," he says.

I try not to begrudge a man his fantasies, but the idea that the nurses, valets, and masseuses of Puducherry were doing it all out of the goodness of their hearts—rather than the goodness of their paychecks—is condescending. It was simple outsourcing, not subcontinental altruism, that saved Steve Herzfeld so much money.

In Reason's May 2009 print edition, Ronald Bailey wrote about the outsourcing of hip replacement.

Increasingly, I suspect the medium is the problem. The cocooned echo-chamber of shock jocks takes what might have been conservatism and turns it into some ghastly expression of contempt for others unlike themselves. It's easy to see how this kind of attitude can embrace torture, because the victims of torture have essentially ceased to be human beings in the rhetoric of the base-right. The suspects are held at such a distance from being like us that we can do anything to them we want. And, as the rhetoric worsens, the targets are now vulnerable children. From a May 28th segment of KRXQ 98.5 FM Sacramento's Rob, Arnie, & Dawn in the Morning:

Williams and States took turns referring to gender dysphoric
children as "idiots" and "freaks," who were just out "for attention"
and had "a mental disorder that just needs to somehow be gotten out of
them," either by verbal abuse on the part of the parents, or even shock
therapy.

"Allowing transgenders to exist, pretty soon it becomes normal to fall in love with the animals," they said.

For his part, States bragged that if his own son were to ever dare
put on a pair of high heels, States would beat his son with one of his
own shoes. He urged parents whose own little boys expressed a desire to
wear a dress to verbally abuse and degrade them as a viable response.
"Because you know what? Boys don't wear high heel shoes. And in my
house, they definitely don't wear high heels.

"I'm going to go, 'You know what? You're a little idiot! You little dumbass!'"
States sneered, adding later, "I look forward to when [the transgender
children] go out into society and society beats them down. And they
wind up in therapy."

Tom Goldstein of SCOTUSblog studies Sotomayor's abortion rulings:

Over the weekend, there's been a minor uproar over New York Representative Charlie Rangel's remarks about President Obama's visit to New York. When a reporter asked Rangel what Obama should do when he visits the city, Rangel replied, ?SMake certain he doesn?"t run around in East Harlem without identification.?

The remark was a reference to the killing of police officer Omar J. Edwards by fellow officer Andrew Dutton. Edwards was in plainclothes, and chasing after someone who was breaking into his car. He had his weapon out. Three other plainclothes officers arrived and yelled for them to stop. One, Dutton, shot Edwards three times as he turned around.

The thing about Rangel's joke is that he's not wrong: We're living in a country where a black man can be president but where black men are still so at risk of accidental violence from police that even black officers are concerned about it. That said, Rangel is a public official whose constituency includes some of the officers he was criticizing. It's his responsibility to make sure that when he does criticize the police, he does so in a respectful and constructive manner. His remark would have been appropriate for a comedian, not a congressman.

In the meantime, it's worth pondering the significance of such an event. There's no indication that Dutton harbors any special animosity towards black people -- rather, racial bias is so socially ingrained that we draw on our biases subconsciously, when we aren't even thinking. That kind of racism is a much greater problem than the forthright prejudice of yesteryear, which for the most part has become socially unacceptable.



-- A. Serwer

People are cutting back on lots of spending these days, but one area that was supposedly relatively safe was in-home entertainment expenditures. Things like cable and satellite TV and Netflix were thought to even thrive during economic downturns as people looked to limit going out, choosing instead to stay in and be entertained. While that seems to be working out for Netflix, cable companies are starting to feel the pinch as people drop their subscriptions and get their TV fix online. While it's a relatively small number of people that are making the move, it's the sort of thing that cable companies have been concerned about for a while. The WSJ story talks about some moves by the likes of Comcast and Time Warner to grab more online viewers, but if the cable companies continue to try and treat their online efforts in the same way as their traditional offerings, it's hard to see much success. It doesn't seem like a coincidence that this is happening as cable companies are looking to introduce caps on their broadband services. They say it's because some consumers are creating too much traffic, in part because of their online video viewing, and it's straining their networks. But perhaps it's just a way to try and capture lost TV revenue from cord-cutters? Of course, trying to get users who are going broadband-only for their TV to take on metered broadband seems like a good way to drive them to competitors with uncapped plans.

Carlo Longino is an expert at the Insight Community. To get insight and analysis from Carlo Longino and other experts on challenges your company faces, click here.

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The plans you are discussing embody my core belief that Americans should have better choices for health insurance, building on the principle that if they like the coverage they have now, they can keep it, while seeing their costs lowered as our reforms take hold. But for those who don't have such options, I agree that we should create a health insurance exchange -- a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.

By plunging into the details of the reform rather than cheering from the sidelines, as he has done for months, Obama raises the political stakes for the summer?"s big legislative battle, and will hearten liberals who have yearned for his intervention to put a public sector option on the table.

We are thrilled to see President Obama's strong, unambiguous commitment to reform that includes the choice of keeping private health insurance or joining a new public health insurance option. The choice of a new public health insurance plan is the only way to control costs, guarantee coverage, ensure quality and transparency, and set a benchmark by which patients will know whether their private health insurance is truly giving them what they're paying for.

There is tremendous unity among President Obama, key committee leadership in both the House and the Senate, the broad coalition represented by Health Care for America Now, and the American people for reform based on the choice of private or public health insurance plans. It is now clearer than ever that this choice will be a fundamental part of the reform sent to the President's desk this year.