Wednesday, February 27, 2013

Rock and Not a Hard Place

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Tuesday, February 26, 2013

Nice Work If You Can Get It

And I got nothing. No really nothing but a lump of coal in my last paycheck thanks to the rise in Payroll Taxes. But then again I actually get a Paycheck. When you are in the big leagues it doesn't actually work like that.

And the same old canards return.  "We have to pay these people this money or they will go elsewhere."  Not there is any elsewhere to go thanks to the shuttering of hedge funds and consolidation of banks and industry but hey stick with the speech. And the other  "we have to let people go thanks to the new regulations"- you know those ones  that no one is actually enforcing or are right now being decimated by their dear friends in Congress,  but let's go with that too. With all that money they could hire better writers, I mean they hired perfectly good Legislators.. geesh.

Wall Street Pay Rises, for Those Who Still Have a Job


It’s nice work – if you can get it.

Wall Street has cut thousands of jobs over the last year or so. On Tuesday, JPMorgan Chase, one of the country’s biggest banks, announced that it was eliminating 4,000 more jobs through layoffs and attrition, adding its name to a string of large banks that continue to cut jobs to reduce expenses.

The good news? For the employees who remain, pay is up, according to a report released Tuesday by the New York State comptroller.

This may seem surprising given the outcry over high compensation during the financial crisis. In recent years, however, faced with greater regulation, a slow economic recovery and the loss of once big moneymaking businesses like selling products tied to mortgages, the banks have tried instead to cut people rather than pay, which they argue is needed to retain talent that might otherwise leave for better paying jobs at hedge funds or elsewhere.

The average cash bonus for people employed in New York City in the financial industry rose by roughly 9 percent, to $121,900, in 2012 and cash bonuses in total are forecast to increase by roughly 8 percent to $20 billion this year, said Thomas P. DiNapoli, the state’s comptroller.

In recent years, some firms have deferred cash payments to employees, and Mr. DiNapoli said part of the increase in 2012 was cash promised in recent years but actually paid out last year. He said that it was “tough” to break out what percentage of the total were deferrals, but he believed that it was still a small part of the total.

All told, the average pay package for securities industry employees in New York was $362,900 in 2011, the last year for which data is available, almost unchanged from 2010.

Wall Street jobs are harder to get than they were just a few years ago, but for those who can get their foot in the door, finance remains the best paying sector in New York City, Mr. DiNapoli told reporters during a conference call

“Profits and bonuses rebounded in 2012, but the industry is still restructuring. Despite its smaller size, the securities industry is still a very important part of the New York City and New York State economies,” he said.

The current economic recovery, he said, is being driven by industries other than Wall Street, which he said has regained only 30 percent of the jobs lost during the downturn. The securities industry in New York City lost 28,300 jobs during the financial crisis and has added only 8,500 since, a net loss of 19,800 jobs. New York City financial industry employment totaled 169,700 at the end of 2012.

Before the start of the financial crisis, business and personal income tax collections from Wall Street related activities accounted for up to 20 percent of New York State tax revenue. In 2012, that contribution fell to 14 percent.

“Wall Street is still in transition, but it is very slowly adjusting to changes in its economic and regulatory environment,” he said.

Designing for Dummies

I think we overlook the power of design and its impact and need on on our Community, both its extrinsic and intrinsic qualities.

As I spend the last few weeks looking at the designs of fashion, from New York to Paris to Milan, the idea of how clothing is an art and a powerful aesthetic of its own expression for both creator and wearer.  It truly does take two to make that one work.   Some things look good on the hanger but not the body and sometimes its how its worn that makes the garment alive.

I love clothes, nothing says being an advocate of sustainability means giving up your passions and I love clothing. Its an expression, its a costume, it evokes a mood, a presence, a sense of purpose, whimsy or just glamour.  Yes its in the eye of the beholder and at times it seems superficial and artificial but done with care and honesty to one's self and one's pocketbook, having a personal signature is more than something on a page on which you sign.

Design is in our buildings, inside and outside.  Sometimes looking out from within makes one reflect more on what surrounds us than what envelopes us.  The interior is as essential as the exterior in those buildings that you place a premium - both work and home.  There is no way one's mood, one's thoughts, one's efforts are not influenced by what surrounds us.  You cannot be unaffected by that which you spend the most time.

I walk through neighborhoods much the same way I walk through Museums. I stop to look at house, a garden or simply a business to see if it explains something, tells a story or simply is pleasing to the eye.  Beauty again in the eye of the beholder and like our taste in clothing its personal and it is entirely our own.

I read this article a couple of weeks back on design and its called "Why We Love Beautiful Things."  We all define beauty as we do sustainability.  Our meanings our, experiences, our culture, our influences and other extrinsic factors have all had some element in what and how we come to recognize beauty.

Stop and smell the roses and you may find that there is no scent. Are they less beautiful? Design may have something to do with that.

Why We Love Beautiful Things


Published: February 15, 2013

GREAT design, the management expert Gary Hamel once said, is like Justice Potter Stewart’s famous definition of pornography — you know it when you see it. You want it, too: brain scan studies reveal that the sight of an attractive product can trigger the part of the motor cerebellum that governs hand movement. Instinctively, we reach out for attractive things; beauty literally moves us.

Yet, while we are drawn to good design, as Mr. Hamel points out, we’re not quite sure why.

This is starting to change. A revolution in the science of design is already under way, and most people, including designers, aren’t even aware of it.

Take color. Last year, German researchers found that just glancing at shades of green can boost creativity and motivation. It’s not hard to guess why: we associate verdant colors with food-bearing vegetation — hues that promise nourishment.

This could partly explain why window views of landscapes, research shows, can speed patient recovery in hospitals, aid learning in classrooms and spur productivity in the workplace. In studies of call centers, for example, workers who could see the outdoors completed tasks 6 to 7 percent more efficiently than those who couldn’t, generating an annual savings of nearly $3,000 per employee.

In some cases the same effect can happen with a photographic or even painted mural, whether or not it looks like an actual view of the outdoors. Corporations invest heavily to understand what incentivizes employees, and it turns out that a little color and a mural could do the trick.

Simple geometry is leading to similar revelations. For more than 2,000 years, philosophers, mathematicians and artists have marveled at the unique properties of the “golden rectangle”: subtract a square from a golden rectangle, and what remains is another golden rectangle, and so on and so on — an infinite spiral. These so-called magical proportions (about 5 by 8) are common in the shapes of books, television sets and credit cards, and they provide the underlying structure for some of the most beloved designs in history: the facades of the Parthenon and Notre Dame, the face of the “Mona Lisa,” the Stradivarius violin and the original iPod.

Experiments going back to the 19th century repeatedly show that people invariably prefer images in these proportions, but no one has known why.

Then, in 2009, a Duke University professor demonstrated that our eyes can scan an image fastest when its shape is a golden rectangle. For instance, it’s the ideal layout of a paragraph of text, the one most conducive to reading and retention. This simple shape speeds up our ability to perceive the world, and without realizing it, we employ it wherever we can.

Certain patterns also have universal appeal. Natural fractals — irregular, self-similar geometry — occur virtually everywhere in nature: in coastlines and riverways, in snowflakes and leaf veins, even in our own lungs. In recent years, physicists have found that people invariably prefer a certain mathematical density of fractals — not too thick, not too sparse. The theory is that this particular pattern echoes the shapes of trees, specifically the acacia, on the African savanna, the place stored in our genetic memory from the cradle of the human race. To paraphrase one biologist, beauty is in the genes of the beholder — home is where the genome is.

LIFE magazine named Jackson Pollock “the greatest living painter in the United States” in 1949, when he was creating canvases now known to conform to the optimal fractal density (about 1.3 on a scale of 1 to 2 from void to solid). Could Pollock’s late paintings result from his lifelong effort to excavate an image buried in all of our brains?

We respond so dramatically to this pattern that it can reduce stress levels by as much as 60 percent — just by being in our field of vision. One researcher has calculated that since Americans spend $300 billion a year dealing with stress-related illness, the economic benefits of these shapes, widely applied, could be in the billions.

It should come as no surprise that good design, often in very subtle ways, can have such dramatic effects. After all, bad design works the other way: poorly designed computers can injure your wrists, awkward chairs can strain your back and over-bright lighting and computer screens can fatigue your eyes.

We think of great design as art, not science, a mysterious gift from the gods, not something that results just from diligent and informed study. But if every designer understood more about the mathematics of attraction, the mechanics of affection, all design — from houses to cellphones to offices and cars — could both look good and be good for you.

One Acronym for Another

I was perusing my online copy of ED+C, the online journal for LEED professionals.  And of course I see the title "Department of Defense says LEED saves tax payer money." Okay really? The skeptic in me of course thought I need to read this study and see if that is true. And as always the devil is in the details and the one detail they left out was well the details.

The overall study summary is below and no, LEED is not the panacea to the DOD taxpaying saving be all end all. That actually might come from the newest cliff, the sequestration, that pushes them into some budget cutting on their own.  Or they might try less wars.  That works too.

I have noted what I think was the essential point of the study was.. and that was more study needs to be done.  Well this is the Government and the endless conversations and studies are what they do best. Doing not as much.

But ultimately is what needs to be studied are the costs and the time frame that following a prescriptive path from a third party entity is adding to the overall costs of the project and are not being returned in ways that do in fact benefit the tax payer. If the information and knowledge and the ability to actually build and maintain a property without costly certifications exist than that too must be included as an option worth pursuing.  

Undoubtedly the tax credit is not applicable in Government buildings so what is the point exactly? 

DOD Should Continue to Require LEED-Silver or Equivalent Rating for Major Building Renovations and New Construction

WASHINGTON -- The U.S. Department of Defense should continue to require that its new buildings or major renovations to facilities be designed to achieve a LEED-Silver or equivalent rating, says a new report from the National Research Council. Based on a review of empirical studies related to energy-efficiency and green building standards, the report concludes that green building certification systems such as LEED offer frameworks for successfully reducing energy and water use in buildings.

The Energy Independence and Security Act of 2007 requires federal agencies to use a green building certification system for new construction and major renovations of buildings. One of the most commonly used systems in the U.S. are the Leadership in Energy and Environmental Design, or LEED certifications, developed by the U.S. Green Building Council. Buildings can qualify for four levels of LEED certification -- certified, silver, gold, or platinum.

DOD established a policy in 2010 that new construction and major repair and renovation projects be certified at least LEED-Silver or its equivalent. In 2012, Congress requested a report from DOD on the energy-efficiency and sustainability standards used for military construction and major renovations of buildings. The DOD's report must include cost-benefit analysis, return on investment, and long-term payback for the building standards related to energy use and high-performance buildings and for the LEED and equivalent green building certification systems. To obtain independent, objective advice in developing the response to this congressional request, DOD asked the National Research Council to conduct a review of the existing literature

The committee that wrote the report found that DOD's current policy is sound, although not every high-performance or green building will have significant energy and water savings -- even if it is certified at a LEED-Silver or equivalent rating. The research studies did not provide sufficient evidence to draw generalizations as to why, but building type as well as the specific technologies employed to reduce energy or water use were factors.

DOD should establish practices to evaluate its high-performance or green buildings after construction to ensure that objectives are met, performance continues to improve, and the measures required to reduce levels of energy and water use are cost-effective. Specifically, for all new construction and major renovations, DOD should measure actual performance for at least three years after initial occupancy and use the resulting information to modify its policies as needed. In addition, data for conventional DOD buildings should be gathered to establish baselines for performance measurement. The report also recommends that DOD retain the flexibility to modify building standards and the application of green building certification systems in ways that are appropriate to the department's operating environment and mission

Using an investment approach that looks at the total cost of lifetime building ownership with the full range of benefits and expenses will also aid in decision-making about investments in DOD buildings, the report says. This approach would account for variations in geographic conditions, climate, type of building, and local prices for energy, water, and other utilities. To be effective, however, DOD will need to ensure that the data used in the analysis are accurate and reliable.

Because high-performance or green buildings incorporate integrated design practices and new technologies, facilities managers will need to be trained to understand how to operate them effectively. Implementation of the Federal Building Personnel Training Act of 2010 should help ensure that DOD facilities managers are certified in the required competencies and skills, the report says.

The study was sponsored by U.S. Department of Defense. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. They are private, independent nonprofit institutions that provide science, technology, and health policy advice under a congressional charter granted to NAS in 1863. The Research Council is the principal operating agency of the National Academy of Sciences and the National Academy of Engineering. For more information, visit A committee roster follows.

Who Needs Food?

Ironically on the weekend of the celebration of the wealthiest in America, I watched Moyer's & Company discuss the non-living wages of the food service industry. The irony that the very people who prepare and serve your food cannot afford to feed themselves is another example of how our system is broken and in need of repair. I urge you to watch the whole show as it discusses the issues surrounding our free market system and what it has done to lowest on the rung of our ladder to nowhere.

Then we have this article below which shares the fact that for those doing the work and selling the product, the tools one needs to lose weight and be healthy are rewarded not with Dancing With the Stars appearances or tickets to the Oscars, but minimum wage. Good thing they lost weight as eating might become an option.

The amusing note was that immediately adjacent to this article was the one discussing the Meditteranean diet and its postive affects on both reducing one's risk of heart attack and stroke. Ah those Greeks, shame about their economy but their health is good. Maybe if they packaged it up as some type of program they could reduce their fiscal debt.  They could make a new movie "My Big Long Life Healthy Diet Greek Wedding".. hmm might have a problem on the marquee.
Weight Watchers has the same resonance of Mary Kay Cosmetics, Avon, Herbalife, Tupperware and other programs that use pyramid schemes to play on the dreams and aspirations of those looking to make a living from sharing their love and passion for health, beauty or whatever has made an improvement in their life.  Sadly that improvement comes at a cost as in debt or wages unearned.  To exploit people who are your biggest cheerleaders, your loudest voices is an oxymoron.  It defeats the purpose and in our age of branding, it damages it. But hey doesn't Jessica Simpson look great!

This is what our economy has become. Two tier, two class. We have those at the top of the run who we celebrate and in turn cater more than food to and those who are routinely ignored.  It is no shock that its largely professions dominated by Women and People of Color, who we assign the most significant of roles in this world where the extraneous identity dominates when suited - wife, mother, sister, brother, father, husband - and ignored and blamed when it does not.  Suits are not just uniforms one wears or applies to delineate success and happiness. You can wear a uniform and still wear it well and with pride. And it also means you should be duly compensated for it.

Low Pay at Weight Watchers Stirs Protest as Stars Rake It In
Published: February 25, 2013

Tammy Williams became a Weight Watchers leader in Texas five years ago after losing 97 pounds in the program. The supplies that she handles fill a bedroom in her home, and she holds four meetings a week advising more than a hundred customers about the diet regimen.

The problem, Ms. Williams said, is that she works so many hours and is paid so little. “They know my love for the program, but I can’t say we’re treated right,” she said. “We are professionals, we have to dress nice, but we are paid less than kids who work at McDonald’s.”

As the highly competitive weight-loss industry continues to suffer from the sluggish economy — Weight Watchers reported a 15.6 percent decline in earnings last year — hundreds of its rank-and-file workers are waging an open rebellion that management is scrambling to address.

This frustration reflects a growing discontent among low-wage workers, as seen in the recent protests at dozens of Walmarts, at high-end retailers in Chicago and at fast-food restaurants in New York. Low-wage workers have become more assertive out of dismay that while corporate profits have rebounded to record levels since the recession, wages have floundered.

Many also feel trapped as the gap between haves and have-nots has widened. Some employees at Weight Watchers expressed irritation at being paid the minimum wage while the company lavishes millions of dollars on celebrities like Jessica Simpson and Jennifer Hudson to advertise its weight-loss program.

Executives at Weight Watchers say they are paying attention to their employees’ concerns, and have hinted they will increase compensation.

The company’s chief executive, David Kirchhoff, wrote to employees earlier this month, saying, “One of our top priorities is to improve your working life at Weight Watchers, and in particular, the way we reward you for the incredible work you do.”

Employees — many of them leaders like Ms. Williams who run meetings — have inundated an internal company Web site with complaints about poor wages and being pressured to work many hours unpaid.

Some leaders say that the $18 base rate for running meetings has not increased in more than a decade, and many complain that they receive no mileage reimbursement for the first 40 miles driven each day. Some also assert that a major reason Weight Watchers keeps its pay so paltry is that the overwhelming majority of its employees are women.

“We are not working for a charity or a nonprofit corp,” one Weight Watchers leader posted on the Web site. “This is a multimillion-dollar company with enough cash to advertise relentlessly on TV, and pay celebrities tons of money to lose weight.”

The restlessness over low pay extends across the weight-loss industry to Weight Watchers’ rivals, including Jenny Craig and Nutrisystem. A pending lawsuit asserts that Jenny Craig’s employees in New York State typically work through their lunch hour, but are not paid for that time — a claim the company denies. That comes after Weight Watchers reached a $6.2 million settlement two years ago to end a class-action lawsuit in California in which employees complained about minimum wage violations, off-the-clock work and receiving paychecks that did not explain how wages were calculated.

”People feel they did everything right. They’re working hard, they have higher levels of education than ever before, and they find the job market is offering them a wage that they can’t live on,” said Janice R. Fine, a professor of employment relations at Rutgers University.

For Weight Watchers, one of the world’s oldest and largest dieting companies, keeping its leaders happy is crucial to the company’s future, because it relies on them to recruit and retain members through the nearly 50,000 face-to-face meetings the company runs each week worldwide.

The leaders, often highly educated professionals who were hired after losing dozens of pounds in the program, sometimes sound like religious disciples, so eager are they to help others lose weight.

But their disillusionment over compensation is not unique to their industry. Sharon H. Mastracci, an expert on women’s employment at the University of Illinois at Chicago and author of “Breaking Out of the Pink-Collar Ghetto,” said these complaints parallel those in other fields with mostly female workers, like child care and social work.

“It’s a female-dominated job, it’s in the service industry, and it’s caring work,” Professor Mastracci said of Weight Watchers. “Caring work is undervalued, and they’re taking for granted that you care so much you’re going to be there no matter what.”

The appeals for higher pay come at a difficult time for Weight Watchers; its earnings slid last year to $257.4 million on slightly higher revenue of $1.83 billion. It forecasts lower earnings this year because of problems recruiting new members to its meetings. Members pay $42.95 a month on average to belong to the program.

Mr. Kirchhoff, who made $2.96 million in 2011 according to Forbes magazine, wrote that revamping the compensation system was complicated and would “require careful consideration.” In a second note, last Wednesday, corporate leaders said they would begin online discussions with 80 employees about the “changes and enhancements” they are seeking.

Stacie Sherer, the company’s communications director, said a large majority of employees earned “significantly more than minimum wage” for their meetings through sales commissions. She dismissed the notion that pay levels were low because most employees were female.

Kelley Brickfield, a leader in Tampa, also defended the company, saying she liked being able to increase her pay through sales commissions. She praised it for having a better benefits package than many other companies.

But Ms. Williams complained that she was paid just $7,600 last year for leading four meetings a week in Wichita Falls, Tex. She receives extra pay as a local coordinator and commissions for selling company products like recipe books, scales and smoothie mixes.

While the company pays for two and a half hours of work to run a meeting, Ms. Williams, who is planning to quit, said it could take three hours or more to set up chairs, weigh in members, give talks, sell products and clean up. (For meetings that attract 50 or 60 members, several leaders said that they received around $60 instead of the $18 base rate, and that receptionists for meetings received a base rate of $12 before commissions.)

Like many leaders, Ms. Williams said she worked many hours unpaid — ordering products, delivering them to meetings, counting and banking the money collected, and preparing her remarks for meetings.

“We’re bankers, we’re storehouses — it’s unduly burdensome,“ said Patricia Sorlien, a Weight Watchers leader outside Seattle. “All of us are highly skilled or we wouldn’t be leaders, yet for the most part we are paid the minimum wage.”

Teri Weatherby began leading meetings in Hartford, Conn., after retiring from her job as an insurance company’s senior vice president. “Other than the financial problems, it’s probably the most rewarding thing I’ve ever done,” she said. “That’s what they prey upon. It’s like an abusive relationship. You know you should leave, but you stay because you love it.”

Grade F for Failure

I have no belief our ailing diseased Medical Industrial Complex will be fixed any time soon. It is so broken, so corrupt, so without a clear plan, leadership and a willingness let alone ability to repair itself I fear everyday that getting sick in America means actually needing or having to use it and not ever coming out of it well again.  If not for the disease borne illnesses that simple hygiene could eliminate, we have upgrading, down grading, no grading at all between the players of the game.

Meaning that on that team its as if there is no Quarterback, Team Captain or Manager to call the shots, make the plays and in turn there are none willing or able to follow the orders to do so.  At least the Captain of the Titanic went down with the ship, I am afraid most Medical providers would push you off in order to bail out first. Lifeboats and Life Preservers should be issued at admit for all patients when you enter the Hospital.

There are many tests coming up in the months ahead to see how well this ship is planning to sale, from the mandatory insurance enrollments, to pay on demand not on supply, to the use of online medical records to expedite care and in turn cost reduction. Yes and this will happen when pigs fly.

Already we have more loopholes than the tax code to somehow reign in costs. There are Self Insurance Markets that will enable companies to actually insure employees to the bare minimum. It is a type of Catastrophic Care policy, the kind I used to posses and no longer as that type of policy puts the bare into minimum.  What this coverage does is instead of paying premiums to insurers, they pay claims filed by employees and health care providers. To avoid huge losses, they often sign up for a special kind of “stop loss” insurance that protects them against very large or unexpected claims, say $50,000 or $100,000 a person.

And in turn,  Stop-loss insurers can and do limit the coverage they provide to employers for selected employees with medical problems. S top-loss insurance companies are generally free to reject less healthy employer groups because they are not subject to the same restrictions as health insurers. As a result, companies with less healthy work forces may find self-insuring more difficult.  Meaning companies will continue or not hire those aging Boomers that are now perceived as causing this whole problem in the first place.  Our demands and of course health actually hitting a nadir and of course windfall of profit for the MIC has nothing to do with it.

And that is becoming now a charming enticement to avoid that whole mandatory thing that is coming down the pike and in turn that means more wage declines as companies will say that is a compensatory benefit.

And in the meantime if you do have insurance if there is no one to provide you with care then what? Yes we are facing numerous shortages of legal and trained Medical professionals, such as Doctors who don't want to live in Mayberry when they can live in New York charge outrageous fees and recoup some of their six figure loans they needed in order to "help people and save lives" are not. The panel established by the Affordable Care Act was to include a panel to ensure that this need is met but alas no, anything with Obama and/or care in the name is duly ignored by Congress

Added to that is the new requirement, vague but still there, the one that insurers cover mental health issues.  That one I can see as very needed in the dysfunction junction. But again if there is no one there to hear you scream, are you heard at all.

And last but not least, again there is no one at home to watch the kids so what happens. Without clear oversight, without clear regulations, leadership and enforcement expect the unexpected as in nothing.   And we have the conflicting message akin to the singles on the Bachelor with one minute saying no to Medicare funding and then 5 minutes later saying yes,  as they need to expand their health care rolls and meet the obligation that the ACA places on the population.  Then in turn, States right now are scrambling to figure out if they are good enough to go on the final 3 dates, where apparently it is in Mexico, where they are learning to cliff jump.  We have been on so many cliffs of late I think of the Mexican cliff divers might just show them how its done.

And last but not least the role of costs. As discussed in my blog the 10K Asprin, CNN has joined the fray and covered another family awash in medical debt. And the simple gross profit margins that dictate costs and in raise costs.  The 10K aspirin.  These cliffs have deep pools. 

Houston we have a problem and its bigger than us all.  And who will save us? NASA can't anymore it has its own budget problems.  And the free market? Its broken too. Just don't tell the rich. 

Monday, February 25, 2013

American Woman

Since the new spokesperson for the American Woman is now Sheryl Sandberg of Facebook, I suggest she use her connections to turn her Lean In group into a Lobbying group for the American Woman. As this war continues and those of us on the front line could use the new General to rally the troops.

I had coffee yesterday and encountered a woman who lives in Portland and she was here to see and meet those who had gotten the Sick Leave Act of Seattle passed.   She and her group want to do the same in Portland. She had her son with her and was trying to juggle all the roles of "wife" "mother" that our President and the Mrs. President seem so proud of acknowledging.  Since I am no one, no one's wife, no one's mother, so one's sister, no one's daughter I am expendable and ignorable. Yes its good to be invisible then no one knows when you are gone.

We lamented that there are few local branches of once powerful national voices for women, such as NOW. The other complaint is that there are so many groups diversified and of sole issue that if they were consolidated and collaborative they might have a more significant impact. With the divisiveness and exclusivity of each competing group for both bodies and monies, you get less done with less.

I have long written that all Rights are HUMAN rights. That the voices of women are not different than the voices of the LGBT community, the Immigrant community and the faces of Color. But divided we stand and united we are not. Until we realize that in numbers there is safety, there is a voice and we have a much more powerful and louder one, I don't see this changing any time soon. 

So my voice is not heard but its not heard because I don't have a Billion dollar check to proffer. Frankly when you have no support system other than your own when you are on your own, the presumption that the Government will supplement that role and be your advocate in those times of need. So until it becomes your NIMBY you stay safely behind the fence.

Ever try to apply for Social Security Disability Insurance, Food Stamps, Housing Aid or assistance of any kind on your own?   I have met more people of late, and of both gender, who find themselves on the brink of homelessness or bankruptcy in their efforts to restore their lives, their health and their place in society when trying to navigate the rough waters of our varying State and Federal agencies.  By the time and if the time comes to actually get help its often too late to do good and often ends up putting you into a further life of dependence and insecurity, meaning what should and could be temporary becomes life long.  Not the intent nor the purpose, our system is so broken and damaged that unless it changes soon, expect more to hit those "welfare rolls" that the We Built It nation profess to despise.

American woman is not the CEO's the CFO's of major corporations, the board tables they sit at are not in the Executive Suite and the titles they carry and the budgets they analyze and the staff they manage are much more intimate, smaller and are the crux to our Society.  The system is not sustainable and if it is not sustainable then the small picture eventually affects the big picture.

Do you get the picture? I do and this Polaroid is not fully developed but its not a pretty one.

We are a Nation that loves to inform the globe about the American way of life and Democracy but we neglect to mention here at home that is largely a falsehood and is game of smoke and mirrors.

Below is an article discussing how our Family leave act is one we are in desperate need. And ironically the one company that actually realized that is Google, the former home and business (pun intended) for the current Real Housewife of Facebook.  Odd that they lead the Nation and the nation has not yet followed, leaned or or even acknowledged the problem. But then this is a Nation that let the Domestic Violence Act Against Women lapse. We are disposable, be us with one or in my case even no one.  Lean in and act Ms. Sandberg or simply just sell your crap like Tupperware to the house next door.

In Paid Family Leave, U.S. Trails Most of the Globe


Published: February 22, 2013

There I was, on the day my six months of maternity leave had ended, pushing my son’s stroller with one hand, clutching a jumbo box of 174 diapers with the other, doing my best to navigate through piles of slushy snow.

It was time for his first day of day care, my time at home over in a blink.

Still, I knew I was relatively fortunate. The first eight weeks of my leave were paid, and I had tacked on another three weeks of paid vacation. Plus, my employer permits workers to take up to six months of unpaid leave.

A large majority of new parents in this country are not so lucky. It is no secret that when it comes to paid parental leave, the United States is among the least generous in the world, ranking down with the handful of countries that don’t offer any paid leave at all, among them Liberia, Suriname and Papua New Guinea.

The American situation hasn’t materially improved since the landmark Family and Medical Leave Act was signed into law 20 years ago this month by President Clinton. The law requires larger employers and public agencies to provide up to 12 weeks of unpaid leave — as well as continuation of health benefits — for the birth or adoption of a child, or to care for an opposite-sex spouse, a parent or a child who has fallen ill (or to deal with your own health problem).

But about 40 percent of workers fall through the cracks because the law only requires many companies with 50 or more employees to comply. To get the benefit, employees must also have worked for the company for at least a year and logged 1,250 hours within the last 12 months. And lots of people simply cannot afford to take unpaid leave.

“This was really intended as a first step,” said Vicki Shabo, director of work and family programs at the National Partnership for Women and Families, referring to the law, which the group helped write. “People really see this as an individual struggle that they need to be responsible for rather than the societywide, systemic issue it is.”
But expanding the policy’s reach has been painfully slow. Some states have taken it upon themselves to bolster the rules and now cover a broader swath of workers or provide some paid leave. And companies that tend to work the hardest to lure employees, including Google, have gone much further to fill in the governmental gaps. (The Bucks personal finance blog will begin to track companies’ parental leave policies. So please let us know about your employer’s rules in the comments section.)

Despite the myriad benefits of paid leaves, the number of employers that offer the time off is dismal. “We know maternity leave is associated with lower infant mortality rates,” said Jody Heymann, dean of the Fielding School of Public Health at the University of California, Los Angeles, and author of the new book “Children’s Chances: How Countries Can Move From Surviving to Thriving.”

She added: “This makes sense. As well as receiving more one-on-one care, infants are more likely to be breast-fed, which lowers illness and hospitalization rates for infants and benefits women’s health. Beyond the marked health advantages, paid maternity leave yields economic gains in terms of reduced health care costs, reduced recruitment and retraining and improved long-term earnings for women.”

According to the Bureau of Labor Statistics, only 11 percent of all private industry workers have access to paid family leave (16 percent of state and local government employees have access to some paid family leave; federal workers don’t get any, though all employees may be able to use accrued sick leave). Well-paid people who work in managerial or professional occupations at companies with 100 employees or more are the most likely to have the benefit, according to the Institute for Women’s Policy Research.

Even the policies at some of the most generous American companies pale in comparison with the 31 countries that provide a year or more of paid maternity leave, typically through government-run insurance programs, experts say. Working Mother compiles a list of the “100 Best Companies” in the United States each year, and parental leave policies are one of several factors baked into those rankings.

Even among the standouts, the average time off in 2012 was seven weeks of fully paid maternity leave, while new fathers received an average of three paid weeks, up from two weeks in 2008. Parents adopting children received an average of six weeks. Keep in mind that the list is not exhaustive. Companies must apply to get on and be willing to fill out a 550-item questionnaire. They must also have at least 500 employees and offer some form of paid maternity leave.

Google beefed up its paid leave for new mothers in 2007 to five months after company officials realized that women were leaving the company at twice the rate of men. After the change, attrition dropped by half. New fathers receive seven weeks of paid leave, as do adoptive parents and other parents who don’t physically give birth, including same-sex partners.

“What one person might get is an accident of where you happen to work or where you happen to be,” Ms. Shabo said. “Instead, what we need are public policies that provide a basic level of protection.”

While the United States takes great pride in its family values, it is the only high-income country that does not offer a paid leave program. (Eight countries in all don’t offer the benefit, according to Dr. Heymann’s research.) Most of Europe and Central Asia — or 38 of 53 countries — provide 26 weeks or more of paid leave for mothers, according to Dr. Heymann’s research. “Twenty years ago there were a few other advanced economies that did not yet provide paid leave, and now, the U.S. is entirely isolated,” she said.

Some lawmakers in Washington have proposed expanding the Family and Medical Leave Act so that it covers more people, either by reducing the required number of hours an employee must work to become eligible or by including smaller companies with 25 or more employees.

Other consumer advocates and members of Congress are more ambitious. They would like to see a paid federal family leave and medical leave insurance program.

Ms. Shabo’s organization, together with the Center for American Progress, has been working with lawmakers to draft legislation that would provide up to 12 weeks of paid leave for the arrival of a new child or for a parent’s serious illness or that of a family member. The costs would be split between workers and their employers, who would each contribute two-tenths of 1 percent of workers’ wages to pay for insurance that would replace up to 66 percent of a worker’s usual wages, subject to a cap of about $1,000 a week.

A handful of states have already struck out on their own and devised similar programs that might serve as models. California and New Jersey, for instance, have established family leave insurance laws — built on those states’ temporary disability insurance programs — which allow workers to take paid leave to care for a new child (or a sick family member). The costs are borne by employees. Under the California program, created in 2002, workers pay 1 percent of their wages to cover both their state disability insurance and paid family leave insurance, which provides 55 percent of an employee’s weekly salary up to about $1,000 a week. New parents can take up to six weeks of family leave; pregnant women can also take time under the program to recover from childbirth.

New Jersey’s program, which began operating in 2009, typically provides two-thirds of the average of a worker’s last eight weeks of pay, to a maximum of $584 a week, according to the National Partnership for Women and Families.

In New York, new mothers can tap the state’s temporary disability insurance program, which is paid for by contributions from both employers and employees and provides up to a paltry $170 a week. (Employers pay, but can seek up to 100 percent of the contribution from employees.) Rhode Island and Hawaii also have provisions for replacing some income.

The patchwork of state laws that are stitched with different company rules can be difficult to navigate, particularly for new parents. “It shouldn’t matter where you live or who you work for,” Ms. Shabo argued. “All that matters is that you should have time to take care of your children without worrying about facing major financial turmoil.”

Kenneth Matos, senior director of employment research and practice at the Families and Work Institute, a research group, emphasized the importance of being able to make decisions that work within the context of the entire family.

“When only the birth parent can take paid leave, you put people in a situation where they have to follow traditional gender roles, which doesn’t always make sense,” Dr. Matos said. “If the male partner has a more flexible job it doesn’t matter, because she is the one who gets the leave. A lot of people are beginning to talk about how these issues need to be looked at as overall family issues, and the decisions need to be made in the context of all of the people involved.”

Friday, February 22, 2013

Card Carrying Gun Carrier

There has been a return to the debate that Gun Carriers should also carry insurance, much like car owners carry car insurance.  Of course the NRA naturally dislikes said plans but of course their hypocrisy and insanity has never been more clearer on the issue of guns.  More guns means more money and everyone must own guns.  The NRA is the Apple of the gun industry.  The idea is that everyone will want and need one and then it will all be good. Whatever.

Well if that is the case let's all carry insurance as we do on our home, cars and other belongings to ensure that if lost or in case of an accident we are sufficiently covered for loss.  And gun damage causes one hell of a loss.

Gun violence is in fact a major health crisis in this country. I would love our invisible Surgeon General to actual comment on the costs associated with injuries related to gun violence.  Who is that person and wow we used to have such famous ones. Is Dr. Koop dead? Maybe by a gun.

The article below discusses how the concept is being tested. And frankly this is one good idea. Just Google the phrase "shooting last night ......" and fill in the City. There is one daily across America and that does not include the suicides and other accidental misfires that result from gun ownership.

A fantastic editorial in this month's Harper's by Thomas Frank discusses the culture of violence that permeates American society. There is no innocent here. From Film, Television, the Media, the Game Makers, the NRA, all play a role in glorifying the idea that all is equal, all debts are paid and resolution comes from the end of a gun. 

I love film but I found it particularly ironic that the Aurora shooter was at the Dark Knight Rising,  a nihilistic film that was not only incredibly uninteresting it slavishly devoted itself to a parallel universe of violence that cannot be lost in this situation. 

Yes sane people can disassociate and suspend disbelief. I certainly did that watching the latest Tarantino movie to sanctify bloodletting, Django Unchained, but I also know Tarantino has an 8th grade education and was a video clerk who managed to figure out the theme of making movies that masses enjoy, sex and violence, the lowest hanging fruit and common denominator.  Imagine what higher education could do?

But I am not a quintessential or typical Tarantino fan.  I love the references to genres and his music. There is often cultural references to times and elements of our "generation" so I have a tendency to overlook the grand guginol that delineates his films.  I would call Tarantino an Auteur of movies but not of film but that is another argument for another time. 

Ultimately gun violence is not solely the result of the mentally ill, gun magazines and/or ease of purchase. It's a multi layered, deep seated and almost embedded value into the American psyche.  And then there was South America and the disturbing violent act by Olympian athlete Oscar Pistorius. So some times some things are not so easily explained. Even the Police Officer investigating the crime is in fact a perpetrator and in turn being investigated for his role in an explosive act of gun aggression.

Gun violence is a culture of violence that goes way beyond a 2nd Amendment. But how America chooses to resolve it seems to center on this and that is the other layer of this tragedy.

Buying a Gun? States Consider Insurance Rule


Published: February 21, 2013

Both sides in a nation sharply divided over guns seem to agree on at least one thing: a bigger role for the insurance industry in a heavily armed society. But just what that role should be, and whether insurers will choose to accept it, are much in dispute.

Lawmakers in at least half a dozen states, including California, Connecticut, Maryland, Massachusetts, New York and Pennsylvania, have proposed legislation this year that would require gun owners to buy liability insurance — much as car owners are required to buy auto insurance. Doing so would give a financial incentive for safe behavior, they hope, as people with less dangerous weapons or safety locks could qualify for lower rates.

“I believe that if we get the private sector and insurance companies involved in gun safety, we can help prevent a number of gun tragedies every year,” said David P. Linsky, a Democratic state representative in Massachusetts who wants to require gun owners to buy insurance. He believes it will encourage more responsible behavior and therefore reduce accidental shootings. “Insurance companies are very good at evaluating risk factors and setting their premiums appropriately,” he added.

Groups representing gun owners oppose efforts to make insurance mandatory, arguing that law-abiding people should not be forced to buy insurance to exercise their constitutional right to bear arms. But some groups, including the National Rifle Association, endorse voluntary liability policies for their members. And as several states pass laws making it easier for people to carry concealed weapons and use them for self-defense, some gun groups are now selling policies to cover some of the legal costs stemming from self-defense shootings.

The United States Concealed Carry Association recently began selling what it calls Self-Defense Shield. “If you’re forced to justifiably use your gun in self-defense,” its Web site says, “Self-Defense Shield will help pay for your expert pro-2nd Amendment lawyer by reimbursing your legal-defense expenses following your acquittal — an ingenious system critical to the arsenal of any responsibly armed citizen.”

Premiums for such insurance range from around $200 to $300 per year; in general, the coverage is narrowly written and excludes cases where a gun is used to commit a crime.

Some specialized underwriters are reviewing what their policies cover when it comes to shootings, and weighing whether they should offer new types of coverage for gun owners. And as more states pass laws allowing people to bring guns to public venues — including restaurants, bars, churches and the parking lots of their workplaces — some business groups have expressed concerns that they could be held liable for shootings on their properties, which could drive up their insurance costs.

On Thursday, when Gov. Dannel P. Malloy of Connecticut outlined his proposals to reduce gun violence — which included universal background checks, a ban on large-capacity ammunition magazines and a stronger assault weapons ban — he called for officials to study “whether owners of firearms should be required to carry additional insurance.”

The insurance industry is wary of some of the proposals to require gun owners to buy liability coverage — and particularly of bills, like one that was filed in New York that would require coverage for damages resulting not only from negligence but also from “willful acts.”

Robert P. Hartwig, the president of the Insurance Information Institute, said that insurance generally covered accidents and unintentional acts — not intentional or illegal ones. “Insurance will cover you if your home burns down in an electrical fire, but it will not cover you if you burn down your own house, and you cannot insure yourself for arson,” he said.

Some claims stemming from shootings have been covered by homeowners’ insurance — even by policies that said they did not cover illegal acts.

The families of the two students responsible for the 1999 killings at Columbine High School in Colorado were able to use money from their homeowners’ policies to settle a lawsuit brought by families of most of the victims. In 2001, a California court ordered an insurance company to defend a policyholder whose 16-year-old son shot and killed a friend with a Beretta handgun that he had found in his mother’s coat. But the year before, a North Carolina court ruled that an insurance company did not have to cover the expenses of a policyholder who had shot and wounded a prowler on his property.

Christopher J. Monge, an insurance agent and gun owner in Verona, Wis., recently wrote a book, “The Gun Owner’s Guide to Insurance for Concealed Carry and Self-Defense,” which he sells at gun shows. Mr. Monge said that the problem with most liability insurance is that it promises coverage only in cases of a gun owner’s negligence, or an accidental shooting — and not if the gun owner shoots someone intentionally in self-defense. “A negligent act is covered by your liability policy, but if you intentionally shoot somebody, it could be excluded,” he said.

So as more states pass self-defense laws, Mr. Monge said that he found several insurance companies that would specifically offer liability coverage in cases of self-defense, usually in the form of an “umbrella” policy that added a higher level of coverage than the routine coverage for negligence in a homeowners’ policy. An umbrella policy adds coverage for unusual, but potentially expensive, incidents.

But he opposes proposals to make liability insurance mandatory. “They’re barking up the wrong tree, if you ask me,” he said. “Ninety-nine percent of gun owners are going to be safe and not go crazy.”

States have been considering mandatory gun insurance bills for years, but no state has passed one yet, said Jon Griffin, a policy associate at the National Conference of State Legislatures. When Illinois considered a bill in 2009, the National Rifle Association wrote that it would “put firearms ownership out of reach for many law-abiding Illinoisans.” The N.R.A. endorses a policy that offers excess liability coverage — “because accidents do happen no matter how careful you are” — and another that offers “self-defense insurance.”

The recent trend of allowing guns in more public places has alarmed some business groups. When Ohio enacted a law allowing guns in bars in 2011, the Ohio Restaurant Association opposed it, writing officials that restaurant owners “expect that this law would be perceived by insurance companies as increasing the risk of injury in establishments that sell alcohol, which of course would result in increased liability insurance costs.” Owners have not reported higher premiums because of the new law, said a spokesman for the association, Jarrod A. Clabaugh, but some worry that a shooting could drive up their insurance costs.

The current debate over mandatory liability laws is being watched with interest by Nelson Lund, the Patrick Henry professor of Constitutional Law and the Second Amendment at George Mason University School of Law. Professor Lund proposed the idea of mandatory insurance in a 1987 article in the Alabama Law Review, seeing it as a form of gun control that could be consistent with the constitutional right to bear arms. But he said that he had not studied any of the current proposals, and noted that it made a great deal of difference how they are written.

“If this were done, the private insurance market would quickly and efficiently make it prohibitively expensive for people with a record of irresponsible ownership of guns to possess them legally,” he wrote in the 1987 article, “but would not impose unreasonable burdens on those who have the self-discipline to exercise their liberty in a responsible fashion.”

Real Housewife of Facebook

I have long loathed the arrogant supercilious Sheryl Sandberg. When I got wind of her upcoming book what she akins to the Friedan of the 21st Century, Feminine Mystique, I laughed my proverbial ass off.

Anyone of her stature writing a book informing women on what they are doing wrong in a society that is working full time to ensure women don't do the same in a fair, equitable and dignified manner is laughable.  I have no idea if being mentored by Laurence Summers included dick sucking (yes I am going down this level and maybe she went down too I have no idea) but that must be some hell of a protein shake.

This is one woman who I would like to make a nice pot of Desperate Housewife coffee and replace the cream with big drop of  STFU. Wow, she is the new Generation X of women that put the X as in marks the spot of utter and complete denial; the other seems to be she of doll eyes - Callista Gingrich.

I have also complained that I find the current State of the Union with regards to women a much larger state. With a President and his "Missus" referring to women as someone's wife, mother, daughter or sister.. how about just WOMAN...  the idea that we must be tangentially connected to someone eles in order to have an identity equally distressing.  Maybe on some level Ms. Sandberg is right. We owe no apologies either, thanks Mitt Romney!

There is so much to say about this that I simply say two words - income inequality. When you resolve that you remove all barriers. Ask David Geffen or Martha Stewart how being billionaires changed the way they were treated and respected. Billions buys a lot of respect and that is the biggest hurdle in overcoming them. Have money you will find less barriers to all other kinds of inequalities.  

I would love to pay for the privilege to have a Harvard Educated Billionaire lecture me on my personal failings. Sign me up! The audacity of this woman to presume or understand what real women who have not fancy degrees, high paying jobs and successful men who either married or mentored her is beyond reason. And if she was such a believer in the power of woman/sister hood just hit the hood and teach them the lessons and give them the opportunities to do it. 

I would be happy to "lean in" and tell her that to her face but the likelihood of that happening is akin to the likelihood of me getting a free degree at Harvard. I guess I should just "suck it up" whatever that means.

A Titan’s How-To on Breaking the Glass Ceiling 

By Jodi Kantor
Published: February 21, 2013

Before Sheryl Sandberg, the chief operating officer of Facebook, started to write “Lean In,” her book-slash-manifesto on women in the workplace, she reread Betty Friedan’s “The Feminine Mystique.” Like the homemaker turned activist who helped start a revolution 50 years ago, Ms. Sandberg wanted to do far more than sell books.

Ms. Sandberg, whose ideas about working women have prompted both enthusiasm and criticism, is attempting nothing less than a Friedan-like feat: a national discussion of a gender-problem-that-has-no-name, this time in the workplace, and a movement to address it.

When her book is published on March 11, accompanied by a carefully orchestrated media campaign, she hopes to create her own version of the consciousness-raising groups of yore: “Lean In Circles,” as she calls them, in which women can share experiences and follow a Sandberg-crafted curriculum for career success. (First assignment: a video on how to command more authority at work by changing how they speak and even sit.)

“I always thought I would run a social movement,” Ms. Sandberg, 43, said in an interview for “Makers,” a new documentary on feminist history.

And yet no one knows whether women will show up for Ms. Sandberg’s revolution, a top-down affair propelled by a fortune worth hundreds of millions on paper, or whether the social media executive can form a women’s network of her own. Only a single test “Lean In Circle” exists. With less than three weeks until launch — which will include a spread in Time magazine and splashy events like a book party at Mayor Michael R. Bloomberg’s home — organizers cannot say how many more groups may sprout up.

Even her advisers acknowledge the awkwardness of a woman with double Harvard degrees, dual stock riches (from Facebook and Google, where she also worked), a 9,000-square-foot house and a small army of household help urging less fortunate women to look inward and work harder. Will more earthbound women, struggling with cash flow and child care, embrace the advice of a Silicon Valley executive whose book acknowledgments include thanks to her wealth adviser and Oprah Winfrey?

“I don’t think anyone has ever tried to do this from anywhere even close to her perch,” said Debora L. Spar, president of Barnard College, who invited Ms. Sandberg to deliver a May 2011 commencement address about gender in the workplace that caught fire online. (Ms. Sandberg, who will grant her first book interview to the CBS program “60 Minutes,” declined to comment for this article.)

Despite decades of efforts, and some visible exceptions, the number of top women leaders in many fields remains stubbornly low: for example, 21 of the current Fortune 500 chief executives are women. In her book, to be published by Knopf, Ms. Sandberg argues that is because women face invisible, even subconscious, barriers in the workplace, and not just from bosses. In her view, women are also sabotaging themselves. “We hold ourselves back in ways both big and small, by lacking self-confidence, by not raising our hands, and by pulling back when we should be leaning in,” she writes, and the result is that “men still run the world.”

s. Sandberg wants to take women through a collective self-awareness exercise. In her book, she urges them to absorb the social science showing they are judged more harshly and paid less than men; resist slowing down in mere anticipation of having children; insist that their husbands split housework equally; draft short- and long-term career plans; and join a “Lean In Circle,” which is half business school and half book club.

The project has the feel of a social experiment: what if women at major corporations could review research on how to overcome gender barriers, along with instruction on skills like negotiation and communication? Will working women, already stretched thin, attend nighttime video lectures on “Unconditional Responsibility” and “Using Stories Powerfully”? The instructions for the gatherings, provided to The New York Times by an outside adviser to the project, are precise, down to membership requirements (participants can miss no more than two monthly meetings per year) and the format (15-minute check-in, 3 minutes each for personal updates, a 90-minute presentation, then discussion).

Ms. Sandberg has asked a wide array of women to contribute their success stories to her new Web site. (Jill Abramson, the executive editor of The Times, wrote an essay, and the newspaper is one of many corporations to sign on to the project.) The written requests ask for positive endings, suggesting that tales closing with missed promotions or broken marriages are unwelcome. Hoping to reach beyond an elite audience, Ms. Sandberg and her foundation joined forces with Cosmopolitan magazine, which is publishing a 40-page supplement to its April issue devoted to Ms. Sandberg’s ideas, and plan to spread her message to community colleges, according to those involved in the project.

But criticism is also starting to build: that Ms. Sandberg places too much of the onus on women who are already struggling to fulfill impossible demands, and too little on government and employers to provide better child care, more flexible jobs and other concrete gains.

Ms. Sandberg “does what too many successful women before her have done: blaming other women for not trying hard enough,” wrote Avivah Wittenberg-Cox, a consultant who works with companies to improve their gender balance, after watching a video of Ms. Sandberg speaking on the topic at the World Economic Forum in Davos last month. “Every resistant man on the planet will be able to quote her” saying that women simply must become more ambitious, Ms. Cox continued. (Ms. Sandberg writes that she focuses on internal barriers because the external ones get more attention.)

Ms. Sandberg’s project, according to members of her launch committee and their solicitations, asks little of the corporations signing on as “launch partners,” which include American Express, Google, Sony, Johnson & Johnson and multiple media businesses. Mostly they are asked to lend their logo to Lean In and distribute its materials to employees. In exchange, they will get recognition for supporting the Lean In cause, the solicitation says.

Ms. Sandberg’s chief critic has been Anne-Marie Slaughter, a Princeton professor and former top State Department official, who published an Atlantic Magazine article titled “Why Women Can’t Have It All,” last year arguing that feminism — and Ms. Sandberg — were holding women to unattainable standards for personal and professional success.

Since then, both women quietly developed perhaps the most notable feminist row since Ms. Friedan refused to shake Gloria Steinem’s hand decades ago.

According to several people who have spoken to both women, Ms. Sandberg felt blindsided by Ms. Slaughter’s criticisms, and though they briefly exchanged e-mails, Ms. Sandberg stopped replying and refused joint speaking appearances. Ms. Slaughter continued her commentary: “Sheryl Sandberg is both superhuman and rich,” she told Fortune magazine, implying that her advice makes little sense for anyone who is not.

“She’s made a real contribution with the book, but it’s only half the story,” Ms. Slaughter said in an interview.

The Slaughter-Sandberg match may represent what some may see as a welcome new phase in the debate over work and motherhood. The “mommy wars,” with working and stay-at-home mothers sniping at one another’s choices, may have finally run their course. Instead, Ms. Sandberg, Ms. Slaughter and many others are arguing about the best strategy for fulfilling feminism’s promise. “If you tell women to look inside themselves, you’re letting the corporations and government off the hook,” said Ms. Spar, the Barnard president, and “if you focus on the corporations and the governments, you’re not being realistic.”

Ms. Sandberg, who wrote a senior thesis at Harvard about domestic violence and women’s income, and who has championed women at Google and Facebook, shows no sign of relenting. On top of running a major company and rearing two young children — her husband, Dave Goldberg, is chief executive of SurveyMonkey, a technology company — she has thrown herself into her new project.

Though she insists she is committed to Facebook, which might be awkward for her to leave given its rocky initial public offering, some wonder whether “Lean In” is the first step toward a new career for her, perhaps in politics.

“She is using all of her social capital on this,” said Rachel Sklar, founder of a networking list for women in technology, who is on the Lean In launch committee. Asked how Ms. Sandberg would balance her demanding job with the creation of a new movement, a member of the team offered a tentative answer: she plans to use her vacation days

The 10K Asprin

Used car salesman get a bad rap. And yes I know Doctors are not fully culpable but they are part of the problem and not the solution by agreeing to and participating in this process.  They are often paid and or rewarded by numerous factors if they play to pay. An insidious industry that is both corrupt and incorrigible with it.  I also read an editorial the other day explaining why few Doctors vestibule as the penalties are too great and their livelihoods often destroyed as a result.  So rather than say anything they do nothing and Patent's die, suffer great pain or are in debt up to their eyes.

I wonder who the Neurologist was that signed my release documents, fraudulently altered them to reflect a much less significant problem allowing me to leave a hospital with a person who no one bothered to confirm a signature, an identity or talk about my long term needs with.  That was not care that was how one throws out trash or garbage and they billed me for it.  I never saw an itemized bill nor fully verified charges, I simply forced my Insurance to pay for it. I did not want money to be the crux of my dispute with them.  In fact I am grateful on some weird level they did or my bills would have been in the 100 of thousands and it still would have been abdominal care, on that much I am sure.

Insurance has tried to reign them in but they too have their own agenda, and that is their bottom line, This is a lose lose scenario for anyone in need of medical treatment with or without insurance. They have rigged the game. Las Vegas has better house rules and there you at least get a free drink. The Hospital will charge you $5 for a cup of water.

Bitter Pill: Why Medical Bills Are Killing Us

Steven Brill
February 20, 2103

Breaking these trillions down into real bills going to real patients cuts through the ideological debate over health care policy. By dissecting the bills that people like Sean Recchi face, we can see exactly how and why we are overspending, where the money is going and how to get it back. We just have to follow the money.

The $21,000 Heartburn Bill

One night last summer at her home near Stamford, Conn., a 64-year-old former sales clerk whom I’ll call Janice S. felt chest pains. She was taken four miles by ambulance to the emergency room at Stamford Hospital, officially a nonprofit institution. After about three hours of tests and some brief encounters with a doctor, she was told she had indigestion and sent home. That was the good news.

The bad news was the bill: $995 for the ambulance ride, $3,000 for the doctors and $17,000 for the hospital — in sum, $21,000 for a false alarm.

Out of work for a year, Janice S. had no insurance. Among the hospital’s charges were three “TROPONIN I” tests for $199.50 each. According to a National Institutes of Health website, a troponin test “measures the levels of certain proteins in the blood” whose release from the heart is a strong indicator of a heart attack. Some labs like to have the test done at intervals, so the fact that Janice S. got three of them is not necessarily an issue. The price is the problem. Stamford Hospital spokesman Scott Orstad told me that the $199.50 figure for the troponin test was taken from what he called the hospital’s chargemaster. The chargemaster, I learned, is every hospital’s internal price list. Decades ago it was a document the size of a phone book; now it’s a massive computer file, thousands of items long, maintained by every hospital.

Stamford Hospital’s chargemaster assigns prices to everything, including Janice S.’s blood tests. It would seem to be an important document. However, I quickly found that although every hospital has a chargemaster, officials treat it as if it were an eccentric uncle living in the attic. Whenever I asked, they deflected all conversation away from it. They even argued that it is irrelevant. I soon found that they have good reason to hope that outsiders pay no attention to the chargemaster or the process that produces it. For there seems to be no process, no rationale, behind the core document that is the basis for hundreds of billions of dollars in health care bills.

Because she was 64, not 65, Janice S. was not on Medicare. But seeing what Medicare would have paid Stamford Hospital for the troponin test if she had been a year older shines a bright light on the role the chargemaster plays in our national medical crisis — and helps us understand the illegitimacy of that $199.50 charge. That’s because Medicare collects troves of data on what every type of treatment, test and other service costs hospitals to deliver. Medicare takes seriously the notion that nonprofit hospitals should be paid for all their costs but actually be nonprofit after their calculation. Thus, under the law, Medicare is supposed to reimburse hospitals for any given service, factoring in not only direct costs but also allocated expenses such as overhead, capital expenses, executive salaries, insurance, differences in regional costs of living and even the education of medical students.

It turns out that Medicare would have paid Stamford $13.94 for each troponin test rather than the $199.50 Janice S. was charged.

Janice S. was also charged $157.61 for a CBC — the complete blood count that those of us who are ER aficionados remember George Clooney ordering several times a night. Medicare pays $11.02 for a CBC in Connecticut. Hospital finance people argue vehemently that Medicare doesn’t pay enough and that they lose as much as 10% on an average Medicare patient. But even if the Medicare price should be, say, 10% higher, it’s a long way from $11.02 plus 10% to $157.61. Yes, every hospital administrator grouses about Medicare’s payment rates — rates that are supervised by a Congress that is heavily lobbied by the American Hospital Association, which spent $1,859,041 on lobbyists in 2012. But an annual expense report that Stamford Hospital is required to file with the federal Department of Health and Human Services offers evidence that Medicare’s rates for the services Janice S. received are on the mark. According to the hospital’s latest filing (covering 2010), its total expenses for laboratory work (like Janice S.’s blood tests) in the 12 months covered by the report were $27.5 million. Its total charges were $293.2 million. That means it charged about 11 times its costs.

 As we examine other bills, we’ll see that like Medicare patients, the large portion of hospital patients who have private health insurance also get discounts off the listed chargemaster figures, assuming the hospital and insurance company have negotiated to include the hospital in the insurer’s network of providers that its customers can use. The insurance discounts are not nearly as steep as the Medicare markdowns, which means that even the discounted insurance-company rates fuel profits at these officially nonprofit hospitals. Those profits are further boosted by payments from the tens of millions of patients who, like the unemployed Janice S., have no insurance or whose insurance does not apply because the patient has exceeded the coverage limits. These patients are asked to pay the chargemaster list prices.

If you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace.

Test Strips
Test Strips
Patient was charged $18 each for Accu-chek diabetes test strips. Amazon sells boxes of 50 for about $27, or 55¢ each

Pay No Attention To the Chargemaster

No hospital’s chargemaster prices are consistent with those of any other hospital, nor do they seem to be based on anything objective — like cost — that any hospital executive I spoke with was able to explain. “They were set in cement a long time ago and just keep going up almost automatically,” says one hospital chief financial officer with a shrug.

At Stamford Hospital I got the first of many brush-offs when I asked about the chargemaster rates on Janice S.’s bill. “Those are not our real rates,” protested hospital spokesman Orstad when I asked him to make hospital CEO Brian Grissler available to explain Janice S.’s bill, in particular the blood-test charges. “It’s a list we use internally in certain cases, but most people never pay those prices. I doubt that Brian [Grissler] has even seen the list in years. So I’m not sure why you care.”

Orstad also refused to comment on any of the specifics in Janice S.’s bill, including the seemingly inflated charges for all the lab work. “I’ve told you I don’t think a bill like this is relevant,” he explained. “Very few people actually pay those rates.”

But Janice S. was asked to pay them. Moreover, the chargemaster rates are relevant, even for those unlike her who have insurance. Insurers with the most leverage, because they have the most customers to offer a hospital that needs patients, will try to negotiate prices 30% to 50% above the Medicare rates rather than discounts off the sky-high chargemaster rates. But insurers are increasingly losing leverage because hospitals are consolidating by buying doctors’ practices and even rival hospitals. In that situation — in which the insurer needs the hospital more than the hospital needs the insurer — the pricing negotiation will be over discounts that work down from the chargemaster prices rather than up from what Medicare would pay. Getting a 50% or even 60% discount off the chargemaster price of an item that costs $13 and lists for $199.50 is still no bargain. “We hate to negotiate off of the chargemaster, but we have to do it a lot now,” says Edward Wardell, a lawyer for the giant health-insurance provider Aetna Inc.

That so few consumers seem to be aware of the chargemaster demonstrates how well the health care industry has steered the debate from why bills are so high to who should pay them.

The expensive technology deployed on Janice S. was a bigger factor in her bill than the lab tests. An “NM MYO REST/SPEC EJCT MOT MUL” was billed at $7,997.54. That’s a stress test using a radioactive dye that is tracked by an X-ray computed tomography, or CT, scan. Medicare would have paid Stamford $554 for that test.

Janice S. was charged an additional $872.44 just for the dye used in the test. The regular stress test patients are more familiar with, in which arteries are monitored electronically with an electrocardiograph, would have cost far less — $1,200 even at the hospital’s chargemaster price. (Medicare would have paid $96 for it.) And although many doctors view the version using the CT scan as more thorough, others consider it unnecessary in most cases.

According to Jack Lewin, a cardiologist and former CEO of the American College of Cardiology, “It depends on the patient, of course, but in most cases you would start with a standard stress test. We are doing too many of these nuclear tests. It is not being used appropriately … Sometimes a cardiogram is enough, and you don’t even need the simpler test. But it usually makes sense to give the patient the simpler one first and then use nuclear for a closer look if there seem to be problems.”

We don’t know the particulars of Janice S.’s condition, so we cannot know why the doctors who treated her ordered the more expensive test. But the incentives are clear. On the basis of market prices, Stamford probably paid about $250,000 for the CT equipment in its operating room. It costs little to operate, so the more it can be used and billed, the quicker the hospital recovers its costs and begins profiting from its purchase. In addition, the cardiologist in the emergency room gave Janice S. a separate bill for $600 to read the test results on top of the $342 he charged for examining her.

According to a McKinsey study of the medical marketplace, a typical piece of equipment will pay for itself in one year if it carries out just 10 to 15 procedures a day. That’s a terrific return on capital equipment that has an expected life span of seven to 10 years. And it means that after a year, every scan ordered by a doctor in the Stamford Hospital emergency room would mean pure profit, less maintenance costs, for the hospital. Plus an extra fee for the doctor.

Another McKinsey report found that health care providers in the U.S. conduct far more CT tests per capita than those in any other country — 71% more than in Germany, for example, where the government-run health care system offers none of those incentives for overtesting. We also pay a lot more for each test, even when it’s Medicare doing the paying. Medicare reimburses hospitals and clinics an average of four times as much as Germany does for CT scans, according to the data gathered by McKinsey.

Medicare’s reimbursement formulas for these tests are regulated by Congress. So too are restrictions on what Medicare can do to limit the use of CT and magnetic resonance imaging (MRI) scans when they might not be medically necessary. Standing at the ready to make sure Congress keeps Medicare at bay is, among other groups, the American College of Radiology, which on Nov. 14 ran a full-page ad in the Capitol Hill–centric newspaper Politico urging Congress to pass the Diagnostic Imaging Services Access Protection Act. It’s a bill that would block efforts by Medicare to discourage doctors from ordering multiple CT scans on the same patient by paying them less per test to read multiple tests of the same patient. (In fact, six of Politico’s 12 pages of ads that day were bought by medical interests urging Congress to spend or not cut back on one of their products.)

The costs associated with high-tech tests are likely to accelerate. McKinsey found that the more CT and MRI scanners are out there, the more doctors use them. In 1997 there were fewer than 3,000 machines available, and they completed an average of 3,800 scans per year. By 2006 there were more than 10,000 in use, and they completed an average of 6,100 per year. According to a study in the Annals of Emergency Medicine, the use of CT scans in America’s emergency rooms “has more than quadrupled in recent decades.” As one former emergency-room doctor puts it, “Giving out CT scans like candy in the ER is the equivalent of putting a 90-year-old grandmother through a pat-down at the airport: Hey, you never know.”
Selling this equipment to hospitals — which has become a key profit center for industrial conglomerates like General Electric and Siemens — is one of the U.S. economy’s bright spots. I recently subscribed to an online headhunter’s listings for medical-equipment salesmen and quickly found an opening in Connecticut that would pay a salary of $85,000 and sales commissions of up to $95,000 more, plus a car allowance. The only requirement was that applicants have “at least one year of experience selling some form of capital equipment.”

In all, on the day I signed up for that jobs website, it carried 186 listings for medical-equipment salespeople just in Connecticut.