Wednesday, June 25, 2014

NCAA, Exploitation of Labor, Internships and the Big Lie




Since Fagin sent out children to pick pockets, in "Oliver Twist," the notion of exploiting children for the profit of adults has been reviled.  But when a million dollar football coach sends his nineteen year olds out to slam their heads and shoulders into the helmets and knees of their opponents, that is just fine. And when chairman of medicine goes home for a full night's sleep, leaving behind 26 year olds to stay up all night with desperately ill patients, vomiting, bleeding, slipping into shock, well that is valuable medical training.

Young apprentices have been exploited by craftsmen, who taught them their trade, and the young have complained about being used to do the unpleasant grunt work for small rewards, while the accomplished craftsmen replied, "I am teaching you the trade and you are benefiting and learning from this work; it may be exhausting, unpleasant, even dangerous, but, in the end, this is the way you ultimately learn and benefit, just as I did, when I was an apprentice."

In the case of the young doctors, well, at least until the end of the 20th century, they were clearly going to be rich just as soon as they passed through the gauntlet, so nobody had much sympathy for them, until a case of a patient dying was attributed to an overwhelmed, under-supervised intern, and then the press, the courts, legislatures all combined to peel away the entrenched powers that be in the medical profession from their self serving policies which kept interns chained to the wards. The other factor that changed attitudes about tolerating this exploitation was the entry of women into medicine in big numbers: These women had children and refused to stand for the exploitation, and their incomes were just one part of the family income, so they were willing to make trade offs, to accept lower salaries if they could work less. 

In the case of the college athlete, the prospect for immediate, future reward is not the same as it was for the doctor: Only a tiny fraction of college athletes make it as pros. But the fact is, they already are pros, just minor league apprentice pros.  While their coaches make millions, while the vendors line up their trucks selling food and logo jerseys outside the stadium, and while the stadium turnstiles spin, clicking up the tickets sold, and while  the TV crews broadcast their games and the celebrity announcers take to the screens,  the college athletes spend their week in practice to the exclusion of study, traveling off campus to games so other schools may profit.

Not that these 18-22 year olds are complaining. They feel lucky to have these non paying jobs, these "internships" because they have the dream they may make it in the pros some day, or because they simply enjoy the moment. Being a campus hero, playing sports they love does not seem like drudgery to many of these semi pro players.  They are happy to be part of a team, to have the experience of belonging, of struggling together with a group of friends.  Their parents may have pushed them to sign contracts with the colleges, but the players are, generally speaking, proud to be offered these contracts, proud to perform--at least they start out that way.

And they can delude themselves that they might wind up getting their tickets punched with a diploma from Notre Dame or Boston College that will insure them a job selling cars or real estate, or maybe making connections in businesses where being a physical presence is more important than knowing anything in particular.

The inner city kid from Baltimore who winds up playing basketball for North Dakota State, who lives, isolated from other students, with his coworkers, who is injured, loses his "scholarship," i.e. his paycheck, and is sent packing may not be as happy as the kid who was recruited from a big time high school program to play at Duke, who is treated better, even if he is not paid any more than the kid at North Dakota. 

But whatever happens to all those happy Duke basketball players who graduate into the real world and do not wind up playing professional basketball?

Now, as lawsuits make their way through the courts,  college presidents are scurrying around with protestations of how important the educational experience is to their "scholar athletes."  It is a sorry scene, watching these CEO's lying about something when even the dimmest citizen out there knows exactly what college sports are--and that has nothing to do with scholarship or classrooms or laboratories but with fields and wood floored courts or ice hockey rinks. The irony is that institutions with "Veritas" (truth) inscribed in their logos are so loathe to speak the truth when it comes to the "scholar athlete."  From Stanford to the University of Florida, every college president lies through his or her teeth every time he opens his/her  mouth about college athletes. These college presidents are, and this is not an invidious comparison, in much the same position as the bishops who moved pedophile priests from one diocese to another, to keep the game going, to not bring down the whole structure.  Of course, coaches are not sexually abusing their players, but they are using their players for their own rewards and the college presidents are profiting from that and they are lying about the relationships between the players and the colleges. The NCAA has become simply an institution held together by a web of lies. 

The big difference between the Catholic priest scandal and the NCAA is few people thought there was perfidy afoot in the parishes, but everyone knows the NCAA is lying about "student athletes"--the entire country winks at the notion that Joe Namath was at Alabama  to get an education. 

The college presidents lie, because there is so much money to protect. 
The men who run the National Football League do not want to have to pay to train their labor force. Baseball has had to invest large dollars to train their talent, and neither football nor basketball wants to make that investment when there is a group of men who are willing to spend that money for them.  The colleges provide these minor leagues and profit handsomely, exorbitantly, from it. They cannot imagine life without that money. 

But the Europeans can imagine universities without big time sports. So can the Asians. 

As Ross Perot once observed, if we were competing with the Japanese and the Chinese in marching bands, we'd have nothing to worry about. But, the trouble is, our country is not competing in the things these sports programs produce.  We need our universities to train a work force to compete on the world stage, in the global economy, and we are doing that while sustaining an irrelevant side line. Call it diversification.  If General Motors decided to produce feature films, and that made them millions, who would complain?  So the University of Michigan produces doctors and lawyers and computer programs, and it puts on a Broadway season in a stadium which seats 100,000 fans waving blue and maize, spending money, having a good time. 
And Michigan can do all this with unpaid labor.
Who's complaining?






Monday, June 23, 2014

Jill LePore: Robots, Creative Disruption and the Global Economy

Maria New, MD
"Every age has a theory of rising and falling, o f growth and decay, of bloom and wilt. Every age has a theory of about the past and the present, of what was and what is,  a notion of time, a theory of history.
   Disruptive innovation as a theory of change is meant to serve both as a chronicle of the past and as a model for the future."
    --Jill Lepore The New Yorker, June 23, 2014. 

In the end, Lepore says "disruptive innovation" is blind to continuity, and fails as  a prophet. 

In his New York Times piece, "Fear Not the Coming of the Robots" Steven Rattner, argues the innovations in technology since the industrial revolution have displaced people, eliminated jobs, but the overall effect of putting telephone operators, typists, travel agents, gas station attendants and elevator operators out of work has been good because it has occurred in the setting of allowing consumers to do all these jobs themselves, better, faster and with little or no expense.

All this makes the Phantom look around his own world of physicians and surgeons and see the changes and wonder which are for the better and which are not.  Surgeons who grasped the importance of laporoscopic surgery by which a gall bladder or a colon can be removed through the use of fiber optic instruments through 4 puncture holes rather than through long incisions through layers of fat, muscle and peritoneum found themselves busier than ever, while those who cleaved to the notion that a beautifully done dissection down to a gall bladder is as much a work of art as a medical procedure, found themselves out of work.  This may be heartless, but it is progress.

On the other hand, the entry of women who are mothers into a profession has changed things, disrupting the value system which placed the patient first.  This system once valued self sacrifice, putting the patient ahead of your own needs, ahead of the needs of your family.  Now, doctors do not apologize for telling a patient they have to leave now, to take their children to the lake for the weekend. Someone who doesn't know you will take the next shift. I limit my commitment to your care. My kids come first.

And then there is the judgment about what it means to be good or to be the best. We are always told America has the world's best medical care. But the Phantom is currently skulking about the international meeting of 10,000 endocrinologists and he was stunned by the presentation of an Italian who showed videos of procedures using ultrasound to inject metastases from thyroid cancer, and successfully treat patients without surgery in the office. When an American asked, from the audience, if the Italian had any thoughts on why American doctors were so far behind  the Europeans in this area, the Italian shrugged, thought for a moment, likely considered the politics of his conjecture and finally said, "Well, you Americans do not have a national health system. We have only to show this procedure works, that it saves the system money and it is good for the patients and we get approval.  The primary consideration is what is good medicine. Here, it's always about who makes the profit."

Then, consider Maria New.  Dr. New is now in her late 80's. When she was in her late 30's she saw children at Cornell Medical school who had been born with "ambiguous genitalia."  A girl would have a clitoris so enlarged, it looked like a penis and her labia were almost fused. Dr. New suspected these girls had been exposed to high levels of male hormone in utero and she had a steroid lab at her disposal to test the blood of these girls and she quickly figured out the biochemistry.  In stages, with advances in technology, she was able to make the diagnosis and define the biochemistry in each patient within a week of birth, then on the day of birth, then months before birth, but only recently has technology allowed the identification of this problem in utero by simply drawing blood from the mother, and this can now be done so early in pregnancy, the problem can be prevented by treating mothers of affected daughters with simple medication--but only if you know the daughter  in utero has that diagnosis.

The problem for Dr. New is, the equipment needed to detect this disease, to allow treatment, costs almost half a million dollars and she cannot get a grant to do this.  Fortunately, an academic in Hong Kong offered to collaborate with her. He had the machine; she had the patients. 

She has to send her patients' blood from New York, by courier, to Hong Kong, where the studies are done within 24 hours.  She visited Oman, where they have two such machines in the hospital still in the boxes, unopened because they do not have a doctor in Oman who knows how to use them.  In New York City, Dr. New can only fill out forms and hope for fortune to smile upon her.

This is where we have come from the globalization of medicine, the aggrandizement of the  for profit motive in American medicine and the refusal of Americans to risk their best medicine in the world fora system of national health.

We have had disruptive innovation in American medicine and the results are decidedly mixed.  We are seeing advances, but they are coming from abroad. That is new. But is it progress?

Wednesday, June 18, 2014

Wild China: Land of the Red Panda, Worker Cormorants, Fishing Bats

 Before there was such a thing as a Western capitalistic democracy, before there was a Peoples Republic of China, before there was Tienanmen Square there was the land. 
In the BBC's astonishing documentary series "Wild China" you see the land, the animals, the people in a way which even at his  advanced age stunned the Phantom. It is still possible to be dazzled,  even in near senility. As you get older, it's harder to be really thrilled because you've seen so much before, but this series does it time and again.

It is almost, but not quite, enough to make the Phantom think he might actually want to go to China some day. Then reason takes hold, and the Phantom realizes: No. It is better to sit comfortably at home in New Hampshire and watch what other people have brought you.


 In an early episode, we see  men using trained cormorants to fish. The birds have a string tied around their necks so they cannot swallow the fish, but after seven returns to the boat bearing the fish they cannot swallow, they refuse to go out again until the string has been removed and they are fed a fish they can swallow.

There are cormorants floating and diving just off Plaice Cove Beach, New Hampshire,  where the Phantom runs his dog in the morning,  and they dive and disappear and surface twenty yards off but they are self employed and can keep every fish they get.

Those Chinese cormorants need a union. 

The most fantastic visuals are the fishing bats, who were filmed at night plucking minnows from just below the surface of the lakes, like eagles swooping in. You can see their  arm bones through their translucent wings and the splashed drops of water. The Phantom is an ardent nature show watcher, but nothing has ever equaled the sequence of these bats--except maybe that scene where the shark explodes through the surface of the water to get the unsuspecting fur seal floating there.


 And then there is the red panda. This creature exists nowhere else on the planet and he eats bamboo, like other pandas, but he looks more like a raccoon and is more closely related to the skunk than to the bear, but he is a wonderful creature. 
And there are snub nosed monkeys who live in mountainous areas where it snows a lot and they live on a sort of moss which is half plant and half fungus. 
And there are the terraced mountains and hills where the people grow rice, and there are villagers who live on either side of the "Angry River" which surges down a ravine and the only way across is by a zip line the villagers use, carrying goats and other animals to markets on either side of the chasm. 

The Phantom is only half way through the second episode of a six part series. If there is nothing more remarkable in the remaining episodes, this still ranks as one of the most spectacular nature shows ever--on a level with "Life Underground" and "Blue Planet."  

No American school child should be allowed to go through 12 years of schooling without being shown these magnificent films. It will change them forever. Can you imagine some kid from inner city Baltimore coming face to face with a red panda?


Sunday, June 15, 2014

Let The Private Sector Lead the Way





Let the private sector lead the way. Private enterprise is always more efficient and provides better service than government bureaucrats.

--Scott Brown, (and any Republican who has read the Tea Party Gospel)

The Phantom arrived at the airport this morning, well ahead of schedule to board his Boston shuttle on U.S. Airways and asked if there was space available on an earlier flight. "Sure, for $75" he was told. 

Declining that bargain, the Phantom watched as that earlier flight loaded and took off with empty seats.  There was nothing unethical or illegal about this legacy airline's rule.  They had agreed to transport the Phantom to Boston at 12:30 PM on the shuttle and they were prepared to keep that promise.  But it was stupid business.

That act of attempted "move up" fee changed the relationship from one of mutual happiness into one in which an adversarial spirit emerged. We were no longer a willing buyer and a willing seller but two parties playing a game of chicken. You can sit here in the waiting room for an hour, or you can pay and get on now. 

If a doctor had kept a patient waiting in a waiting room when that patient could see the patient scheduled ahead of him had canceled  and the waiting patient, who arrived early knew he was being kept in the waiting room while he could have been taken back to the exam room early, that would have become one unhappy patient.

If you arrive early at the ferry and there is space, the boat men put you on. Across a whole variety of businesses and services, the prevailing spirit is, "We want you to be happy with us." 

It is supposed to be the government worker, complacent in his job security, who keeps you waiting, who doesn't care whether or not he keeps your business or your goodwill because you do not have anywhere else to go, who is supposed to be the unresponsive,  just do it by the book face of an indifferent bureaucracy.

But, in real life, it is the big private for profit companies who act with imperious disregard for their customers.

Southwest airlines has made its living understanding the psychology of "we aim to please" and customers have beaten a path to the Southwest door.  But Southwest does not have space at DC National airport, or at a lot of other airports where the legacy airlines have managed to lock out the competition.

If there really were free open market competition, airlines would not get away with playing games of who will blink first with their customers.

That is the problem with free market, the private sector is always better Republicans and economists: The market, in the United States at least, is only rarely truly "free."
A business uses its size and power to occupy a position and the customer has no bargaining power.

In New Hampshire, the live free or die" state with its libertarian ideology allows corporations to enforce "non compete" clauses, so doctors who want to leave their employers cannot set up shop down the street,  and architects, lawyers, even housing contractors have to leave town and start over if they want to continue their services. They are locked into their "owners" (the corporations) as surely as baseball players were once locked into their club owners by the old "reserve clause." 

So when you hear Scott Brown or any other Republican waxing euphoric about how bad government is and how wonderful free market, big business is, think about the last time you ran up against free market, big business style.




Sunday, June 8, 2014

The Ordering: Suzanne Mettler and Degrees of Inequality


It is a man's opinion of himself which determines his own fate.
            --Henry David Thoreau

The college systems works well for those born into affluent families, according to Suzanne Mettler, professor of government at Cornell. The system we have now of "first order colleges"  (Harvard, Yale, Princeton, MIT, and the non-jock part of Stanford) and "second tier"  upper class colleges (the rest of the Ivy League, and about thirty to fifty other highly selective colleges from Swarthmore to Duke to Wellsley) and a "third tier" respectability (Vanderbilt, NYU, Notre Dame) to selective schools like Boston College and Michigan all allow a certain ordering, which one might imagine the human resources people at the bank  use to order the applicants applying for ground level jobs.
You might imagine that, but you'd likely be wrong.

The fact is, this caste system doesn't really seem to play out in the lives of people who flow through these caste determiners. In fact, it is entirely possible, as Andrew Hacker (professor of government at Princeton,  Cornell, then Queens college) has suggested,  it may be what the Harvard tier produces are unimaginative managers, who become well paid lawyers, bank presidents, the well to do bourgeoisie who never do much of transcendent importance, who never see the possibilities in a new technology like computers, who never make any really significant discoveries in science or engineering, but who do make significant six figure salaries and provide very well for their families.  This happens not so much because of anything Yale or NYU taught them or any connections made there, but because they came from families which prepared them over a period of decades with certain expectations and a sense of entitlement. 

What appalls professor Mettler is how people from lower class families are sold a bogus dream by the University of Phoenix and its ilk, telling the hapless paying poor that all they need is that University of Phoenix merit badge and the knowledge imparted along the way, and they will change their lives, leaping from lower class lives to upper class or at least to upper middle class lives. 
What most if not all wind up with is a lower class life now made more difficult by high debt.

The Phantom suspects there might be answers in the numbers, if colleges and universities had those numbers or permitted those numbers to be generated, but the Phantom suspects  those numbers have never been systematically collected.
What you would like to know is,  looking at all college freshman, starting with the income of their parents, their place in the class structure of American society, how many moved up, how many fell and how many stayed the same? And you would like to see those numbers at 1, 5, 10, 20, 30 and 50 years post graduation.

Some would argue all that is relevant is what happens a year after graduation--that is all you can ask of a college--providing a foot in the door, but given the new patterns of employment and unemployment of twenty somethings, the Phantom would like long term data.

The Phantom hears, all day long, brief life histories of his fellow citizens.  It is his impression that people from families with more than 4 children tend to be poorer, to pursue careers in areas which do not require prolonged training or gestation--they need to get to work. People from families of eight tend to graduate from high school, to stay within a few miles of where they graduated high school and to struggle, often working two jobs without prospects for ever living anything more than pay check to pay check. Some find trades and crafts--HVAC, plumbing, electrician, machinist--and they do better than their parents. But most follow the same path their parents followed, like salmon swimming upstream, spawning and turning belly up--their fates, financially, romantically, socially are locked in, predetermined.

If we could figure out whether these impressions are accurate, we might be able to figure out whether we might want to change these patterns and then, harder yet, we might figure out how we could change these patterns.

We do have historical precedent:  After WWII, returning veterans went through college on the GI bill and sons of farmers and laborers and factory workers moved into white collar jobs, first homes, bought first cars, established families, but this was in the setting of government spending and a booming economy, very different times.

When the Phantom asks the woman who is working in a day care center every morning and  stocking shelves a Walmart every evening and in Macy's selling handbags every weekend what her educational back ground is, she'll say she went to college. Where?  Oh, Hesser College or McIntosh, the for profit places. And she thinks this credential is the same as if she had gone to Harvard or Boston College. She went to college, after all. 

When the Phantom asks the 20 year old mother of a two year old what her plans are for the future, he hears she is taking a strenuous course at some local for profit to be a "Medical Assistant" for which she has to study anatomy and physiology and a bunch of other courses which her future employer does not care about. She is working hard because she has been told by somebody this will be good for her future and she has been duped.  It is sad to see.

But her parents were factory workers and they have no idea what to advise their daughter about the worth of a particular "college degree."  She was one of six kids, and one has gone into the Army, one works for the state highway department, filling potholes, one worked for a local factory, got laid off in the recession, then overdosed on meth and died.  These are the stories the Phantom hears every day.

President Reagan shrugged and said, "The poor will always be with us," and he cut funding for student loans for real colleges.  The whole notion that  the government or any sector of the American civilization should be concerned about changing the lot of large portions of the citizenry died during Reagan's reign.

The new for profit "college degree" is just one more way the haves keep the have not's under their thumb.  Develop a "business model" for a college, sell it to the unsuspecting who are trying to move up the caste system, and make your bundle on the backs of the dispossessed. 

Is this a great country, or what?



Wednesday, June 4, 2014

Suffer the Children

The next time you hear someone talking about morality, and about how people should get what they deserve, think about these images.

What do children deserve?


These kids grew up only a few miles away from me, when I was a white child, growing up across the Potomac River from them, the other side of the railroad tracks. It was white, segregated Arlington, Virginia for me. My neighborhood looked a lot different. I guess I "deserved" better, because, after all, I was 7 and white and living on the right side of the tracks (or, in this case, the river.)


On the other hand, these white kids in New York City, weren't much better off, not because they were white, or Irish or Jewish, but because they were impoverished.  Poverty does not always cleave to race or ancestry; sometimes it's just the luck of the draw in a system which does not care.


These kids were made homeless by Adolf Hitler, who had nothing against them personally, but he was making a point.


The feet dangling above this group of happy white men belonged to a 16 year old Black child who was lynched for some offense--possibly whistling at a white woman. Look at the faces of these upright citizens. Don't they look virtuous? They have imposed their moral outlook on the Black boy.  Any time you hear people talking about the land of the free, home of the brave think of this lovely image. Look at the smiles, and the general look of satisfaction on these (admittedly Southern) Americans. 

The New South is likely different. Enough people from the North have diluted out the hate in places like the Research Triangle in North Carolina, in Georgia and New Orleans, maybe even in Birmingham and Baton Rouge, but get out beyond the sparkling urban towers in the South and it's Easy Rider country. This, too, is America.

These photos are courtesy of the wonderful website "Historyporn."

It brings to mind the world adults provide their children, and the children of others.

They eat their young.