Alaska Blogger's House Burns Down

[UPDATE 9-16-09 10:30am: Tea said I could post this picture from her blog. She also added a comment below. When I pressed her she said gift certificates to Sears would help - she's got 9 kids to clothe. Also looking into setting up a pay pal account for her.]

Tea N Crumpet's house burned down. Here blog Stress Management was one of the early ones and she writes about living in Wasilla with nine kids. There's not much I can say, but I did want to note it here. You can read about it at the link above and a follow up post from today.

The Red Cross was there along with the Firefighters with vouchers for a hotel. She did save her laptop as she mentions on my post below about mine being in the shop. No one got hurt, but Tea seems to have gulped some smoke retrieving her laptop and purse. (I have it back. The diagnostic on the hardware showed nothing wrong and the problem didn't appear while it was in the shop. I'm just using it now for the first time. My fingers are crossed it's ok.)

Tea, my heart goes out to you and your family. We do want to know how we can help out as you work your way back to some form of normal.

Do lasers work by focusing sound waves?

Take out a piece a paper and write the numbers 1-10, then mark the answers to the following questions:

True or False? (you've got a 50/50 chance)

1. Lasers work by focusing sound waves.

2. It is the father's gene that decides whether the baby is a boy or a girl.

3. All radioactivity is man-made.

4. The center of the Earth is very hot.

5. The universe began with a huge explosion.

6. Antibiotics kill viruses as well as bacteria.

7. Electrons are smaller than atoms.

8. Does the Earth go around the Sun, or does the Sun go around the Earth? (I know this isn't a true or false question, I didn't write this quiz)

9. Human beings are developed from earlier species of animals.

10. The continents have been moving their locations for millions of years and will continue to move.

These are some of the questions on an international survey reported in Science and Engineering Indicators 2006.

I found this in my ongoing attempts to understand why so many people believe in government death panels, believe that medicare works well and they don't want the government taking it over, and other such silliness. (We get distorted ideas about the world.  On television ten thousand people seems important, but one million people is less than one-half of one percent of the adult US population.)

The best that Americans did on the questions above (the data for United States was 2004) was about 78% of people got the correct answer on questions #4 and #10. That means that about 22% of the folks got these two questions wrong. (Of course this was a sample of the US adult population - you have to understand some statistics and probability to understand the counter-intuitive notion that you can sample a small portion of the population and predict accurately what the whole population 'knows.' But assuming good statisticians were in charge, that means about 42 million people don't know the answers to #4 and #10.) (Remember, if people guessed on all the questions, the odds are they would have gotten half of them right.)

38% got question #2 (the father's gene) WRONG.

More than 40% got question #6 (antibiotics) WRONG.

I guess the most shocking was that 40% got question #8 (earth around the sun?) WRONG. For me this is more shocking because it is the most tangible concept and one that we can actually see and don't need too much coaching from grade school teachers to get. Maybe they should have asked about whether the earth was round or flat too.

Perhaps less surprising, but more disturbing were questions #5 (universe began) and #9 (human development from earlier species.) I say less surprising because it's a lot easier, conceptually, to understand that some giant bearded God, who leans from the clouds on the Vatican ceiling, created the universe and human beings than it is to understand the big bang theory or evolution. But over 65% got #5  and 58% got #8 wrong! I would add another caveat though. Reading beyond just the headline statistics, I found that when the question was phrased, "Scientific theory holds that ..." the correct/incorrect ratio flips. So, 20% know about the big bang and evolution, but just don't believe it. The other 40+% . . . who knows?

So how'd you do on the test? You can see the answers and the stats for the US, China, South Korea, Japan, Malaysia, EU-25, and Russia on this page from the National Science Foundation. This particular test is a few years old - the US and EU data are 2005. How many know what EU-25 means? Some must because I do get hits from people in Europe.

What does this have to do with anything? Do people really need to know any of this stuff? Not to lead their daily lives, but they do if they expect to have a clue about global warming, nuclear energy, stem cell research, and whether the earth is more than 6,000 years old. Or what various public policies are about. I suspect that a lot of people have knowledge in some areas, but not others.

I also don't think that there's a correlation between political parties and knowing the answers, but I suspect that the people who believe what Sarah Palin says, on the whole, do less well on this than the average person. But that's simply a guess, but it would be interesting to find out.

So what happens when someone doesn't know something? I'd say there are a couple of key options. They can

1. Pretend like they do know.

2. Keep quiet and hope nobody asks them a question that will reveal their ignorance

3. Acknowledge they don't know and feel stupid and helpless.

4. Acknowledge they don't know and decide to find out the answers.

The scary thing is people who are confronted with their ignorance - get asked questions like those above or those right below - see they don't know the answers, but then go on to believe that their opinion on any of a number of public policy issues is just as good as someone who knows all the answers. Ignorance really means not knowing how much you don't know.

If the questions above seem a little distant from our daily lives (in a sense we can use modern technology and generally live our lives without understanding how it works, but since we are voters, our ignorance imperils all). Here are some questions relevant to terms we hear and/or are expected to make decisions about in the course of our daily lives.

1. An acre equals how many square miles? (When you hear that a fire burned 2,000 acres, do you have any idea how much that is?)

2. How much is the Anchorage [replace with your own city] Municipal budget? (If we don't even know how much the budget is, how can we say it is too high?  How do we know that our taxes are too high? Compared to what? How much would we pay for what our local government does if we had to pay private companies?  )

3. How many milligrams of salt are recommended for an adult per day?(This apparently varies from country to country.)

4. What are the five most populous countries in the world?

5. Write one word in a language that doesn't use the Roman alphabet.

The first three questions cover concepts that are in the news every single day, yet most people can't answer them, though I'd guess number 3 will get the most right answers.

The last two we may not face every day, but wouldn't it be nice to know something about the countries of visitors and immigrants we meet?  Shouldn't we all be able to point out on a map where those five countries are? How about when we have a strong opinion about one of those countries? Those five countries make up 46 percent of the world's population. I'd say that we should know them before knowing the names of five deodorants or how many times Lindsay Lohan was arrested.

And the last one. You can survive without reading any Chinese characters, or not being able to read sushi in Japanese. But I promise you a lot of Japanese can read Starbucks in English.  I think non-Roman alphabets act like curtains to most people born in the US. They seem completely impenetrable. But they aren't really. Billions of people read Chinese, Russian, Arabic, or Hindi. 

In ten hours almost anyone could learn to read 20-50 words in a language with a different alphabet.  If you had a good teacher or a good book and the discipline to apply yourself. (Ten of the 20 most populous countries use non-Roman writing.)

Sorry.  I'm getting a little carried away here. I just want people to remember that few of us use a very large percent of our brains.  We have a lot of excess capacity.   Nevertheless, even people who use very little of that capacity are able to deceive themselves into thinking that their opinion is as good as anyone else's. Somehow, "the right to one's opinion" has morphed into "my opinion is as good as yours."

Until we each face our relative ignorance and gain a little more humility (if you aren't humbled looking at all the books in a library, what does that suggest?) we have little hope of getting along and taking care of the planet in a way that will sustain life.

Acres.

Anchorage Municipal budget.

Salt.

Populous Countries.

Black Screen Back so Back to MacHaus

The evil black screen came back last night after almost two days with no problem. As long as I don't leave my computer for more than a couple of minutes, I have no problem, but then it goes black and I have to reboot. Stephen at Apple thinks it might be a hardware malfunction and since it's still under warranty I can take it in to MacHaus and have them do a diagnostic. I did learn that the first call to Apple got me to the first level people and the second call on the same case number got me to a higher level expert who gave me a direct number back to him.

I hope this doesn't take long. Computer stores don't give loaner computers like some car places do when the car's being repaired. Besides, my computer is much more personalized than my car ever was. While I can blog from my wife's computer, all my stuff is on this one. But I do have everything backed up on the external hard drive.

Anchorage Daily News Updated Photo Policy - Icon-Sized Photos Usable

On August 14 I posted about the new acting police chief Steve Smith. The post incuded a photo of Smith I'd taken. The ADN posted an excerpt of the post and the photo along with a link to my blog.

I had done a post about the ADN letter to another blogger to take down a picture he'd gotten from their website and I'd supported the ADN's decision. But I also pointed out that the ADN had used blogger photos without permission in the newspaper and newsreader. While I favor general openness, I accepted what some people argue - that a photo is a complete work and so using the whole photo wasn't the same as taking a brief excerpt of text. The rules are evolving here and part of me is for sharing everything as long as there is proper credit and links. But when some people take other people's work stuff for profit, that isn't acceptable to me.

I wrote again about my own personal evolving guidelines for blogging two weeks ago and talked about photo policy there too. (There's another one where I talked about photo policy on pictures of kids.)

So, when the ADN had my photo of Smith up I emailed Mark Dent, who runs the ADN Newsreader, with copies to other higher ups at the ADN including publisher Pat Dougherty. I felt a little bad ratting on Mark like that without giving him a chance to make a correction first, but this was an issue bigger than him, and they needed to know their paper wasn't following the policy they insist bloggers follow.

I got an immediate reply from Dougherty apologizing, something about policy and actual practice needing to get in sync, and that the photo would be down before I got the email. Well, it wasn't. And it wasn't down later either. Mark sent an apology too saying he would take it down and there was some reference to fair use and 'icon-sized' photos. I asked him whether he was saying people could use 'icon-sized' photos of ADN pictures and he referred me up to the policy makers. I didn't follow up on it then, but last week when I checked out a sitemeter link from the ADN newsreader I found that the picture was still up and sent another email to the ADN.

I don't post the contents of private emails to me without the permission of the emailer, so I sent another email to Pat to ask if I could post his response and he wrote that was fine with him.

So, here's what I asked:

So, Pat, is the ADN policy now that it is ok to post 'icon size photos' even if they are copyrighted and you don't have permission? If so, I assume that means that is t[w]hat bloggers can do with ADN photos. Please clarify.

And he responded:

That's correct. I realize "icon-sized photo" is a term of art, without a precise definition. The intention is simply to provide our readers with the visual information that a photo is available by following the link provided. We try to do that with small versions of the photo that don't supplant the experience of viewing the photo in its full published form.

We are assured that's an appropriate fair use.

It's worth noting that the point of the Newsreader is to make it easy for readers to find content -- text or photos -- on sites other than our own. I have no issue with someone else doing the same with our material. [emphasis added]

"Supplant the experience of viewing a photo in its full published form" is definitely a term of art too. Thumbnail is a tiny picture that I interpret as smaller than what the ADN has published on the newsreader. Icon sized is what you see when you use Google image. Another aspect here is how big the photo file is. The basic question is, if the viewer clicks on the photo will it show up the same size or be much bigger. Originally, my photo of Smith could be enlarged on the ADN site, but they eventually changed that. [Now I can't even find the post anymore.] In fact it looks like they really are using smaller photos on the newsreader now, though most can be enlarged because, presumably, the ADN has copyright permission since they mostly are from AP or other Alaska newspapers.

I would note that when I googled - "icon-sized photo" fair use - I got this:

However, if you look up thumbnail sized photo and fair use, you get a lot of hits.

Wikipedia tells us this interpretation of the Fair Use Doctrine comes from

Kelly v. Arriba Soft Corporation (280 F.3d 934 (CA9 2002) withdrawn, re-filed at 336 F.3d 811(CA9 2003)) is a U.S. court case between a commercial photographer and a search engine company. During the case ownership of Arriba Soft changed to Sorceron, the operator of the Internet search engine Ditto.com. The court found that US search engines may use thumbnails of images (size limits not determined), though the issue of inline linking to full size images instead of going to the original site was not resolved.

Clearly a thumbnail of an image that someone searches for on a website or search engine is a different animal than the pictures at the ADN Newsreader. The Newsreader is more an extension of the ADN's news service, though Dougherty does phrase his reply to give it the search engine spin. But I'm not going to hire a lawyer over that. And the pictures the ADN is using now are getting pretty close to the size of the icons of pictures Google uses in Google image search results.

But Pat's email does say that the ADN photos can be used by bloggers without asking permission IF they are "icon-sized." Or better yet, thumbnail sized.

Kids Enjoy Chinese Cultural Fair in Anchorage

Yesterday afternoon I invited the daughters of friends to go to the Chinese Fair at UAA put on by the Confucius Institute. In the end, their parents came too. I was a little underwhelmed after the quality of Thursday night's performance. But even though the Student Union hadn't been transformed visually into a Chinese village fair, it turned out that the activities were good ones that got the kids and the adults involved.



Each table had some aspect of Chinese culture. This one was called Chinese toys and this was a game where you had to use chopsticks to move tiny beans from cup to cup.





This kid was really getting into the chance to learn some Chinese calligraphy. You can see the character for river (the three vertical lines) and below the character for mountain.





There was also origami - I didn't think to ask about the Chinese claim to what I thought was a Japanese artform.




There were also people who would write people's names on these tags using Chinese characters.













I was hoping to add something about Confucius Institutes in general but if I'm going to get this up, I'll have to leave that part for later. They are sponsored by the Chinese government through the Ministry of Education and they are a way for China to promote Chinese language and culture. There has been some criticism that this is a means of Chinese propaganda and even espionage. But I think the same claims can and have been made for Western organizations that do the same thing. One particular issue with universities is the extent to which the funding agreements give control to the Chinese over curriculum of regular university classes on language and China. One way universities have dealt with this is not by having the CI within academic units - such as the language department or other departments which might cover aspects of Chinese politics, history, etc. in their courses. My understanding of how this works at UAA is that the CI is NOT housed in an academic department, such as Languages, but separately with International Programs which has taken the place of the old American Russian Center.

The benefits, if this works out as hoped, will be extra resources to improve opportunities to study Chinese language in the Anchorage School System and the university and help for the business community that want to tap Chinese markets and resources. If this is going to be more than a symbolic presence, I suspect there will need to be more resources and a clearer focus on a few things that can be done well.

That's actually the gist of what I had to say. Perhaps I'll get up a post with more details another time.

Guests to Airport and Checking Out Consumer World

I took our guests to drop off their rental car. Since they wanted to go to McCarthy in Wrangle-St. Elias National Park, they had to get a local company that allowed driving on the McCarthy road. The look of the place was a refreshing change from the standard airport car rental clones. Even on a rainy morning it was bright and cheery.




Coming back from the airport we often pass this giant furniture store that popped up on this corner a few years ago, but we've never gone in.

Still a little embarrassed by the saggy hide-a-bed couch our guests slept on, I decided to just see what Bailey's has to offer. I haven't looked at furniture in Anchorage for many years. I just remember it being expensive and with a limited selection. I didn't get far on this early Saturday visit before Pam asked if I needed any help, coffee, soft drink, etc. I said I was just looking and she left me alone. Later, I did catch Pam and her trainee, DeLynn 'lying down on the job.'







I wandered into what I thought was a small section. Hah! The Home Theater section is bigger than most Anchorage furniture stores. There I ran into Pam and DeLynn again. It looked like I had to retrace my steps and they came along. It was very low key, I think it was clear I wasn't going to buy anything, but they did want to show me around and make sure I saw the waterfall.







Above the waterfall to the second floor is a large rock wall with various birds and other animals. I'm not much of a big time consumer and this is not the kind of place I spend much time, but since I prod others to go places they haven't gone before, I think I have to take my own advice, so there I was.

Most of the furniture is just not my taste, but I thought the prices were reasonable by Anchorage standards, though I can't judge the quality well. And, if nothing else, on a cold wintry day, this store might be a good place to go walking. You can go up and down the stairs and there's lots of room, plus they give you free coffee.

Somehow I feel compelled to say this is not a paid store ad, it's not even an ad. It's just part of Anchorage and so is fair game for this blog. And Pam and DeLynn were delightful hosts.

University of Alaska Anchorage Confucius Institute Opening Celebration

Thursday night I walked over to the Wendy Williamson Auditorium at UAA to see the performances celebrating the opening of the Confucius Institute. I've been busy with a number of things today - including computer problems following the installation of Snow Leopard which I think may now finally be over - so I had trouble getting the video completed. [Update Oct. 3 - see this later post for what the Snow Leopard problem was for me. Doesn't mean it will work for you, but it seems to have solved my problem.]

I'll try to do another post or two - one on Confucius and one on Confucius Institutes - but in the meantime here's a glimpse of the celebration. There were entertainers from Anchorage, other parts of the US, and some brought over from China.

This really did have a Chinese feel to it. I was particularly interested in seeing the 'change of face' act. This is a particularly Chinese art form handed down from generation to generation. There's a great film about such an artist who is looking for an apprentice to teach his art to. And as part of the Opening Week celebration, the Confucius Institute will show the movie Saturday night. This is an amazing skill and Thursday night was the first time I saw it in person. It's at the end of the video.




The following is what UAA's website had about Thursday's show (there's a bit of all of the acts on the video)

A Celebration of Chinese Performing Arts

Thursday, Sept. 10, 7 p.m. at the Wendy Williamson Auditorium

• Dr. J.D. Zhang, Sichuan Opera “Change of Face” artist and master of traditional Chinese magic [top picture]
  
• Guoming Sun, Asia International Martial Arts Champion performing double Chain-whip and Drunk Sword [right]
  
• Weiguang Dang, Famous Chinese Baritone
• Dr. Yuxiang Wu, Classical Chinese Flute
• There will be choral singers, dancers and other performances by members of the Alaska Chinese Association.

There was also some formal stuff. The Dean of the College of Arts and Sciences [left] spoke as did the director of the Institute and the the Vice Consul General from the Chinese Consulate in San Francisco [picture above.]

All the events are free. Friday night there was a talk on "Overcoming the Global Economic Crisis: The Chinese Gamble" which I missed because our (originally from Taiwan) guests got back from their trip to Kennecott Mine this evening.

Here's the Saturday schedule from the Institute website. I expect this too will be pretty genuine and worth attending. And it should be good for kids and it's free. This is not your every day fare, the Chinese government is using these Institutes to put a good face forward in the world, so this is probably as close to being in China as it gets at a public event in Alaska.

Chinese Adventure: A carnival of
activities, games, performances and prizes

Saturday, Sept. 12, Noon to 4 p.m. at the UAA Student Union on the 1st Floor [parking is free on Saturdays, and if you don't know where the student union is, this is a good time to go looking for it (it's on Providence between Providence Hospital and Lake Otis) next to the sports center].

Come witness and participate in traditional dance and martial arts performances, calligraphy, paper cutting and folding, Chinese games and more. These opportunities made possible with assistance from the Alaska Chinese Association and the UAA Chinese Language Club.

And then in the evening the movie I mentioned above. This is a really interesting movie and if I recall right, appropriate for kids. [Let me amend this thought. It's probably good for mature kids about 12 or over. It probably has subtitles, but if you are one of those anti-subtitles people, try not to pass that prejudice on to your kids. It helps them improve their reading and gives access to many great films.] One of the key characters is the kid who is being trained. The Fine Arts Building is on the far east side of the campus. The street that comes out of the Providence Hospital onto Providence Dr. goes right into campus there. Turn right at the first corner.

Film Presentation: The King of Masks (1999)
Sunday, Sept. 13, 6:30 p.m. in the Fine Arts Building 150
Directed by Wu Tian-Ming, The King of Masks is set in 1930s Sichuan Province and tells the tale of an aging master of the traditional Sichuan Opera art of Change of Face, rapid mask changes to display the emotions of varied players, and his quest to find a protégé to carry on his art. This is a simple, moving and well-acted film starring Zhang Zhigang and Xu Zhu.

Moving To Snow Leopard [UPDATE: The Black Screen of Snow Leopard]

[Update: I've joined an elite group who have their screens turn black. A Mac Forum came up with some possible work arounds, but not real fixes. People seem to think it has to do with the picture preview and I've been using iPhoto and now iMovie. I can get something back if I hit the F10 key or those around it, but the edges of the screen are black and then it all goes black.]

[Update Sept 23: for the progress of this still ongoing issue, see comments to this post and check the label (right column bottom) 'snow leopard.' As I write I'm waiting for a new adapter cord that is coming by Fedex from Apple. I've narrowed it down: the only time I get the black screen is when the adapter cord (the white cord the comes with the Macbook) is connected and I don't touch the keyboard for a few minutes. When it runs on battery and I leave, nothing bad happens.]

I bought a copy of Snow Leopard when it came out almost two weeks ago now I think. At the Apple User Group that following Wednesday I saw a copy of the ebook, Take Control: Upgrading to Snow Leopard. That seemed like something useful to look at before upgrading.

I did learn some things. I thought I had a bootable back up before, but apparently not. So I downloaded Carbon Copy Cloner at the book's recommendation. But after going through lists of all the things that can go wrong, I was less inclined to install Snow Leopard. (Snow Leopard is the operating system upgrade for Macs. It follows Leopard, Tiger, and Panther.)

Finally I realized that I was getting advice that was appropriate for going to the moon but I was just going for a bike ride. The odds were good that nothing bad was going to happen and if it did, I'd go back to the MacHaus and have them help me. So, today, I finally installed Snow Leopard. The instructions in Snow Leopard merely said to stick the disk into the computer and push the install button. (The ebook was about 80 pages of things to worry about.) Actually, it would be nice for installation material to tell people to have the 5 gb free that they told us at the meeting (the ebook said, well, you really should have 10 gb free). It took 1 hour and 25 minutes.

At the meeting, Ben, the Apple guy from Best Buy who comes to the meetings regularly and really knows his stuff, told us we'd get 7GB freed up when we had Snow Leopard installed. That's pretty cool - not only does it not take up more room, but it cleans up stuff already there and you have more room when you are done than when you started. Well I started with 7.53 GB free and when it was over I had 21.56 GB free. (Yeah, I know, it must have been a real mess in there. But at least the installation cleaned it up.)

So I still have to send in a review for the ebook. It's for people who really want to take precautions for every possible thing that could go wrong. My suggestion is to make sure you've got 5 gb free and then go for it. Well, back up all your files first, at least, on an external hard drive. The ebook is for people who want to know the details of every possible illness they could ever have.

Now I'm checking things out. It says I should have a download 'stack' but I don't see one. One of the coolest new features is the ability to draw Chinese characters on the trackpad, but I haven't tried that either. If it were Thai letters, I would have tried by now.

So now I can start plowing through all the other manuals for electronic equipment that have been pouring into my life.

[Update Oct. 3 - see this later post for what the Snow Leopard problem was for me. Doesn't mean it will work for you, but it seems to have solved my problem.]

Public - Private Conflict in US Health Care - Some Historical Context

Rashmi Prasad, a colleague at the University of Alaska Anchorage, and I presented a paper in a conference on poverty reduction in New Delhi in 2006. We were trying to step back and look at how Indians and Americans think about poverty based on their differing models of the world and humans in that world. We assumed if there were different basic models of the relationship between society and the individual, this would lead to different approaches to policy for alleviating poverty. For our key example of poverty policy in the US, we used material Rashmi had developed previously on:

"the evolution of the almshouse, or poorhouse, to the nursing home, the present repository for the elderly poor who can no longer live independently."

A significant part of that history is related to conflicting American stories about public and private responsibilities. I think this history helps inform the battle that is going on now in the US over health care reform so I thought I'd try to excerpt some of Rashmi's argument. I'm going to excerpt much more extensively than I normally would from a paper, but it is a paper that we wrote, so we aren't stealing anyone else's material. The whole paper is available at Google books. The link starts at this discussion of alms houses, but you can scroll to the beginning if you like.

First we described some of the American stories that underlie our modern health policies. There's a lot more detail, of course, in the paper. [Most of the rest of this is quoted from the paper. If it is indented, it's a quotation - at least it is my intent to indent.]

Story 1: Self-Determination and individualism: The Liberal Creed

This is a seminal United States narrative embodied in the US Constitution’s “life, liberty, and pursuit of happiness.” Individuals are free to determine their fate, free to choose, free to fail. It is a creed consonant with the optimism that non-Americans often find characteristic of the country. High value is placed on achievement and ascription. One will boast of humble origins and being a self-made man. The rugged individual is celebrated, along with the virtues of thrift, initiative, enterprise, and self-reliance. We see this in politics as well as the popular culture. Herbert Hoover warned against the slackening of these values in his opposition to Franklin Roosevelt’s ‘New Deal’ initiatives during the Great Depression (Hofstadter 1968: 263).

• "We must have government that builds stamina into communities and men…. We must stop this softening of thrift, self-reliance and self-respect through dependence on government. We must stop telling youth that the country is going to the devil and they haven’t a chance. We must stop dissipating the initiative and aspirations of our people. We must revive the courage of men and women and their faith in American liberty. We must recover these spiritual heritages of America. . ."

• "This is a classless country. If we hold to our unique American ideal of equal opportunity there can never be classes or masses in our country. There is no employing class, no working class, no farming class. You may pigeonhole a man or woman as a farmer or a worker or a professional man or an employer or even a banker. But the son of the farmer will be a doctor or a worker or even a banker, and his daughter a teacher. The son of a worker will be an employer—or maybe President."

This narrative has often been mobilized to counter arguments favoring social-insurance by characterizing it as a form of group coercion of individuals and ‘creeping socialism’. Such narratives have helped to maintain physician’s property rights and to define health services as commodities instead of entitlements.

Story 2: The Deserving and Undeserving Poor

The existence of poor people in the United States required other stories. Differentiating among the deserving and undeserving poor became a pressing social concern in periods of tangibly rising pauperism. Traditional Christian narratives required relief for the sick and the lame. However, increases in claims to public relief were attributed to inappropriate outdoor relief to the able-bodied. The Quincy report (a commonwealth of Massachusetts commission on pauper laws in 1821) indicating the two classes of poor:

1. The impotent poor; in which denomination are included all, who are wholly incapable of work, through old age, infancy, sickness or corporeal debility.


2. the able poor; in which denomination are included all, who are capable of work, of some nature or other; but differing in the degree of their capacity, and in the kind of work of which they are capable. (Quincy, p.1) . . .

Story 3: The Christian Ideas of a Calling and of Charity

Protestants were the dominant Christian denomination to settle in the North American colonies. Their form of Christianity saw work as a religious calling, as the morally proper thing for people to do. “The Protestant Work Ethic” or just “Work Ethic” is still invoked today, as is the proverb “Idle hands are the devil’s tools.” Yet, Christ’s advocacy of charity to those less fortunate was also present and underpins some of the story of the deserving poor.

Story 4: Science – the solution to all problems

The 20th Century saw a rapid rise in the application of science to society’s problems. With science came the professionalization of increasing numbers of social domains from the late 19th century onwards (Abbott 1988). The public became accustomed to listening in awe to the ‘miracles’ produced by modern science. The field of medicine, for example, suddenly had a scientific basis, medical schools became professionalized, and it emerged as the exemplary and most prestigious of professions as doctors were now able to more reliably cure many more patients. For many, science became a new religion.

Story 5: The Government’s Role

Stories can be powerful, but when the story hits smack against a contradictory reality, new stories begin to emerge. The power of corporations at the beginning of the 20th Century raised questions about laissez faire capitalism and Theodore Roosevelt used his power as president to bust the large trusts. The Great Depression demonstrated even more problems with capitalism. Marxists stories – many brought by immigrants – began to compete with the market story. Keynesian economics argued for a powerful role for government to macro-manage the economy and strongly influenced President Franklin Roosevelt’s New Deal programs. The American story was not a Communist story as much as a story about the need for a strong government to counter market failures. By the late 1970s, the new reality of the tremendous growth of government along with an economic depression, made the market story appealing again. Ronald Reagan was elected President in 1980 on the theme that government was the problem and that the market was the solution.

Okay. This background now gets us to the Almshouses story in which we tried to show how these different American values played a role at different times.

The Almshouse

The corporate towns of Colonial America were essentially made up of members and closed to others. These towns provided ‘outdoor relief’, to recognized members of a community. ‘Outdoor relief’ could be money or goods given to the member. By the early 19th century increases in pauperism, especially of the urban, rootless sort had become prevalent and a rising financial burden on existing outdoor relief practices maintained by cities. A desire to weed the able-bodied (i.e. undeserving) from the relief rolls brought advocates of ‘indoor relief’ into prominence. ‘Indoor relief’ meant that beneficiaries became, essentially, inmates, of physical institutions. Here relief was controlled by the institution, not the poor beneficiary. The term inmate, used to describe the inhabitants, reflects their status. If you were poor and in need you went to the almshouse. This included the sick, though few special provisions were made to treat illness in almshouses. Inspired by Benthamite ideals, these reformers advocated the substitution of outdoor relief with institutions that would deter the able-bodied poor from seeking relief, rehabilitate the deserving poor through productive work, and, in the expectations of some reformers, even turn a profit. Administrators of poorhouses went to considerable lengths to enforce the norms of work:

"In 1855 a New York critic of relief praised the success of the Providence, Rhode Island, poorhouse which, he claimed, utilized pauper labor so efficiently that it operated much more cheaply than almost any other urban almshouse. Even if the almshouse managers had no “profitable work”, they set inmates to work at some task, however pointless. During his last visit, he “saw a party of men carrying wood from one corner of the yard to another and piling it there; when it was all removed it was brought back again and piled in the old place”.(Katz 1984: 120)

As Katz (1984) points out, amongst the contradictory goals of poorhouses, harsh deterrence emerged as their primary function. Poorhouses’ ominous reputations made them a fate to be avoided in 19th century America. Yet from the mid-19th century onwards, the institution endured, though specific populations were moving out to specialized institutions. Children went to orphanages, the mentally ill to asylums, and the elderly poor of specific religious denominations to church run shelters for their own members. Large scale hardships such as economic depressions, and the smaller personal calamities which befell poorer families left few recourses but the poorhouse for the rest.


The first community hospitals offered limited medical services, and were not frequented by physicians. They were largely board and care facilities to help the feeble, dependent aged of their respective communities cope with chronic ailments. Dr. William Osler was one of the first physicians to make a regular practice of visiting hospitals, in order to show his students a range of interesting medical cases. In the first decades of the 20th century, the hospital became a site of increasingly intensive medical care, and less a place for the care of chronic old age ailments.

Old Age Homes

Poorhouses persisted well into the 20th century and became largely the abode of the aged poor and sick lacking either the means, family, or religious community support. These institutions were funded and operated by county and municipal governments and the bad reputation they had long since acquired was endemic in the popular mind. ‘Over the hill and to the poorhouse’ for example was a story in Harper’s, which subsequently became a popular song (Haber, 1993, p. 91)

Social Security

The poorhouse endured until the advent of Social Security legislation in the 1930s. People had long advocated for old age pensions. There was an important precedent in the form of Civil War veterans’ pensions, which ultimately became an old age pension and at its height consumed one-third of the U.S. federal government budget. It was the trauma of the Great Depression that once again brought the issue of old age pensions to the forefront, contributing to the passage of the Social Security Act of 1935. Social Security put the benefits into the hands of the beneficiaries, a point of debate before passage, reflecting the older change from ‘outside’ to ‘inside’ relief, revolved around the question: should direct payments be made to poorhouses or to their aged inmates? The decision to make direct income payments to the aged residing in poorhouses led to an exodus from the institutions in favor of private board and care, which had become abundant because of the Depression era need for households to take in boarders to generate income.

Capitalistic Medicine

Medical doctors were among the best organized and most prestigious professions in the newly industrializing United States. Local medical societies exerted a powerful influence over the character in health care in their communities. Above all, doctors fought to maintain a ‘fee for service’ character to their practice of medicine, fiercely resisting the formation of ‘pre-paid’ and other ‘socialistic’ forms of financing health services.

Failures of National Health Insurance

Health insurance emerged in the United States first as a private commodity, not as a means to pool the health risks of the entire population, rich and poor alike. The largest insurance underwriter, Blue Cross, emerged as an answer to a slump in the demand for hospital services during the Great Depression. Formulas for reimbursement favored the provider of health services entirely. Attempts at national health insurance to pool together the entire population have suffered resounding defeats, starting with President Harry Truman’s proposal in 1949 (defeated by the American Medical Association-the principal representative of doctors) to Bill Clinton’s Health Security Act in 1994.

Medicaid and Medicare

After emerging as a private commodity, health insurance became a job benefit for those employed by well-to-do public and private employers. The poor and the aged remained outside the umbrella of this private welfare state. Poor relief, including health care, remained the bailiwick of local governments, and the poorly equipped county hospitals. The legacy of the Great Depression resulted in a more activist federal government, and with the elections of John F. Kennedy and Lyndon Johnson, such notions as the ‘Great Society’ and the ‘War on Poverty’. A rare conjuncture of events led to an extension of Social Security legislation in the form of ‘Medicare’ (hospital insurance for the elderly) and ‘Medicaid’ (insurance for low-income persons and families).

Those Americans with health insurance (about 85%) are grouped into the following categories: the favorably employed, the aged, the poor, and military veterans. The quality of coverage among the groups forms a class hierarchy, with the favorably employed at the top and Medicaid viewed by health providers as the least desirable.

Nursing Homes

The evolution of health services for the poor in America comes full circle in the nursing home. In the United States over 1,500,000 elderly permanently reside in ‘Skilled Nursing Facilities’. They are largely custodial facilities for the poor and chronically sick aged, operated by for-profit corporations. [NOTE: We are talking here about nursing homes for the poor. There are also nicer physical facilities for those who can afford them.] Critics charge nursing homes with creating an inhumane environment for inmates through an over-reliance on psychoactive medications and physical restraints, and an impoverished social support network. Most residents of these institutions are Medicare and Medicaid beneficiaries; however, payment is made through Medicaid (the ‘welfare’ program rather than the entitlement program.). Nursing home care for Medicaid recipients is reimbursed at Spartan levels, leaving few resources for genuine medical services.

Despite the quality of services, Nursing Home care consumes the lion’s share (about one-half) of the health care resources earmarked for the poor, one more indication once again, of America’s priorities in helping the ‘deserving’ poor.

The conflicts between the belief of many that health care is a right, that we shouldn't let people die because of poverty (Christian charity values) and the belief that people should take care of themselves and not become wards of the state (rugged individualism) still play in today's health care debate. So do the other 'stories' mentioned above.

This was an overview for an Asian audience of the evolution of health care for the poor in the United States, from almshouses to nursing homes. The point of the paper overall was to illustrate that approaches to poverty reduction will differ from culture to culture, based on the world views and value systems of each culture. The United States, with a strong belief in the opportunities for and responsibilities of the individual talks about poverty very differently from a culture like India where there is much more focus on the systemic and class structure and how they need to be modified to reduce poverty.

In any case, I think Rashmi's overview, abbreviated as it is, might help some people get a longer term perspective on how we got where we are today and why.



References:

Abbott, Andrew. (1988). The System of Professions: An Essay on the Division of Expert Labor, University of Chicago Press, Chicago, Il.

Haber, Carol. (1993). “’Over the Hill to the Poorhouse’: Rhetoric and Reality of Institutional History of the Aged”, in Societal Impact on Aging: Historical Perspectives, edited by Warner Schaie and Andrew Achenbaum, New York, Springer Publishing Company, pp. 90-113.

Hofstadter, Richard ed. (1968). Ten Major Issues in American Politics, Oxford University Press, New York, NY.

Katz, Michael B. (1984). Poorhouses and the Origin of the Public Old Age Home, Milbank Memorial Fund Quarterly, 62(1): 110-140.

Quincy, Josiah (1821). "Report of the Committee on the Subject of Pauperism and a House of Industry in the Town of Boston." Kress Collection. Baker Library at Harvard, Cambridge, MA.

Missing. Looking. Found.

When you bike you see things you miss driving. This poster was right next to me as I waited for the light to change. I couldn't help but wonder, "What happened?" "Did they find him?"

So, when I got home I called. The woman said, "Oh, yeah, we found him, you can take the poster down."

Short story: Someone went missing. People cared enough for him to post signs all over. They found him.

If you see one of the posters, you can take it down.