FRIDAY, JULY 1, 2011
Op-Ed: The final payoff
It’s worth considering the benefits of turning down end-of-life care
BY REIHAN SALAM
It can cost as much as $10,000 a day to keep a dying patient in an intensive care unit. Over weeks and months, those numbers add up. More than a quarter of all Medicare spending occurs during the last year of patients’ lives, much of it on treatments that have no hope of succeeding in any meaningful sense. As far as most medical providers are concerned, this arrangement works just fine. The money flows into salaries, facilities, pharmaceuticals and new medical equipment, keeping millions of people employed and happy.
But it is worth remembering that the money Medicare spends at the end of life could be life-changing for families. A month spent in intensive care could, for example, cost $300,000, enough for a middle-class family to buy a home or start a business or pay for a lifetime of education. Yet Medicare offers patients only two choices when they are diagnosed with a fatal illness: pull the plug and get nothing or undergo an expensive course of treatment and let taxpayers foot the bill. There needs to be another way.
President Obama has been tearing into congressional Republicans for refusing to back tax hikes as part of a deficit deal. The core conservative concern about taxes is the desire to avoid what Keith Joseph, one of Margaret Thatcher’s closest political allies, called “the pocket-money society.” As the responsibilities of government expand, and as government’s share of our paycheck grows, Joseph argued, we’re left in the position of children collecting an allowance. The major life decisions are handled by people wiser than ourselves, and we’re left with pocket money to spend on nights out at the movies and other frivolous things. This may not be entirely fair. There is such a thing as being too anti-tax, particularly when we face enormous deficits, and Republicans should be more open to curbing tax breaks and loopholes.
But it is also true that we could save a great deal of money by giving people more choice and more responsibility for how they live their own lives, particularly when it comes to Medicare. We might even save enough to eliminate the need for steep tax hikes. Earlier this year, House Budget Chairman Paul Ryan offered his plan for Medicare premium support, which would offer subsidies to Medicare beneficiaries to purchase their own insurance plans. This represented a big step forward. Critics have warned that Ryan’s subsidies are too stingy, and Democrats have fought the proposed overhaul tooth and nail. Though something like premium support should eventually be implemented, reformers have been looking to other strategies.
That is where cash-for-care comes in. Lorens Helmchen, a health economist at George Mason University, has been working on an innovative proposal that would give patients a cash payment for choosing a lower-cost therapy over a higher-cost one. While there are many kinks to be worked out, the basic idea is deeply attractive. It increases cost-consciousness, thus encouraging medical providers to lower their costs rather than pad them. It also has the potential to increase non-medical consumption for the elderly. Helmchen is keenly aware of the potential dangers of his proposal, including the danger that it will be interpreted as a bribe to patients to choose less-than-adequate care. That is absolutely not his intention. He is calling for a modest pilot program that would be used in relatively few instances.
My own view is that cash-for-care should also include cash-for-no-care. Painful as it is to say, a father facing a terminal cancer diagnosis will save taxpayers an extraordinary sum if he chooses to die peacefully rather than press for the most aggressive, and most expensive, treatment. He should be allowed to give some portion of the money that would otherwise have been spent raging against the dying of the light to the people he loves. I realize that some will find this heartless and cruel. One hates to think of family members pressuring elderly relatives into giving up hope prematurely just to make a profit. But it is important to remember that the status quo generates enormous profits for those who offer false hope, a fact that should be more than a little morally discomfiting.
Ultimately, cash-for-no-care would lead to a redistribution of resources away from medical providers and toward families burdened by the loss of a loved one. And that strikes me as decent and humane.
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Photos from day one of Kate and William’s Canadian tour
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The History Page: The Gospel queen of L.A.
Aimee Semple McPherson saves souls – sexily and scandalously
BY SWATI PANDEY
After surviving the death of her first husband from malaria, being stranded in China with a newborn, and nearly dying herself after several operations to cure her of a disease that doctors couldn’t diagnose, 23-year-old Aimee Semple McPherson began touring the United States in what she called the “Gospel Car,” a 1912 Packard marked with the words “Where Will You Spend Eternity?” She had received what she believed to be a message from God to preach to her countrymen, and would go on to expound the faith she knew from childhood, a tempered Pentecostalism.
McPherson was tall, dark-haired, beautiful and magnetic, capable of easy seduction but avowedly conservative and wholesome, the non-secular version of some current, comely Republican candidates. She was a preternaturally skilled public speaker, who sometimes spoke in tongues and healed the sick. Crutches piled up outside her revivals. As word spread of what seemed to be miracles, she worked her way from roadside revivals to massive public arenas. But in her early career, she never named her theology or articulated it precisely.
In 1918, still a mere 28 years old, she arrived in Los Angeles in her Gospel Car. The city was on the verge of an immense economic and population boom, thanks to oil, real estate, Hollywood and the sun. It was rife with religious fervor of all kinds — members of new cults and old traditions papered the city with fliers and hired migrants to walk the streets with signs.
McPherson didn’t originally intend to launch her own sect. In her early career, it seemed her only goal was to help her followers be born again into any Protestant faith — to save souls. But her theatrical methods, which included all-night tent revivals, suggested a craving for fame and widespread adulation. Whatever her motivations, in the City of Angels she became the founder of her own faith, the International Church of the Foursquare Gospel, which, even 90 years later, would have thousands of branches and millions of members.
Within a couple years of arriving in the growing metropolis, McPherson set about constructing Angelus Temple at the intersection of Glendale and Sunset boulevards. To help fund it, she solicited “chair-holders,” asking for $25 from donors for a seat in their name: “Do you know that some poor discouraged sinner may sit in your chair and be converted?” she asked her audiences.
In the fall of 1922, McPherson had the vision on which she would base her gospel. In it she saw the creature described in the Old Testament book of Ezekiel as having the faces of a man, a lion, an ox and an eagle. “In my soul was born a harmony that was struck and sustained upon four, full, quivering strings,” McPherson said of the vision, “and from it were plucked words that sprang and leaped into being — the Foursquare Gospel.” She believed each face represented an aspect of Christ as, respectively, savior, baptizer, healer and future king.
The gospel, like much of McPherson’s career, seemed equal parts inspiration and calculation, aimed at reaching the most people and winning the most attention. Like other elements of her preaching, the Foursquare Gospel was by no means new; McPherson simply delivered it with the most punch. She stressed ties between Foursquare and other Protestant faiths against the looming threats of modernism, Darwinism and Swing-era vice.
Angelus Temple opened on New Year’s Day 1923, a grand neoclassical building shaped like a megaphone. McPherson invited to the stage preachers from the Methodist Episcopal, United Brethren, Baptist, Congregational and Southern Methodist denominations. They spoke to a capacity crowd of over 5,000, who were seated in mahogany chairs, below a domed ceiling painted like the sky, in front of a $22,000 organ.
Foursquare’s first church was a hit. Every seat was filled for three sermons daily, and McPherson decided to expand her work. She performed “visual sermons,” posing, for instance, as a damsel in distress opposite a tall, menacing image of the “gorilla of evolution.” She took over a radio station to broadcast the gospel. She launched a commissary that came to serve hundreds of thousands of poor during the Depression. She instituted a biblical college that ordained women, to no small controversy. Foursquare spread across the country and the world, calling its churches “lighthouses.”
But McPherson’s supporters and detractors both credited for her success a quality that had little to do with the potency of Foursquare: her sex appeal. She was an ideal vessel for religion at the dawn of the celebrity age. Her lips were full, her hair luxuriously curled. With the figure of a Hollywood star, she often struck poses for photographers, dramatically lit, one hip slinking sexily below the other. She wore virginal white as a rule, but often in the form of tight satin gowns. Reporters commenting on her opening-day sermon remarked on her “womanliness” — some genteelly said no more, while others couldn’t resist using the word “buxom.”
Though the church still has 60,000 “lighthouses” around the world, McPherson’s legacy is ineluctably bound to her sex appeal, not her gospel, and particularly to the scandals she seemed to court. The largest and unseemliest was her claim of being kidnapped, drugged, tortured and abandoned in the Sonora Desert in 1926. No evidence of any crimes — or any injury to her person — was found, and most suspected she ran off for the weekend with a lover, an episode that Pete Seeger memorialized in song: “The dents in the mattress fit Aimee’s caboose.” Her early death in 1944 (likely due to an accidental overdose of Seconal) and elaborate funeral (a 1,200-pound brass coffin, nearly dropped by its pallbearers) inspired much sorrow and conspiracy-theorizing. The outburst of mourning left many to wonder what was more powerful for Aimee’s followers, the woman or the church. Today, McPherson is best known, like many a mass-media evangelist after her, for her failings, not for her faith.
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Point/Counterpoint: Lord of the swimsuits
This summer’s feature: The return of the one-piece
BY EMMA BARKER
One-pieces are a hard pill to swallow. The prospect of a white-blue midriff persevering through August is enough to bring out last year’s bikini. Not to mention the other pitfalls: wedgies front and back, side-boob, alien tan lines, that weird slopey section where the suit doesn’t quite hug your body. On the one hand, one-pieces conjure images of a curvaceous Marilyn Monroe looking sleek and flattered while frolicking in the waves like, you know, we all do in one-pieces. On the other hand, they evoke memories of ’90s grandmas sporting brazen, form-fitting florals. Last season, fashion designers eased us into the trend with cut-out suits and barely connected bikinis, but this year the one-piece of the ’60s is back with the full force of its tummy reinforcement panels. Shopping the trend brings up whole new body issues I’d never before considered: Is my torso longer than the average torso? Should I find one that covers my hip bones? (Yes, unless you want to look like Jane Fonda.) But, just as my new one-piece embraces me in a warm, sunny hug, so I embraced my newly reserved look. Are you on board with the one-piece? We pondered both sides of the issue.
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Another brick in the haul
Toys by subscription train the next generation of Lego experts
BY NICHOLAS DELEON
Ever think you’d see the day when you’d be able to buy a Lego subscription?
Lego Master Builder Academy is the company’s first foray into premium, subscription-based toy distribution that’s for kids 8 years old and up. In fact, it’s the first subscription-based toy scheme that The Daily could remember. A $29.99 starter set, called Level One Lego Master Builder Academy Space Designer, was released June 1, with a further five sets available as part of a subscription that goes live today.
And just what does a Lego subscription get you, besides an almost infinite number of geek points? For $69.99 per year (available via the company’s website, or at Legoland parks and discovery centers), a new Lego set comes to your door every other month. Lego has already announced the next six sets, and they include a Microbuild Designer, a Robot Designer, a Flight Designer, a Create Designer and an Auto Designer. As you might expect, the difficulty increases with each subsequent set.
Each set comes with a thick instruction manual that includes plans on how to build up to three different creations, including handy tips from actual Lego Master Builders. (Yes, there’s such as thing as Master Builders: They’re the guys who design the sets and create the large displays found at various parks and stores.) A single subscription lasts for one year and also grants access to exclusive, subscribers-only Web content.
The program is currently only available in the U.S., though Lego plans to make it available elsewhere beginning in 2012. Considering the company’s European roots — it was founded in and is based in Denmark — it’d be hard to imagine it being U.S.-exclusive for too long.
Lego Master Builder Academy also includes a number of social features to make using the service a little more sticky. The system awards badges for completing certain tasks, such as advancing through the levels, and these badges can be shared and compared online. Each set includes five different badges that can be earned.
All told, subscribing to the service will net you some 1,000 Lego pieces over the duration of the subscription. The Space Designer starter set, for example, comes with 178 pieces.
“People are really excited about learning from Lego Master Builders,” said Michael McNally, Lego’s brand director. “Kids love getting things in the mail, and for parents and other gift-givers to look forward to a new set every other month see it as the best gift they can give.”
The idea behind Lego Master Builder Academy (MBA, get it?) isn’t merely to get you on the hook for several months, but to encourage “a generation of more accomplished builders by giving them the tips and insights they need to conceptualize and design their own models,” Lego senior brand manager Tim Kirchmann said in a statement.
The Daily has been playing with the program’s Space Designer starter set for a few days now, and if nothing else, it’s created an intense desire to spend all day stacking and restacking hundreds of Lego pieces. We were able to build the first set in a little less than an hour, with the detailed build instructions far and away more helpful than the sometimes cryptic instructions found in Lego sets of old.
“Figuring out how much information to include in each kit was probably the biggest challenge in creating Master Builder Academy,” said McNally. “We had to be disciplined so as not to include too much information, so that by the time you get to more advanced kits, you feel as if you’ve made progress and have gotten better as you go along.”
Even though Lego Master Builder Academy is described as being for kids 8 and up, what person wouldn’t want to receive a steady stream of brand-new Lego sets every few weeks?
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$100 million man gives us the slip
Wrong hedge funder named as owner of mega-checking account
BY RICHARD JOHNSON FRIDAY, JULY 1, 2011
The billionaire who left an ATM receipt showing he had nearly $100 million in his bank account isn’t hedge funder David Tepper, as was first reported. It’s hedge funder Ron Baron, sources tell The Daily.
The receipt, also showing that $400 had been withdrawn for a fee of $2.75, was left at 10:14 p.m. June 18 in the slot of the ATM machine at the Capital One Bank in East Hampton, N.Y., where the next customer found it and sent a photo of it to Dealbreaker.com.
The website identified the $100 million man as Tepper, even though Tepper, who runs Appaloosa Management, said he hadn’t used an ATM in three years, and hadn’t been in the Hamptons in the month of June.
Tepper — who recently paid $43.5 million for a house in Sagaponack that he promptly demolished to build a mansion twice its size — also told the New York Post, “I would never do something as irresponsible as leaving $100 million in a savings account.” Bank accounts earn hardly any interest, and the FDIC insures a maximum of only $250,000.
Sources say the real ATM user was Ron Baron, of Baron Capital Management, who bought a farm in East Hampton four years ago from Adelaide de Menil for $103 million, a record for residential real estate at the time. Baron’s new 28,000-square-foot house is almost complete — with painting and landscaping costs no doubt requiring a great deal of liquidity.
Baron was not immediately available for comment.
Credit: The Daily (www.thedaily.com)
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