Tuesday, July 22, 2014

Fourfer Tuesday

1. Barefaced Shamelessness.

You'd think, given the current white-hot scandal in which it's embroiled, the IRS would put this on hold for the moment:

Days after IRS officials said in a sworn statement that former top agency employee Lois G. Lerner’s computer memory had been wiped clean, the agency put out word to contractors Monday that it needs help to destroy at least another 3,200 hard drives.

The Internal Revenue Service solicitation for “media destruction” services reflects an otherwise routine job to protect sensitive taxpayer information, but it was made while the agency’s record destruction practices remain under a sharp congressional spotlight.

Congressional investigators of the IRS targeting of conservative groups have been hampered by the unexplained destruction of emails and other records of Ms. Lerner, the former head of the IRS tax-exempt division and a central figure in the scandal.

The loss of Ms. Lerner’s hard drive also raised broader questions about why the tax agency never reported the missing records to the National Archives and Records Administration, as required by the Federal Records Act....

Dan Epstein, executive director of the watchdog group Cause of Action, said rules require the archivist to sign off on the destruction of federal records.

“This solicitation, combined with the failure of the IRS to consult the Archivist about Lois Lerner’s hard drive, should put hesitation into any assumption that consultation with the Archivist is happening and prompt a thorough assessment of record retention at the IRS,” Mr. Epstein said Monday.

The only conclusion I can draw from the above is that the IRS, and whoever in the White House has been tasked with protecting Obama from it, have assessed the consequences of blatantly violating the Federal Records Act as less painful for the IRS and the Obama Administration than the consequences of allowing any detailed records of Lerner's communications to come to light. Given the toothlessness of Congress and the nature of the Justice Department at this time, that could well be true.

2. The Wiggle Room That Yet Remains To American Medicine.

I find this development heartening, though because of its cost it won't be available to everyone:

[Dr. Frederick] Becker is shifting to a new style of practice, sometimes called concierge or retainer medicine. With the help of a company that has been helping physicians make such shifts for over 13 years, he will cease caring for a total of 2,500 patients and instead cut back to about 600. These patients will pay an annual fee of $1,650. In exchange, they will receive a two-hour annual visit with a complete physical exam, same-day appointments, 24-hour physician phone access, and personalized, web-based resources to promote wellness.

When patients get admitted to the hospital, Becker will remain their physician, and their health insurance will still pay for much of their care. Will it make more money for physicians? Becker doubts it, but if it does, he plans to plow any additional income he might derive back into his group practice, helping to lessen the economic pressures on his colleagues.

The concierge model of practice is growing, and it is estimated that more than 4,000 U.S. physicians have adopted some variation of it. Most are general internists, with family practitioners second. It is attractive to physicians because they are relieved of much of the pressure to move patients through quickly, and they can devote more time to prevention and wellness.

As an end-run around the ongoing bureaucratization of medical practice, this is highly attractive to physicians and patients both. The downside, of course, is that those who can't afford to pay such an annual fee will have increasing difficulty finding a primary care physician, owing to the accelerating retirement of currently practicing doctors and the dwindling supply of new doctors. Perhaps the "doc in a box" phenomenon will fill the gap, but it will be a while before the results of the new incentive structures become clear -- and you may be very sure that the federal government will stick its fingers into the works whenever a mascot-group screeches about "a right to affordable care."

3. Our Tranquil World.

It sometimes appears that the entire Obama Administration has been dosed with something that numbs one to reality:

Barack Obama’s team recently took credit for improving the “tranquility of the global community,” and the president made it clear just what a calm place the world has become during his tenure.

But this summer Obama’s tranquil world has descended into medieval barbarism in a way scarcely seen in decades.

The justly celebrated Victor Davis Hanson gives us a compact yet comprehensive rundown. Please read it all.

The central question, of course, is how anyone could sincerely maintain that the world is a more tranquil -- i.e., peaceful -- place owing to the efforts of Barack Hussein Obama and his lieutenants. Press secretaries, of course, are liars for pay, who are required to say what they've been instructed to say, and to deflect inquiries that might rip the cover off the administration's representations. Adroitness of rhetoric and tactical insincerity are written into the job description. But is it even conceivable that any official inside the foreign-policy apparatus of the Obama Administration has ever believed that Obamunist foreign policy has made the world a more tranquil place?

The silver lining is that should she gain the Democrats' presidential nomination, Hillary Clinton will be required to defend the mess she helped to make. Whatever she might think of herself, her abilities don't extend to using black paint to paint in white.

4. For Readers.

A pleasant recent discovery is urban fantasist Seanan McGuire. I recently finished her three-book "Incryptid" series, and was enthralled throughout by her freewheeling imagination and her facility for combining exciting action with good characterization and gentle humor. I've just begun her "October Daye" series, and so far it's equally captivating. Fans of contemporary fantasy hungry for something other than the ubiquitous vampire, werewolf, and zombie crap might want to give her a look.

Along with the pleasures of the stories themselves, Miss McGuire's Kindle-edition books are modestly priced -- and good reading in ebook format that's less expensive than the paperback edition is getting to be harder and harder to find.

I have a deadline to meet, so that will be all for today, Gentle Reader. If you'd like, you can help me to stay focused by going to Amazon, Barnes & Noble, or Smashwords and buying a few of my deathless masterpieces. Hint, hint!

1 comment:

CGHill said...

Seanan McGuire also makes some fascinating music, somewhere between folk and filk. I've been listening to her Stars Fall Home album lately.