All our family healthcare visits are now billed as CPT E&M Code "Level Four"

Very few people will understand what that subject line means.

The short version is that the way we account for physician services was born broken in 1994 and it is now in a state of advanced collapse.

It can’t go on and it can’t stop.

Don Berwick, the best CMS administrator we’ve ever had (forced out by GOP) said this five years ago:

.. Dr. Donald Berwick, the immediate past administrator of the Centers for Medicare and Medicaid Services (CMS), which administers the Medicare program, said a small portion of the billing increase is likely caused by outright fraud, but in the majority of cases hospitals are legally boosting profits by targeting the vulnerabilities of Medicare’s payment system. “They are learning how to play the game,” Berwick said about the hospitals....

... Berwick, the former CMS head, said patients haven’t changed. What’s changed is the aggressiveness of how hospitals bill. “They are smart,” Berwick said. “If you create a payment system in which there is a premium for increasing the number of things you do or the recording of what you do, well, that’s what you’ll get.”...

See also

• Gordon's Notes: Health care reform. Be humble. Be afraid of the accounting rules. 1/2009. RBRVS. We had such good intentions.
• Gordon’s Notes: Electronic health records and payment increases: It’s not fraud. 10/2012. 

Curious Priceline credit card fraud today

Around 2:30pm Amex.app tells me a $1.00 authorization charge has been placed for Priceline. Which I didn’t do. 

I’m in a meeting so I figure I’ll follow up later.

Around 4pm I get a Google Voice transcription from “Cynthia” of the “Priceline.com fraud prevention department” asking me to call 203-441-8455. Someone has ordered two plane tickets on my Amex card.

I call Amex and they do see the transactions. They never made it to my account though, so they must have run hard into Amex fraud detection (best in the industry AFAIK). I’m issued a new card. Noteworthy: I’m told my many recurring online transactions won’t break and later in the day Apple Pay tells me it’s automatically updated my information with the new card — though I won’t get the physical card for a few days.

I do call 203-441-8455. They claim to be Priceline Fraud Prevention, but they sound awfully shady. I already knew I wasn’t going to give them any personal data so I carried on. (I later googled the number, found a 2012 ref that said this was indeed them.)

I was told two plane tickets were bought on my card — and there’s a name attached to each ticket (vaguely Indian/middle eastern sounding names). The harried woman says the plane leaves in 30 minutes so they probably can’t block them. Which is, of course, Priceline’s problem. There’s a reason I like American Express.

Note to Priceline.com: your Fraud Prevention department should sound less like an international call shop scam operation.

I checked my ancient and little used Priceline account. It had a robust password, had no transaction records, and it didn’t hold my Google Voice number. I don’t think it was hacked. I changed the password anyway.

It’s a bit weird. Why would someone use a stolen credit card to buy plane tickets when they have to match the name on the tickets to their personal ID? It seems a risky behavior! And how did Priceline get my Google Voice number? (Maybe from AMEX?) Least odd is that someone stole my AMEX credentials (the physical card is at home). I assume all my credit card numbers are available online for a few dollars.

I wonder if Priceline is a particularly effective way to buy plane tickets with a stolen credit card number? I doubt Priceline will report any of this to the police, even though they probably have the traveler’s true names.

A change to my publishing streams

These are the last days of app.net. It ends in 3 days. App.net has been good to me. Great tools, smart and interesting people, RSS integration (albeit grudgingly at first) and the best communication/conversation platform I’ve worked with. App.net was what Twitter should have been. It has made clear how badly Twitter has failed.

These are, surprisingly, also the end times for Maciej’s Pinboard as a publishing platform. I have 33,236 pins there, and something is broken. Neither pinner.app or pushpin.app are able to connect and download the streams. From what Maciej has written in the past I may have passed some throttling limit. I’m using Pinboard in ways he did not intend — and the iOS apps don’t scale either. 

So I need to make some changes. Gordon’s Notes and Tech will stay on Blogger for now — it’s been surprisingly robust and trouble free for many years. It helps that there’s an exit strategy to WordPress if Google kills it, but as best I can tell Google is going to keep Blogger limping along.

My DreamHost wordpress microblog has mirrored my pinboard stream for years. I’m going to see if there’s a way to make it a true microblog publishing platform. I’m not sure how to do that, in particular it’s not obvious how I can conveniently post via Reeder.app. It will take me a while to work that out.

In the meantime there are several app.net spinoffs in the work. I’m tracking several of these as much as my time allows - especially pnut.io (@jgordon) and 10centuries (@jgordon). March 2017 is a heck of a month for me so things have gone slowly.

Uncertain times! For now if you follow kateva.org/sh you’ll see what I’m up to, no matter how the process evolves.

Warfare goes to the elite

Once upon a time tens of thousands of New Yorkers moved paper from one file cabinet to another. Once upon a time there were jobs for strong bodies. Once upon a time you could be blue collar and middle class.

Once upon a time anyone could be a warrior …

Special Operations Troops Top Casualty List as U.S. Relies More on Elite Forces

… “We’ve moved out of the major combat operations business,” said Linda Robinson, a counterterrorism expert at the RAND Corporation. In recent years, she said, the military has effectively outsourced rank-and-file infantry duties to local forces in places like Afghanistan, Iraq and Syria, leaving only a cadre of highly skilled Americans to train troops and take out high-value targets…

Now the physical and cognitive elite dominate warfare. Automation and globalization — in this case drones and outsourcing to local infantry.

Trump didn’t come from nowhere.

Crisis-T: what to do about the delusions and the lies.

I’ve been using “crisis-T” as a tag for our times. I used to think it was a bit melodramatic; that maybe T would somehow veer to the fantasies of Thiel and the like.

Welcome to week two of Crisis-T. A week in which I’ve started monitoring neo-soviet propaganda for clues to what Bannon, Flynn and Putin are thinking (the troika).

Emily and I are still working out how to respond to this. I hope the March for Science happens — I’d join that one way or another. We already subscribe to the NYT, The Atlantic, The New Yorker, and Talking Points — it’s essential to support journalism with hard coin. The 2018 congressional campaign has begun and we will be active (I’ll likely vote in the GOP primaries, more on that later). We’ve done our first of many ACLU and Planned Parenthood donations. Basically we more or less track what Scalzi is doing.

I write and tweet of course, but that’s more therapeutic than useful. It does mean though that I run into some of the issues that real journalists face. Like how to approach the maelstrom of lies and delusions that Bannon and Trump produce. On the one hand presidential speech is a form of action, it can’t be disregarded. On the other hand I’m beginning to worry Bannon is not a conventional idiot. He may have a real talent for strategic propaganda and effective distraction.

I wonder if we should treat the lie-stream like the weather.  Box it on the proverbial page 2 as Bannon-T lies and delusions of the day. Each lie-delusion is then listed with a contrasting statement of testable reality. Then the main pages can focus on even more important problems, like swapping the Joint Chiefs of Staff and Director of National Intelligence for Bannon on the principals committee of the National Security Council.

More as we figure this out …

Update Jan 30, 2017: Jeff Atwood has one of the best action lists I’ve seen.

Crisis-T: Subscribing to the NYT (and a few others)

The absolute minimal response to Crisis-T starts with financial support for quality journalism and donation to the ACLU. If you have a reasonable income and don’t do some of this then you aren’t even trying.

Today quality mainstream journalism means the New York Times and perhaps the Washington Post. The Economist might an option if you’re a conservative, but they don’t do much investigative journalism. Really, if you’re a conservative who opposes T then WaPo and the NYT are your options. (The WSJ is not an option.)

Outside of the mainstream I’m a fan and supporter of Talking Points Memo ($50/y). It’s avowedly liberal-dem but also conscientious journalism. Josh Marshall is a marvel. The New Yorker’s been doing great work, we support them as well.

Of these minimal responses the NYT is the most expensive. At one point their list subscriber price was somewhere north of $350 — though list was mostly for those who didn’t shop around. I still have a faculty price of $98/year for web and app access though I haven’t taught for years. It’s possible all you need to qualify is a .edu email.

Today the web/app price list price is $143. I’d pay that much, but you can do a yearly subscription through the iTunes app for $130. I couldn’t find the Android and Kindle subscription costs.

The best price is the student price - at $52 a year billed monthly.  Some schools may pay for digital access to all students, but if you opt into a school-funded free subscription you’re not supporting journalism. I don’t think the NYT does anything to block limited sharing of a student account. It appears the only test for the student rate is an educational address

I suspect I’m not the only subscriber who shares their account with a spouse. That’s a substantial, if improper, discount. (“Subscribers to All Digital Access at the college rate are not eligible to share their access with a family member.” — which implies other subscribers can share.)

So you have a wide range of ways to pay for digital access to the NYT - from list at $143/y to iTunes at $130/y to student/.edu at $52/y. Spousal sharing reduces the cost even more. Some rates are more proper than others, but all support investigative journalism. Pick one.

PS. Dear NYT: $100 a year with spousal sharing would be a great way to grow your readership.

CrossFit has invaded my dreams. You should try it.

I awoke last night sweaty and anxious.

I was dreaming about the kipping muscle up; a move that still eludes me.

Which is nuts. I am an old man. Acrobats do this stuff in their sleep. Even when I was young I didn’t aspire to being an acrobat. CrossFit is invading my dreams…

Maybe it’s because the regular workouts have become normal. I was 53 when I started 3.5 years ago, now after a few hundred workouts even handstand pushups don’t seem that exceptional. After the first year I did 70-80% of the “women’s Rx”. Now as an older guy I sometimes do the “men’s rx” — and I usually do at least the women’s. I started out going twice a week, now I do 3-4 CrossFit workouts and 2 light workouts at a typical gym while my 17yo does his Tae Kwon Do. (Plus hockey, mountain biking, inline skating, etc)

It’s hard to remember when tattoos and workout music seemed novel or when I thought big guys would notice how puny I am (that’s truly funny, but there you go).

I once thought it was kind of amazing to do CrossFit as an old man. Now it seems like something anyone with decent knees can do. It’s just a matter of scaling. Do 1/5 of the weight and half the reps. Do regular pushups instead of handstand pushups. Use bands. It can mostly be scaled. It’s hard to get around truly bad knees though.

So what sticks now are the things I suck at, skill moves like double-unders (I’m absolutely the world’s worst) and the muscle ups (bar and ring).

CrossFit is fun. It’s safer than walking around Saint Paul — our drivers are distracted dolts. Good gyms like Union Fitness - CrossFit Saint Paul will make you feel your money is well spent. Lots of slots for a flexible schedule, great peers, great coaches. Done with care CrossFit will fix your sore back (once mine was worse than yours). Exercise doesn’t control weight in clinical trials — but they’re not sending people to CrossFit. CrossFit will control weight if you have any kind of diet control. You don’t have to move to the Twin Cities (though you are welcome) either, there are good gyms in small towns and big cities now. You can find one near you.

Give it a try.

If my familial genetic arthritis holds off (big if) I now don’t see why I can’t be doing CrossFit into my 60s and 70s. Sure I won’t lift as much, and maybe I’ll never do a muscle up, but I’m good at scale. CrossFit ain’t the fountain of youth, but it’s as close as we can get.

Quicken for Mac 2017 -- $45 upgrade for nothing.

Quicken for Mac 2017 new features …

Compare your income and spending year over year with custom reports
Customize your budgeting goals month-by-month (12-month budget)
Pay your bills in Quicken with Quicken Bill Pay (fees apply)
Get more power on-the-go with the improved mobile app
Enjoy a new look that’s easier to use and navigate

On the other hand …

Quicken 2017 for Mac does not have certain investment reports/views, such as Performance (IRR), or Allocation by Investment.

We’ve been using 2015 and somehow I thought the 2017 update was worth paying for. Wrong. The only change I notice is new UI to learn.

That was a real waste of money. 

Intuit sold Quicken for Mac to a private equity company. The corporate headquarters are “3760 Haven Avenue, Menlo Park, CA 94025”. This is the current street view (7/2016).

We can live with Quicken 2015 - or 2017. We can do our investment allocation reports by hand. So I don’t think it’s a bad buy — once.

No upgrades though. Quicken 2017 is a classic, stinky, private equity move — fire everybody, put in a little bit of work, squeeze the market.

Stick with the version you have.

Crisis-T: blame it on the iPhone (too)

It’s a human thing. Something insane happens and we try to figure out “why now?”. We did a lot of that in the fall of 2001. Today I looked back at some of what I wrote then. It’s somewhat unhinged — most of us were a bit nuts then. Most of what I wrote is best forgotten, but I still have a soft spot for this Nov 2001 diagram …

I think some of it works for Nov 2016 too, particularly the belief/fact breakdown, the relative poverty, the cultural dislocation, the response to modernity and changing roles of women, and the role of communication technology. Demographic pressure and environmental degradation aren’t factors in Crisis-T though.

More than those common factors I’ve blamed Crisis-T on automation and globalization reducing the demand for non-elite labor (aka “mass disability”). That doesn’t account for the Russian infowar and fake news factors though (“Meme belief=facts” and “communications tech” in my old diagram). Why were they so apparently influential? 

Maybe we should blame the iPhone …

Why Trolls Won in 2016 Bryan Mengus, Gizmodo

… Edgar Welch, armed with multiple weapons, entered a DC pizzeria and fired, seeking to “investigate” the pizza gate conspiracy—the debunked theory that John Podesta and Hillary Clinton are the architects of a child sex-trafficking ring covertly headquartered in the nonexistent basement of the restaurant Comet Ping Pong. Egged on by conspiracy videos hosted on YouTube, and disinformation posted broadly across internet communities and social networks, Welch made the 350-mile drive filled with righteous purpose. A brief interview with the New York Times revealed that the shooter had only recently had internet installed in his home….

…. the earliest public incarnation of the internet—USENET—was populated mostly by academia. It also had little to no moderation. Each September, new college students would get easy access to the network, leading to an uptick in low-value posts which would taper off as the newbies got a sense for the culture of USENET’s various newsgroups. 1993 is immortalized as the Eternal September when AOL began to offer USENET to a flood of brand-new internet users, and overwhelmed by those who could finally afford access, that original USENET culture never bounced back.

Similarly, when Facebook was first founded in 2004, it was only available to Harvard students … The trend has remained fairly consistent: the wealthy, urban, and highly-educated are the first to benefit from and use new technologies while the poor, rural, and less educated lag behind. That margin has shrunk drastically since 2004, as cheaper computers and broadband access became attainable for most Americans.

…  the vast majority of internet users today do not come from the elite set. According to Pew Research, 63 percent of adults in the US used the internet in 2004. By 2015 that number had skyrocketed to 84 percent. Among the study’s conclusions were that, “the most pronounced growth has come among those in lower-income households and those with lower levels of educational attainment” …

… What we’re experiencing now is a huge influx of relatively new internet users—USENET’s Eternal September on an enormous scale—wrapped in political unrest.

“White Low-Income Non-College” (WLINC) and “non-elite” are politically correct [1] ways of speaking about the 40% of white Americans who have IQ scores below 100. It’s a population that was protected from net exposure until Apple introduced the first mass market computing device in June of 2007 — and Google and Facebook made mass market computing inexpensive and irresistible.

And so it has come to pass that in 2016 a population vulnerable to manipulation and yearning for the comfort of the mass movement has been dispossessed by technological change and empowered by the Facebook ad-funded manipulation engine.

So we can blame the iPhone too.

- fn -

[1] I think, for once, the term actually applies.

Investment things I learned in Crisis-T

All the money Trump will take from the poor and give to the rich has to go somewhere. So share prices should rise.

On the other hand, a 10% import tariff will lead to a global trade war. I’m particularly looking forward to the carbon tariffs an angry China applies to the US. So share prices should fall.

Corporate behemoths will increase monopoly and monopsony powers and fully leverage regulatory capture in an era where corruption exceeds living memory. So share prices should rise.

Trump will, WTF, resume underground nuclear testing or something like that. So share prices should fall…

Hey, I don’t know what the market is going to do. If I knew I’d hire people to manage the billions we don’t have. I do know the our equity investments have grown over the Obama years, I see some warning signs, and our portfolio is now equity-heavy. So it makes sense to rebalance. Crisis-T just means I made myself do it.

I chose to rebalance primarily in our retirement accounts, so the sales had no tax implications. I sold shares and parked the cash. In a few months, when we learn if the GOP Senate has a spine, we may sell more in our taxable accounts and shift the retirement back into equities. It’s probably not an orthodox way of proceeding, but it’s relatively easy to adjust.

Since I rarely mess with our investments (largely S&P, extended market, and whole market index funds — plus college 529 plans I don’t touch) I learned a few things. In no particular order …

1. If you sell shares in Vanguard’s ultra-cheap low overhead index funds you can’t buy back into the same fund until 30 days post-sale. So if you make it one big sale if the timing is good. Vanguard makes it easy to create a cash fund to hold sales within a particular account family.
2. Fidelity’s 401K accounts are completely different business from their HSA accounts which are unrelated to their … Oh. Heck. I don’t like Fidelity.
3. It takes a long time for these mutual fund orders to sell. They seem to sell at near market close the day after the order is placed — and the online accounts aren’t updated for a while. So you can’t do any of this under market pressure. I placed a sell order at 7pm on Thur, they were in process Friday, the web site was updated Sat pm.
4. If you’re not using a SEP IRA you might as well roll it into a regular IRA. You can always create a new SEP IRA in future.
5. Rollovers are complicated and slow. Even the Vanguard ‘concierge’ people seemed unsure about all the rules. You can borrow against 401K funds, but the investment options may be poor. You may be able to rollover a former employers 401K into a new employers 401K — but it’s all special cases. There may be a way to create an IRA account that a 401K can roll into and still be able to rollover into a 401K — but that’s just weird. Once you mix a 401K with IRA funds you can’t reverse it, it’s all IRA then. There’s a reason people spend money for tax lawyers.
6. Vanguard has a much better web site than Fidelity and Vanguard message responses are excellent.
7. Vanguard is in the midst of switching all their funds into a brokerage framework. I worry that it will increase costs but I’m naturally suspicious. I’d like to read something about why the change.

Save America. Vote GOP.

In the real world HRC is President and the GOP is beginning a painful reform process that will lead to a far better conservative party and a healthy American democracy.

In our consensus hallucination a walking tire fire is President, the GOP is further from reform than ever, and smart Dems are reading Josh Marshall’s advice. Oh, and the wake-up button isn’t working.

While we’re waiting for wakefulness we might as well come up with a plan or two. Plan one is to address the root cause of non-college misery. That will be useful if we survive (hint: avoid war with China) to get a sane government again.

Plan two is about getting a sane government. Towards that end we need to save the GOP from its addiction to the unreal. Unreality is a dangerous drug, after decades of abuse the GOP is in desperate need of rehab …

From Tabloids to Facebook: the Reality Wars (revised from my original)

I’ve been thinking about Russia’s successful hacking of the 2016 US election. It shouldn’t be seen in isolation.

It should be understood as part of the ancient human struggle with delusion and illusion — the reality wars.

In the US the reality wars were once bipartisan; each party struggled to separate fact from fantasy. Over the past few decades the GOP stopped fighting, they embraced the unreal. From Reagan to Gingrich to the Tea Party to Trump. By the 21st century we began seeing books like “The Republican War on Science”.

Unreality spread like a virus. AM talk radio was infested. Then came Drudge and Fox. Later Breitbart and finally the Facebook fake news stream. From the Clinton “murders” to birtherism to child pizza porn slaves.

This wasn’t bipartisan. The anti-reality meme, a core historic component of fascism, became concentrated in the GOP. Russia jumped on board, but Russia is more of a plague carrier than an intelligent agent. They lost their reality-war in the 90s. All their news is unreal now. Putin, like Trump, takes the fakes.

Trump’s victory is a triumph of the unreal. Of Will, I suppose. Now it threatens us all.

The rebellion against reason, against the perception of the real, is old. It’s a core component of fascism, but it’s much older than fascism. The Enlightenment was a setback for the unreal, but it wasn’t a final defeat. Now, in our troubled 3rd millennium, anti-reason is strong. It has taken over Russia. It has taken over the GOP, and Trump’s GOP has taken over America.

Somehow we have to rescue the GOP from it’s addiction to the unreal. That would be hard if it had been defeated. Now it seems impossible.

But there is a way. We need to vote GOP.

Vote GOP … in the primaries that is. In my home of Minnesota the Dem contenders are all pretty reasonable. I can send some money and volunteer to support the party, but my primary/caucus vote isn’t needed. On the other hand, the Minnesota GOP has lots of reality denialists running for office. I can use my primary vote to favor relatively sane GOP contenders.

If even half of Dems vote GOP in primaries we can ally with sane conservatives to pull the GOP back from the brink. Yes, there are a few sane conservatives. They are a dying breed, but there is room to ally with them here.

Then, in the election, we vote Dem. If America is lucky the Dems win. If America is unwise the GOP wins — but it’s a saner GOP. A setback, but not a catastrophe.

Work for a sane GOP. As a good Dem, vote GOP. 

Piketty's latest work on inequality is wrong about education.

The NYT has a readable summary of Thomas Piketty, Emmanuel Saez and Gabriel Zucman’s US income research. Much of it is familiar, but I was struck by this paragraph:

[since 1979] … Younger adults between 20 and 45 years old have seen their after-tax incomes flatline.

But over the same period, seniors in the bottom half have seen their after-tax incomes grow by over 70 percent. The bulk of that gain represents increased health care spending through Medicare.

Growth rates of a few percent a year do add up; health care is eating everything. Maybe it’s time to reread my old health care post.

Their findings are very important, but one of their recommendations falls flat (emphases mine) …

… improving education and job training, equalizing distribution of human and financial capital, and increasing labor bargaining power, combined with a return to steeply progressive taxation

No, education and job training aren’t the answer. Roughly 40-50% of the US population has an IQ of less than 100. People with an IQ of under 100 have many skills, but they are not going to succeed in an academic program. Canada has the world’s highest “college” (includes 2 year vocational programs) graduation rate, and even they top out at around 56% of the population. I’m not sure why economists struggle with this basic arithmetic, my guess is they spend too much time with the cognitive elite.

What is the answer? We need to flip our thinking. We can’t change people to fit the work available in the natural post-industrial economy. We need to change the work to fit the humans. We need to incentivize work that is meaningful and rewarding across the cognitive spectrum. Germany did some of that by biasing their economy towards manufacturing. We can do some of that too (sorry Germany, that’s going to hurt you!), but we’re going to have to think more broadly. We’ll need to provide direct or indirect subsidies for work that’s productive even if it can’t compete with automation. We’ll have to apply work support lessons from the US military (long history of productive work across cognitive spectrum) and from traditional disability work support programs.

 

Resistance prelude: Orchid Island, Taiwan

I hope to write about my response to “crisis-T". Yes, that T. The anti-O. 

This is a prelude to that post. It’s a note about Orchid Island, Taiwan. I visited it in early 1982, shortly before the nuclear waste dump opened. You can see the facility on Google Maps, it’s not a secret:

In Google Maps the port that receives the waste is labeled as the “Taiwan Power Company Discarded Materials Port”.

Orchid Island, also called “Lanyu island” and once known as “Death Island” [1], didn’t ask to be Taiwan’s nuclear waste dump. It was a gift from the big island. Despite the waste material Orchid Island is something of a tourist attraction these days. I remember it as severely beautiful and I hope it’s doing well.

I write about the island now as a reminder that Taiwan has an extensive and sophisticated nuclear power program. At times Taiwan has had an active nuclear weapons program. If Taiwan wanted a nuclear deterrent against invasion by China they could certainly produce one. Of course, to quote Wikipedia: “The People’s Republic of China has announced that any Republic of China possession of nuclear weapons is grounds for an immediate attack.” (no citation, I can’t tell which PRC official entered that.)

Trump has, of course, thrown a spanner into America’s China/Taiwan machinery…

I’ll get back to this.

- fn -

[1] Google somehow found this 1953 San Bernardino Sun article on Orchid Island:

Women Rule Island --Can Divorce Mates by Handing Back Engagement Gift of Beads
By SPENCER MOOSA TAIPEH, Formosa LT

All a native woman has to do to be divorced on “Orchid Island" is to hand back to her husband the string of agate beads he gave her for their engagement.

Mrs. Carveth Wells, the first non-aborigine woman ever to visit the tiny dot of land 50 miles southeast of Formosa, brought back this report of, her four-day visit:

Women outnumber men and definitely are the bosses among the 1,457 Yamis tribesmen who probably originated in Malaya.

WEAR LEAF APRONS The women wear leaf aprons and nothing else. They put on improvised bras only when strangers appear. The men just wear G-strings. If no children are born to a couple, the wife takes it for granted the man is to blame and divorces him. If she has more than three children, she's just as apt to leave him. Too big a family, too much trouble.

The women like a certain fish that is hard to catch. If her husband doesn’t provide her with enough of such fish the woman just hands him his beads and starts husband-hunting. The men not only fish but have to do most of the housework. The women cultivate taro, a starchy root which is an important item of food.

The Chinese name for the island is Lan Yu, or Orchid Island. It also has a grim nickname “Death Island.” The prevalence of disease gave the island its nickname. One particular mite penetrates the skin without being felt and often kills its victim within 24 hours.

However, the World Health Organization sprayed the island in June with DDT, eliminating most of the lice, and mosquitoes.

POLICEMEN STAY IDLE There are three policemen on the island but the chief, Capt. Jacob Yang, says there is no crime so they have nothing to do. Mrs. Wells, wife of the explorer, made the trip for the American Museum of Natural History in New York. Villagers walked for miles to gaze in wonder on her white skin and blonde hair…

When I visited in 1982 the Yamis and I were still exotic to one another.

Fallows: "the most grievous blow that the American idea has suffered in my lifetime"

The Atlantic, Jan/Feb 2017

Despair and Hope in Trump’s America - James Fallows - The Atlantic

… I view Trump’s election as the most grievous blow that the American idea has suffered in my lifetime. The Kennedy and King assassinations and the 9/11 attacks were crimes and tragedies. The wars in Vietnam and Iraq were disastrous mistakes. But the country recovered. For a democratic process to elevate a man expressing total disregard for democratic norms and institutions is worse. The American republic is based on rules but has always depended for its survival on norms—standards of behavior, conduct toward fellow citizens and especially critics and opponents that is decent beyond what the letter of the law dictates. Trump disdains them all.

Fallows seems to think Facebook-empowered Russian led infowar was quite powerful.

TNC has an eulogy for the Obama era in the same issue. Grief.

Automated purchases of index funds - how to view and discontinue at Vanguard

It’s dull stuff, but if you’re a lazy investor it’s hard to beat dollar cost average investing. Every month dollars automatically flow from a cash fund to buy index fund shares. Historically there were no fees for doing this within a fund family. We have been using this to buy Vanguard low-expense S&P index fund shares since shortly after the last crash.

I think it’s time to stop.

Except it’s hard to figure out how to stop - or how to start for that matter. In the Bogle era Vanguard used to talk about this sort of thing, but the world has moved on. There’s no money for Vanguard in these transactions. Google gave me some clues — here’s how to do it.

1. Go to My accounts > account maintenance.
2. In “Banking and money movement” click “Automatic exchange”

From here you can see active transactions, follow the directions to delete (or create) one. You can’t delete a transaction on the day it’s scheduled to occur. When you delete you get a printable transaction record and a copy is emailed to your account of record.