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624 lines
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<title>17 March, 2023</title>
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<title>Daily-Dose</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><style>*{overflow-x:hidden;}</style><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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<body>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
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<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
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<ul>
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<li><a href="#from-new-yorker">From New Yorker</a></li>
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<li><a href="#from-vox">From Vox</a></li>
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<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
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<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
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<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
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<li><a href="#from-ars-technica">From Ars Technica</a></li>
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<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
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</ul>
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<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
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<ul>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Hip-Hop at Fifty: An Elegy</strong> - A generation is still dying younger than it should—this time, of “natural causes.” - <a href="https://www.newyorker.com/news/daily-comment/hip-hop-at-fifty-an-elegy">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why Barney Frank Went to Work for Signature Bank</strong> - The former congressman, who overhauled financial regulation after the 2008 crisis, sits on the board of a bank that was just seized by the government. What happened? - <a href="https://www.newyorker.com/news/q-and-a/why-barney-frank-went-to-work-for-signature-bank">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Fallout of Fox News’ Public Shaming</strong> - The Dominion lawsuit has exposed instances of pandering and duplicity, but none of it is likely to change the network’s business model. - <a href="https://www.newyorker.com/news/annals-of-communications/the-fallout-of-fox-news-public-shaming">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The G.O.P. and the Ghosts of Iraq</strong> - Ukraine shows that Republicans have moved a long way from the Party of George W. Bush. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/the-gop-and-the-ghosts-of-iraq">link</a></p></li>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What Secrets Does the “Donald Trump of Beijing” Know?</strong> - The case against Guo Wengui could expose more about America’s politics than China’s. - <a href="https://www.newyorker.com/news/daily-comment/what-secrets-does-the-donald-trump-of-beijing-know">link</a></p></li>
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</ul>
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<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
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<ul>
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<li><strong>Your brain may not be private much longer</strong> -
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<figure>
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<img alt="A woman equipped with a brain-computer interface that she is wearing as a bathing-suit-style cap on her head." src="https://cdn.vox-cdn.com/thumbor/U_8mCMeeVyzjg9ve3D75sGa-t1o=/104x0:2396x1719/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72084705/brain_computer_interface_AP_17163559072734.0.jpg"/>
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<figcaption>
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A woman equipped with a brain-computer interface, one form of neurotechnology. | Florian Voggeneder/Guger Technologies/AP
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</figcaption>
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</figure>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
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Neurotechnology is upon us. Your brain urgently needs new rights.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="O9YByZ">
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If you’ve ever wished your brain was more user-friendly, neurotechnology might seem like a dream come true. It’s all about offering you ways to <a href="https://www.vox.com/future-perfect/22727109/enlightenment-technology-neurofeedback-brain-stimulation-psychedelics">hack your brain</a>, getting it to do more of what you want and less of what you don’t want.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TSsbvQ">
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There are “<a href="https://www.vox.com/the-goods/2019/7/8/18772467/nootropics-silicon-valley-brain-fitness-goop-smart-drugs">nootropics</a>” — also known as “smart drugs” or “cognitive enhancers” — pills that supposedly give your brain a boost. There’s neurofeedback, a tool for training yourself to regulate your brain waves; <a href="https://www.washingtonpost.com/national/health-science/therapists-are-using-neurofeedback-to-treat-adhd-ptsd-and-other-conditions/2015/01/16/b38e6cee-5ec3-11e4-91f7-5d89b5e8c251_story.html">research has shown</a> it has the potential to help people struggling with conditions like ADHD and PTSD. There’s brain stimulation, which uses electric currents to directly target certain brain areas and change their behavior; it’s <a href="https://www.nytimes.com/2021/10/04/health/depression-treatment-deep-brain-stimulation.html">shown promise</a> in treating severe depression by disrupting depression-linked neural activity.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a7zsqB">
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Oh, and Elon Musk and Mark Zuckerberg are working on brain-computer interfaces that could <a href="https://www.vox.com/future-perfect/2019/8/5/20750259/facebook-ai-mind-reading-brain-computer-interface">pick up thoughts directly from your neurons and translate them into words</a> in real time, which could one day allow you to control your phone or computer with just your thoughts.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TjVfkZ">
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Some of these technologies can offer very valuable help to people who need it. Brain-computer interfaces, for example, are already <a href="https://www.nature.com/articles/d41586-022-01047-w">helping some paralyzed people</a>.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JqRReh">
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But neurotechnology can also seriously threaten privacy and freedom of thought. In China, the government is mining data from some employees’ brains by having them wear <a href="https://voxcom.cmail20.com/t/d-l-xlkdhkd-jytjceij-u/">caps that scan their brainwaves</a> for anxiety, rage, or fatigue.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4zx0M6">
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Lest you think other countries are above this kind of mind-reading, police worldwide have been exploring <a href="https://www.theverge.com/2015/2/2/7951549/brain-fingerprinting-technology-unproven-courtroom-science-farwell-p300">“brain-fingerprinting” technology</a>, which analyzes automatic responses that occur in our brains when we encounter stimuli we recognize. The claim is that this could enable police to interrogate a suspect’s brain; his brain responses would be more negative for faces or phrases he doesn’t recognize than for faces or phrases he does recognize. The tech is <a href="https://www.researchgate.net/publication/344526903_Brain_Fingerprinting_A_Warning_Against_Early_Implementation">scientifically questionable</a>, yet India’s police have used it since 2003, Singapore’s police bought it in 2013, and the Florida State Police <a href="https://www.bbc.com/future/article/20160125-is-it-wise-that-the-police-have-started-scanning-brains">signed a contract to use it in 2014</a>.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="siufuz">
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All these developments worry Nita Farahany, an ethicist and lawyer at Duke University and the author of a new book, <a href="https://www.nitafarahany.com/the-battle-for-your-brain"><em>The Battle for Your Brain: Defending the Right to Think Freely in the Age of Neurotechnology</em></a>. As an Iranian American, she’s particularly scared of a future where governments read minds and punish people for thinking about, say, organizing to overthrow an authoritarian regime. “Will George Orwell’s dystopian vision of thoughtcrime become a modern-day reality?” she writes.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S0bcrY">
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Yet Farahany is no Luddite: She believes we should be free to embrace neurotechnology if we choose<strong> </strong>— but only if we also update our laws so we can reap its benefits without courting its risks. She argues that we need to revamp human rights law with a focus on protecting our cognitive liberty — the right to self-determination over our brains, our thoughts, our inner world.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Dechyu">
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I talked to Farahany about the ethical dilemmas raised by emerging neurotechnologies. Should you have the right to enhance your brain however you want? What about erasing painful memories, à la <em>Eternal Sunshine of the Spotless Mind</em>? A transcript of our conversation, condensed and edited for clarity, follows.
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</p>
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<h4 id="UzNrvE">
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Sigal Samuel
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Si0GLU">
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Neurotechnology seems like it’s on a collision course with freedom of thought. Do you think that huge risk is counterbalanced by the benefits we stand to reap?
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</p>
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<h4 id="ujE7Ek">
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Nita Farahany
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qLem1g">
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The risks are profound. And the gaps in our existing rights are deeply problematic. So, where do I come out on the balance? I’m a little bit of a tech inevitabilist. I think the idea that you can somehow stop the train and say, “On balance, maybe this isn’t better for humanity and therefore we shouldn’t introduce it” — I just don’t see it working.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DRfS2W">
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Maybe people will say, “My brain is too sacred and the risks are so profound that I’m not willing to do it myself,” but with the ways that people unwittingly give up information all the time and the benefits that are promised to them, I think that’s unlikely. I think we’ve got to carve out a different approach.
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</p>
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<h4 id="CEJFVr">
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Sigal Samuel
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="th7XMo">
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I hear the idea that maybe we can’t or don’t want to ban the tech wholesale, but I do want to push back a bit on this idea of tech inevitability. That strikes me as <a href="https://www.vox.com/the-highlight/2019/10/1/20887003/tech-technology-evolution-natural-inevitable-ethics">a myth that the tech world likes to tell itself</a> and all of us. History is full of examples of technologies that we’ve either decided not to build or that we’ve built but placed very tight restrictions on — nuclear weapons, genetic engineering.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iDWqWU">
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I tend to think more in terms of, how can we shape the incentive structure so that companies or governments will be less likely to roll out certain technologies? And of course, part of the incentive structure has to be law.
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</p>
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<h4 id="GQX0yh">
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Nita Farahany
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vPZFgV">
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Let me respond to [the idea of placing] tight regulations around it. Here’s the thing that keeps me from going there: We have an unbelievable burden of neurological disease and mental illness worldwide. Even as our physical health overall improves, our mental health is deteriorating, and depression rates are skyrocketing.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z51XnW">
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I think we need urgently to address that. And part of the reason that we haven’t urgently addressed that is because we haven’t invested the same, and put brain health and wellness on the same level, as all the rest of our physical health. And I think empowering people with information to be able to take their mental health and brain health into their own hands could be transformational for those trends. My hope is to find some way to make that possible.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d1JXll">
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The dystopian possibilities of this technology are off the charts, but so is the possibility of finally claiming cognitive freedom in the sense of true mental health and well-being.
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</p>
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<h4 id="EJg2nr">
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Sigal Samuel
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Zp8Gn0">
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What exactly is cognitive freedom or cognitive liberty to you?
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</p>
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<h4 id="toA84y">
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Nita Farahany
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wS8Aza">
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It’s a right <em>from</em> and a right <em>to</em>. Overall, I define it as the right to self-determination over our brains and mental experiences. That means a right from interference, and a right to access, change, and improve our own brains. That’s maybe why I come out differently than some people who might just say, let’s tightly regulate this or just ban it.
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</p>
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<aside id="YqlrYv">
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</div>
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</aside>
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<h4 id="PvhEbB">
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Sigal Samuel
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UDQPvA">
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In terms of a freedom <em>to</em>, there are all kinds of cognitive enhancements that people might be interested in. I’m thinking of nootropics or smart drugs, but there are also other types of neurotechnology that people could potentially use — neurofeedback, brain stimulation.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z9sA9N">
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Even if we imagine that we’re in a world where these technologies are equally accessible to all, I still wonder: Should workers actually be forbidden from cognitive enhancements because it creates a norm that others might then feel subject to? Will the pressure to enhance become coercive so people end up using smart drugs or devices even though they didn’t want to?
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</p>
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<h4 id="pZsXLN">
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Nita Farahany
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="C7p8xI">
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It’s a good question. That especially becomes problematic if we’re talking about drugs that are unhealthy, right? Part of the reason that we ban steroids in sports is because we want to protect players in a kind of paternalistic way … because that can have serious health consequences.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="V0iCFs">
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But I want you to imagine if there aren’t health consequences. Let’s not talk about methamphetamines; let’s talk about drugs that have very clean safety profiles. Then ask the same question of, if everybody feels pressure because everybody else has improved their health and well-being or their cognitive abilities, what’s wrong with that world?
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gmXn23">
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And if what’s wrong with that world is that we feel like we’ve increased the rat race, and made us all feel like we have to be more productive all the time, then what we’re complaining about is the structures and underlying forces in society, not the drugs.
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</p>
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<h4 id="FBpkLY">
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Sigal Samuel
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="52mgub">
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I think the issue would be, who gets to decide what counts as improvement? I was once having a conversation with some folks in the Bay Area. We were talking about smart drugs and everyone at the table was saying, “If you put a pill in front of me right now that could send up my IQ from, let’s say, 100 to 150, I’d want to take that!” I was an outlier saying, “Actually, I don’t necessarily want to be smarter. Smarter is not necessarily happier or wiser. And I’m also worried about the implicit coercion thing.”
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</p>
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<h4 id="s7VqHJ">
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Nita Farahany
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5f4q7Y">
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For me, it all comes back to the same question: Do you have a right to self-determination over your own brain? So to your question, “Who gets to decide?” — I think <em>you</em> get to decide. I think you should be the one who decides whether or not you enhance or slow it down, or you don’t do any of those things at all.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bvck9l">
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I’m writing against the grain, right? There is what I think is a very strong paternalistic drive when it comes to health, even in mainstream academia and bioethics, where people are, for the most part, extremely liberal. And I come out differently. I come out believing that giving people autonomy over their brains and mental experiences is critical.
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</p>
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<h4 id="GaGve0">
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Sigal Samuel
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="erOt9s">
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There is truth to that, but at the same time, I think you’re writing very much with the grain in the sense that the dominant mode of thinking since the Enlightenment is that the individual is the proper seat of autonomy and decision-making. And you’re very much arguing for individual autonomy.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9KAYzt">
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I classically think of myself as someone who is very ardently pro that! But I’m also aware that even people like John Stuart Mill, who was really harping on liberty and the individual, were simultaneously acknowledging that we’ve got to have liberty, but only up to the point where it hits upon society’s interests and maybe harms others.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yLpgMM">
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So far we’ve mostly been talking about enhancing the brain, but there’s this question about whether cognitive liberty means I should also be allowed to diminish my brain. I right away think of <em>Eternal Sunshine of the Spotless Mind</em> and the ability to erase painful memories.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ohEYIw">
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In your book, you talk about this specific neurotech technique, DecNef, that can potentially be used to process traumatic memory. A person sits inside a scanner and recalls a traumatic memory. Machine learning algorithms map the areas of the brain that that activates, and then the person basically erases those memories through a process of neural feedback. So the idea is that neurotech may offer hope for healing traumatic memory, or maybe even prevent it from getting established in the brain to begin with.
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</p>
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<h4 id="TpFjvr">
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Nita Farahany
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dcLuHP">
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Yeah, I write about this because it’s very personal to me. … I give the example of our second daughter, Callista, who died. And our experience of being in the hospital with her and how traumatic that was and the PTSD that I suffered for years as a result afterwards. And I tried therapy. I tried the drugs [like propranolol, a medication usually prescribed for high blood pressure that was studied — in vain, it turned out — to see if it could prevent PTSD by disrupting memory consolidation]. I have not yet tried DecNef, but I would if I had the opportunity to and was still suffering from PTSD.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j1ME59">
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It works in the same way that, when you are most symptomatic of intractable depression, you have a particular pattern of neurons firing in your brain — and then through implicit reactivation of those same pathways, you could rewire the brain by training it over and over again to have a different outcome. The precision with which you can see the activation patterns and then use that information to rewire it is profound.
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</p>
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<aside id="d9rshy">
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<div>
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</div>
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</aside>
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<h4 id="T5lsoC">
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Sigal Samuel
|
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PfRZum">
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It was really striking to me that you wrote that you would try DecNef if given the chance. That set me off wondering for myself personally. On the one hand, it sounds amazing, this idea of neurotech healing traumatic memory or even preventing it from getting established in the brain to begin with.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ob92Ry">
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On the other hand, I was thinking about how my dad passed away about a year ago. In the last year of his life, I was caring for him and it was really intense. I think probably there was some kind of trauma incurred there. And as a result, the past year has been one of the hardest years of my life.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hDqPst">
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If you’d asked me earlier whether I want to sign up for this thing that will prevent that mental anguish, I might have been tempted. But a year later, having gone through that suffering, I actually think there was a lot of growth that thankfully I was able to come out of it with. More self-compassion and compassion. It reminds me of this concept of post-traumatic growth, where people come out of an experience with new capacities — the flip side of PTSD. And in the book you also write that as a result of your experience, you feel like you came out with more compassion and you’re a stronger ethicist.
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</p>
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<h4 id="z2836L">
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Nita Farahany
|
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ACq398">
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Yeah, I don’t think I would’ve used DecNef ex ante. There is something really important about suffering. It has been core to the human condition. It helps us to prevail. So much poetry and music and everything else comes from suffering.
|
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h2bY2J">
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I say I would have used it because the trauma echoed for years and I couldn’t sleep, and it was vivid in ways that… I couldn’t function. I would never want to forget Callista or what we went through with Callista. But living through it — from the emotional power of it, to the fear, to the smells, to the echoes of the sounds in my brain — I did not need it at that level.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j30a2k">
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And so if DecNef could help turn it down so that when I remembered it, I could remember as I do now, with fondness … but not literally relive it — I would, I would do that. I would regain that time to not relive that over and over again.
|
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</p>
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<h4 id="Tun3GT">
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Sigal Samuel
|
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j3YOej">
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Absolutely. That makes a ton of sense. This is something that I was genuinely struggling with while reading, because on the one hand I felt this sense of, I don’t want to cheat myself out of an opportunity for potential post-traumatic growth, but also, I think there really is such a thing as too much suffering.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8QgW0v">
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The Buddhist teacher Thich Nhat Hanh has a phrase I really like: “No mud, no lotus.” Meaning, some suffering can be fertile ground for growth. But when he was presented with the question of how much we should suffer, he said, “Not too much!” Because that can just be like a landslide that we don’t know how to pull ourselves out of.
|
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</p>
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<h4 id="fNqIMZ">
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Nita Farahany
|
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="e3N6rL">
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I think that’s right. I hope that people’s choices are to not eliminate experiencing sadness and suffering. I don’t want that. I don’t think that’s good for humanity. I also don’t think it’s up to me to decide for individuals what suffering they do and don’t want to go through.
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</p>
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<h4 id="nKe3F5">
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Sigal Samuel
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="G9Egc0">
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Absolutely. And I want to underline that treating PTSD or depression is not the same as eliminating suffering. We should absolutely treat things like PTSD or depression. But I’m really not sure about the quest to eliminate suffering, as some people want to do in the transhumanist movement — the movement that’s all about using tech to usher in a new phase of human evolution.
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SNYDJm">
|
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You ask in your book: “If your brain had a switch to turn off suffering, would you use it?” I wouldn’t.
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</p>
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<h4 id="2epbhl">
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Nita Farahany
|
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</h4>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tHZIMe">
|
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I wouldn’t. But I would turn down the volume for the years that followed [with PTSD], because I didn’t need it at that volume.
|
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</p></li>
|
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<li><strong>Time doesn’t have to be money</strong> -
|
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<figure>
|
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<img alt="An illustration in the style of Salvador Dali, with a sunset landscape in the background and a rotary phone and melting clock in the foreground." src="https://cdn.vox-cdn.com/thumbor/kBRZuCLs1noVPvyZsNjcS4YOt7g=/0x38:5100x3863/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72084661/GettyImages_1297151633.0.jpg"/>
|
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<figcaption>
|
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Judy Unger/Getty Images
|
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</figcaption>
|
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</figure>
|
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
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Two new books, Jenny Odell’s Saving Time and Pooja Laksmin’s Real Self-Care, offer a framework for thinking about the world beyond capitalism.
|
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</p>
|
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="p4y0YZ">
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One of the peculiarities of life during lockdown was that time seemed to melt and become liquid. Days expanded to last for years; weeks rippled like stones were skipping across their surface. The chronological markers that we were used to vanished in those years indoors, and so we were unmoored in time. For many of us, the only constant left was work, which threatened to overwhelm and swallow up the vast overflow of time.
|
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</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uXqL1z">
|
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This moment in time was, writes Jenny Odell in her new book <a href="https://go.skimresources.com?id=1025X1701643&xs=1&url=https%3A%2F%2Fbookshop.org%2Fp%2Fbooks%2Fsaving-time-discovering-a-life-beyond-the-clock-jenny-odell%2F18556369%3Fean%3D9780593242704&xcust=VoxSavingTime031623"><em>Saving Time</em></a>, a moment of kairos, the Greek word for time meaning time as a crisis point at which other possibilities become visible. “What I find in kairos is a lifeline,” she writes, “a sliver of the audacity to imagine something different.”
|
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</p>
|
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rnqKrK">
|
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|
Odell, an artist whose last book <a href="https://www.vox.com/the-goods/2019/3/25/18280689/jenny-odell-how-to-do-nothing-interview-facebook-instagram"><em>How to Do Nothing</em></a> became a surprise bestseller after its publication in 2019, attempts in <em>Saving Time</em> to make visual the ways in which capitalist conceptions of time are artificial and historically situated, and provide newer and more nourishing alternatives. As the pandemic continues its long slow ebb and <a href="https://www.vox.com/energy-and-environment/23550073/california-floods-rainfall-weather-climate-change-whiplash">the climate crisis comes into ever sharper definition</a>, time has continued to warp around us, to speed up and slow down, to seem both foreordained and capricious. We live in the darkest, dumbest timeline, goes the Twitter joke, and we are watching the end of the world. Yet in the space we find outside of work time, Odell argues, we can find room to tend to both our own psyches and to our ailing planet.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MnoOnx">
|
|||
|
|
<em>Saving Time</em> is one of two major new books that purports to deal with the problem of capitalism and how it warps our lives, and to do so more meaningfully than the productivity gurus on LinkedIn. The other is <a href="https://go.skimresources.com?id=1025X1701643&xs=1&url=https%3A%2F%2Fbookshop.org%2Fp%2Fbooks%2Freal-self-care-a-transformative-program-for-redefining-wellness-crystals-cleanses-and-bubble-baths-not-included-pooja-lakshmin%2F18564150%3Fean%3D9780593489727&xcust=VoxRealSelfCare031623"><em>Real-Self Care</em></a>, a new book from psychiatrist and New York Times contributor Pooja Lakshmin. Lakshmin’s <em>Real Self-Care</em> is a self-help book that aims to offer self-care tips that go beyond telling individual people to buy more expensive face creams, and instead help readers both live within the systemic outrages of capitalism and find ways of changing the system.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E8mjRV">
|
|||
|
|
Together, the two form a handbook of sorts, a practical guide for living in a time that makes it hard to see what time is.
|
|||
|
|
</p>
|
|||
|
|
<h3 id="QqIfsa">
|
|||
|
|
We’ve been trained to see our time as money. Does it have to be that way?
|
|||
|
|
</h3>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MvDjK0">
|
|||
|
|
<a href="https://www.vox.com/culture/22308547/pandemic-anniversary-labor-works-intimacy-how-to-do-nothing"><em>How to Do Nothing</em></a> became a hit during the pandemic because it offered ways to wrest your attention away from work and screens and toward the physical world, re-creating yourself as an embodied being within a unique geographical context.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aPV9P3">
|
|||
|
|
The brief of <em>Saving Time</em> is to pull off the same trick, this time focused on time rather than attention: finding ways to shake our sense of time away from that fostered by capitalism, as a resource to be extracted, and into a more holistic sense of time as a creative force, on the huge scale of geological time and on the tiny tender scale of plants.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="baeyXC">
|
|||
|
|
“Time” is a more theoretical subject than attention, and as such, <em>Saving Time</em> lacks the empathetic practicality that made <em>How to Do Nothing</em> such a hit. This is a dutiful book that conscientiously checks its privilege at every opportunity. Still, as Odell churns out fact after fact on the history of how we think about time, we start to get a sense of <a href="https://www.vox.com/culture/2020/4/17/21201878/quarantine-productivity-social-distancing-coronavirus-pandemic-covid-19-capitalism-ep-thompson">how strange and artificial contemporary labor time is</a>.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="83EHQI">
|
|||
|
|
Clock time, Odell tells us, is the product of European conquest: first developed by medieval monks who needed to participate in coordinated prayers at set times of the day, and standardized by the British railway system so that all trains would run on the same schedule. As late as the 18th century in China, where life was organized around calendar dates rather than by the hour, Western clocks were dismissed as “simply intricate oddities, destined for the pleasure of the senses,” objects that “fulfil[led] no basic needs.”
|
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|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aA1eg4">
|
|||
|
|
Today in China, time is very different. All 3.7 million square miles of the country have lived on Beijing time since 1949, regardless of how far any given location might be from the capital. Xinjiang, 1,000 miles west of Beijing and a hub for the local Uyghur population, has historically held out and kept use of Xinjiang time, which is two hours behind Beijing time. Lately, as part of its genocidal regime against the Uyghur, the Chinese government has been cracking down on Xinjiang time. One man, Odell writes, was detained by authorities for keeping his wristwatch on Xinjiang time rather than Beijing time: the act, Chinese authorities declared, of a terrorist. The way we mark time is political, and those politics are high stakes.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VgaZPZ">
|
|||
|
|
In the West, we have learned to think of time as a commodity to be bought and sold. We sell our time to our employers, often 40 hours a week of it or more, and then our employers attempt to extract ever more time from us. <a href="https://annehelen.substack.com/p/how-email-became-work">Emails take over time off for office workers</a>; hourly workers are <a href="https://workforce.com/news/hourly-worker-burnout-major-problem-stop-overlooking">understaffed and overscheduled</a>. <em>Saving Time</em> is a call to move away from this way of seeing time, to think of it as historically contingent rather than as a law of nature. “I think the reason most people see time as money is not that they want to, but that they have to,” Odell writes.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xptIKk">
|
|||
|
|
Odell’s solution to this issue is not for us all to quit our jobs or hustle our way into early retirement. (Although she does suggest experimenting with mediocrity if you can afford to do so, which is close enough to <a href="https://www.vox.com/recode/23548422/quiet-quitting-hiring-great-resignation-words-about-work">quiet quitting</a> to make a trend piece.) Rather, she proposes that instead of thinking of our leisure as time away from work that will simply refresh us for more work, we think of it as time that is actively focused on deepening our understanding of ourselves and the world around us.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JQTT9K">
|
|||
|
|
Leisure thought of in this way, Odell writes, becomes not “an experience to be consumed or a goal to be met,” but “a state of mind or an emotional posture — one that, like falling asleep, can be achieved only by letting go.” Her suggestions for finding this state of mind remain largely unchanged from her recommendations in <em>How to Do Nothing</em>: Find a piece of natural landscape, something as small as a particular tree branch, and observe it, closely. See how it changes day to day. Join a local mutual aid group. <a href="https://www.vox.com/22992901/how-to-find-your-community-as-an-adult">Care for your community</a>. See if giving your time away to someone else leads not to a loss of time but an enrichment of it, a sense of time expanding ever outward.
|
|||
|
|
</p>
|
|||
|
|
<h3 id="SVAhzT">
|
|||
|
|
Can learning to advocate for ourselves lead to systemic change?
|
|||
|
|
</h3>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tsrpvO">
|
|||
|
|
The idea that helping others helps ourselves is central to the thesis of <em>Real Self-Care</em>. By making time for ourselves, Lakshmin argues, we are able to find the space to enact systemic change on the world. Her project is to distinguish what she calls real self-care from the faux self-care peddled by the wellness industry of yoga retreats and green juices. Instead, she argues, real self-care means identifying your values and drawing firm boundaries in your life.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZrIqVV">
|
|||
|
|
Lakshmin does not come by this argument lightly. During her medical residency as a psychiatrist, she became disillusioned with the same issue that <em>Real Self-Care</em> aims to tackle: Many of her patients were struggling with systemic problems, not psychiatric problems. They needed child care and health insurance, but all Lakshmin was able to offer them was antidepressants and therapy. As Lakshmin would later write, “This isn’t just about burnout, it’s about betrayal” — betrayal of individual people by a state that failed to provide them what they needed to live their lives.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XR3OIp">
|
|||
|
|
This problem seemed so disillusioning to Lakshmin during her residency that she dropped out to join a wellness commune focused on orgasmic meditation. The group would later be <a href="https://www.lamag.com/culturefiles/inside-hollywoods-orgasm-cult/">investigated by the FBI as a cult</a>, but Lakshmin spent two years living with them before she eventually made up her mind to escape. She was convinced at the time that she had found the answer to her burnout in this group that purported to be a utopia for women, their needs, and their bodies. She was only able to leave after she began to believe that one wellness practice couldn’t be the solution to everything.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="F65oJz">
|
|||
|
|
So Lakshmin knows, she writes, how alluring the wellness industry can be when it sells itself to us as the solution to all our problems. “I had been seduced by the fantasy that an external solution — this shiny wellness practice — could transform my life,” she tells us. Now, she believes that “real self-care” can only be done from within.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tDYFWo">
|
|||
|
|
<em>Real Self-Help</em> is not a lyrical or philosophical meditation on its subject like <em>Saving Time</em>. It is a true self-help book, with exercises for the reader to help identify your personal values and sidebars that advise you on whether or not you should seek mental health counseling. Where Lakshmin aligns with Odell is in her contention that once that internal work begins, it evolves into systemic reform.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6VI13A">
|
|||
|
|
“Real Self-Care is about changing our internal landscape so that we can go forth and exert power and agency in the outside world,” she writes. “I think of this as planting seeds of revolution — we are seeding the future for ourselves and for the next generation as well.”
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Xy3jsw">
|
|||
|
|
To that end, <em>Real Self-Care</em> is dotted with stories of women advocating for themselves and reaping the structural rewards for doing so. One of Lakshmin’s patients, Sonia, is a depressed mother in her 30s who feels abandoned by her husband when he goes right back to work after the birth of their two children. During her pregnancy with her third child, Sonia asks her husband to take paternity leave this time (self-care). He’s the first man to ask for parental leave at the small startup where he works, and his request prompts the company leadership to instate a policy of gender-neutral parental leave for all their employees (systemic change). “And it started with Sonia learning how to treat herself with compassion,” Lakshmin writes.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dbyA8v">
|
|||
|
|
This kind of boundary setting is not, Lakshmin acknowledges, available to everyone. Plenty of companies would just as soon have denied Sonia’s husband’s request for parental leave, and plenty of men wouldn’t have asked for that leave in the first place. For those in precarious positions, Lakshmin advises they try saying no to a small task, looking at the results, and making plans from there — including exit plans.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="58C6iv">
|
|||
|
|
It’s also useful, she suggests, to look to your community for help when possible. “Humans thrive on shared connections,” she writes. “Instead of resisting and turning away supports in your life, remind yourself that the people who offer help are receiving as well.”
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S3Iy5l">
|
|||
|
|
This advice, too, is in alignment with <em>Saving Time</em>: a reminder that we don’t exist as individuals awash in a sea of indignities against which we are powerless, but as human beings with human relationships in which all kinds of possibilities exist: connection and help and responsibility and solidarity. In order to make the most of those possibilities, though, Lakshmin argues that we must understand ourselves, what we want from others, and what we are willing to give in return.
|
|||
|
|
</p>
|
|||
|
|
<p class="c-end-para" data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="G7Xjcw">
|
|||
|
|
The biggest gift both of these books have to offer, though, is the possibility that life doesn’t have to be this way. We don’t have to languish, impotent, in our dumb dark world, letting time march us forward and watching everything burn. We can step outside of work time and into the time scale of a tree branch, of a patch of moss. We can advocate for ourselves and for our neighbors. Instead of drowning in time, we can swim.
|
|||
|
|
</p></li>
|
|||
|
|
<li><strong>Medicare is being privatized right before our eyes</strong> -
|
|||
|
|
<figure>
|
|||
|
|
<img alt="Woman standing outside a truck with a Medicare Advantage sign on it." src="https://cdn.vox-cdn.com/thumbor/QqF3NKvdPNKm_Rupq90FohwDHns=/555x0:4928x3280/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72084574/465687182.0.jpg"/>
|
|||
|
|
<figcaption>
|
|||
|
|
Carol Berman speaks with pedestrians about Medicare Advantage benefits during the Coalition for Medicare Choices’ Medicare Advantage Food Truck stop in Washington on March 9, 2015. | Bill Clark/CQ Roll Call
|
|||
|
|
</figcaption>
|
|||
|
|
</figure>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The enormous success of Medicare Advantage — and the potential risks — explained.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E4um9j">
|
|||
|
|
<a href="https://www.vox.com/policy/2023/3/9/23630856/joe-biden-budget-medicare-trust-fund-taxes">Medicare</a> is undergoing a subtle but fundamental transformation from government program to public benefit provided by private companies, a shift with major implications for both patients and taxpayers.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pDO4z1">
|
|||
|
|
The driver of that change, an alternative version of the program known as Medicare Advantage, has been the subject of scrutiny in recent weeks. President Joe Biden and House Republicans have been bickering over the administration’s <a href="https://www.kff.org/policy-watch/is-the-biden-administration-proposing-cuts-to-medicare-advantage/">proposed changes to payments</a> for the private plans that sell Medicare Advantage plans. Fresh fears over <a href="https://www.vox.com/policy/2023/3/9/23630856/joe-biden-budget-medicare-trust-fund-taxes">Medicare’s solvency</a> have renewed the debate about how much the plans <a href="https://www.healthaffairs.org/do/10.1377/forefront.20220223.736815/">cost the federal government</a>. And a new <a href="https://www.statnews.com/2023/03/13/medicare-advantage-plans-denial-artificial-intelligence/">STAT investigation</a> adds to concerns about how private companies oversee the public benefits they are supposed to provide.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jw0EIC">
|
|||
|
|
Underlying all of those concerns is the fact of Medicare Advantage’s explosive growth. Almost half of people on Medicare, <a href="https://khn.org/morning-breakout/medicare-advantage-enrollment-reaches-31-million-though-is-slowing/">31 million Americans</a>, are now enrolled in a Medicare Advantage plan, nearly double the share of 10 years ago. It is widely assumed that Medicare Advantage will cover a majority of the program’s beneficiaries within the next few years.
|
|||
|
|
</p>
|
|||
|
|
<figure class="e-image">
|
|||
|
|
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/59BoWsFn-wrn5uN5dyBF0U4jNy0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24506830/total_medicare_advantage_enrollment_2007_2022.png"/> <cite>Kaiser Family Foundation</cite>
|
|||
|
|
</figure>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d1Yguu">
|
|||
|
|
Medicare has traditionally been a government-run insurance program for people over 65 and those with long-term disabilities. Medicare Advantage allows private insurers to offer their own plans that provide Medicare benefits as well as some additional perks not available in the original program. The secret to the program’s success is simplicity. Traditional Medicare is a fragmented program; Part A covers hospital care and Part B covers outpatient services. Patients must enroll in a separate Part D plan for prescription drug coverage that is administered by private insurers. Most people also purchase supplemental coverage, extra insurance that helps reduce their out-of-pocket costs.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2pHpFh">
|
|||
|
|
Medicare Advantage, also known as Part C, combines those benefits into one insurance plan that also includes an annual limit on out-of-pocket costs, something that does not technically exists in regular Medicare.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cu6JMm">
|
|||
|
|
But the benefits to patients seem to come at a cost to taxpayers. Though the health insurance industry <a href="https://www.ahip.org/news/press-releases/new-study-medicare-advantage-costs-less-than-original-medicare">disputes</a> these findings, MedPAC, the independent committee tasked with overseeing Medicare on Congress’s behalf, <a href="https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/mar21_medpac_report_to_the_congress_sec.pdf#page=401">found</a> Medicare Advantage plans cost the federal government more money per patient than the original program would have if those same people had stuck with the traditional benefits.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ahc7TW">
|
|||
|
|
Private companies are also making healthy margins on their Medicare business. <a href="https://www.kff.org/medicare/issue-brief/health-insurer-financial-performance/">A Kaiser Family Foundation analysis</a> found that insurers were making more money per patient in Medicare Advantage than with their individual or employer-sponsored plans. Humana, which covers 5 million beneficiaries, or roughly one in five people who have elected to go with the Medicare alternative, <a href="https://www.ajmc.com/view/humana-leaving-commercial-business-will-focus-on-government-funded-programs">recently announced</a> it was dropping the rest of its portfolio to focus exclusively on the Medicare Advantage market and Medicaid managed care, a version of that government program that is similarly run by private insurers with state supervision.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tEr31e">
|
|||
|
|
Patients have clearly found something to like in what Medicare Advantage offers. The program was established in 1997 to give people a streamlined alternative, a private option less overt than <a href="https://khn.org/morning-breakout/gop-platform/">more recent GOP voucher proposals</a>.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DVPycZ">
|
|||
|
|
But scholarly research and news investigations have revealed notable downsides in turning over a program that covers America’s seniors, the people who need and use the most health care, to private companies. Medicare Advantage enrollees are more likely to report trouble affording health care than people on traditional Medicare. Some of the behavior by Medicare Advantage plans, such as using AI to decide when to stop covering services for their enrollees, may be becoming more common in the private sector but is still unheard of for public programs.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OcoWn3">
|
|||
|
|
The trade-off the United States seems to be making is accepting more administrative bloat and more stringent provision of benefits in exchange for a more navigable Medicare plan. The trade-off is one other countries have made as they designed universal health care programs. (A similar trend is <a href="https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-managed-care/">underway in Medicaid</a>.)
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Opi3S3">
|
|||
|
|
But as concern grows about Medicare facing a potential financial cliff, and evidence mounts about the costs of Medicare Advantage, the risks of the trade-off are becoming clearer. Medicare is no longer what it used to be: Once the epitome of government-run health insurance, its benefits are on the verge of being primarily funneled through private companies. Any attempts to change the program will have to wrestle with that reality.
|
|||
|
|
</p>
|
|||
|
|
<h3 id="c1zN4r">
|
|||
|
|
How Medicare Advantage got so popular
|
|||
|
|
</h3>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="p2Z4J2">
|
|||
|
|
Pilot programs for private insurers’ administration of Medicare date to the 1970s, but the Medicare Advantage program was created by the Balanced Budget Act of 1997, at a time when concerns about Medicare’s solvency ran high. Originally known as Medicare Choice or Part C, it was renamed Medicare Advantage in 2003, when Medicare was expanded to cover prescription drugs.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gw5439">
|
|||
|
|
The idea was to provide patients with a simpler Medicare plan. If you have <a href="https://www.medicare.gov/basics/costs/medicare-costs">traditional Medicare</a>, you are combining Part A, for which most people don’t pay a premium, and B, for which most people do, with a separate Part D drug plan, and potentially supplemental coverage too. With Medicare Advantage, people can enroll in a single insurance plan that would provide the full menu of benefits.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yqRAhW">
|
|||
|
|
Some Medicare Advantage plans also include dental, hearing, and vision benefits, services that are not covered by the traditional program but can be critical for seniors. Medicare Advantage plans also set annual caps on out-of-pocket costs, which don’t apply in traditional Medicare. (Supplemental coverage or Medicaid instead lower costs for most — but not all — Americans who opt for the original version of the program.)
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S0DeIu">
|
|||
|
|
Beneficiaries pay monthly premiums to purchase a Medicare Advantage plan; people with lower incomes qualify for subsidies. There are notable limitations in coverage. In traditional Medicare, for example, patients can go to any doctor or hospital that accepts Medicare; Medicare Advantage has more limited provider networks, and patients can be on the hook for higher costs if they are treated at an out-of-network doctor or hospital.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="raa7MQ">
|
|||
|
|
The federal government pays Medicare Advantage plans a flat rate for the expected cost of covering their particular customers and the insurers are required to adhere to certain rules about benefits and costs. But companies still have flexibility about how to run their plans and have a financial incentive to limit expenses. The less money they spend, the more they get to keep for themselves.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uRgkUN">
|
|||
|
|
Still, customers will vote with their feet and, after <a href="https://www.cbo.gov/sites/default/files/105th-congress-1997-1998/reports/bba-97.pdf">slower-than-expected initial uptake</a>, Medicare Advantage is now growing so quickly that it will soon be the dominant form of Medicare.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EYwqo1">
|
|||
|
|
Why the movement? In <a href="https://www.healthaffairs.org/do/10.1377/forefront.20210304.136304/full/">a 2021 analysis published in Health Affairs</a>, Ken Terry and David Muhlestein observed that “we’re witnessing the rapid privatization of Medicare” and offered an explanation: Medicare Advantage plans “offer beneficiaries a better deal than traditional Medicare.”
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DUixjs">
|
|||
|
|
The premiums people pay for a Medicare Advantage plan can be significantly lower than the combined cost of supplemental coverage and a Part D plan — less than $50 compared to more than $200 on average, per Terry and Muhlestein — with the added benefit of having only a single insurance card. According to <a href="https://www.commonwealthfund.org/publications/issue-briefs/2022/oct/traditional-medicare-or-advantage-how-older-americans-choose">a 2022 Commonwealth Fund survey</a>, the additional benefits offered by Medicare Advantage plans (such as dental or vision) and the limits on out-of-pocket costs were the most common reasons seniors gave for choosing the alternative over the original program.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qhjJbP">
|
|||
|
|
In general, patients with traditional Medicare and people with Medicare Advantage say they have similar satisfaction with their benefits. On some metrics, the latter group excels; people with a Medicare Advantage plan are more likely to have a regular doctor and to say they have received preventive health care services. With a few exceptions for particular medicines, Medicare Advantage customers report fewer problems accessing their prescription drugs too.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6w17r1">
|
|||
|
|
But people enrolled in Medicare Advantage also experience a unique set of problems compared to people who choose the original program.
|
|||
|
|
</p>
|
|||
|
|
<h3 id="6b6Qmw">
|
|||
|
|
The potential downsides of Medicare Advantage’s growth
|
|||
|
|
</h3>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CU1BYP">
|
|||
|
|
Those problems, based on the available research, start with cost. A higher percentage of Medicare Advantage enrollees report having problems affording care (about 19 percent, per <a href="https://www.kff.org/medicare/issue-brief/cost-related-problems-are-less-common-among-beneficiaries-in-traditional-medicare-than-in-medicare-advantage-mainly-due-to-supplemental-coverage/">a 2021 KFF analysis</a>) than those on traditional Medicare (15 percent), though people on the original program without supplemental coverage had the most problems with affordability (30 percent). (Most people on Medicare do purchase this coverage.) Black Americans and people with lower incomes were more likely to report having trouble paying for health care while enrolled in Medicare Advantage.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0k3P6I">
|
|||
|
|
Other findings appear worrisome too. Medicare Advantage patients are <a href="https://www.ajmc.com/view/comparison-of-the-use-of-top-ranked-cancer-hospitals-between-medicare-advantage-and-traditional-medicare">less likely to receive medical care at the highest-rated facilities</a> for their particular needs, compared to people with traditional Medicare, a reflection of more restrictive provider networks. Families also <a href="https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2771443">reported</a> more satisfaction with end-of-life care when using traditional Medicare.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wcinwy">
|
|||
|
|
Specific business practices by Medicare Advantage plans, and their consequences for patients, have also been called into question by investigative reporting and government inquiries over the past few years, practices that seem to run counter to Medicare’s function as an entitlement program for Americans over 65 and those with long-term disabilities.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9HTw0u">
|
|||
|
|
This week, STAT <a href="https://www.statnews.com/2023/03/13/medicare-advantage-plans-denial-artificial-intelligence/">reported</a> on the increasing use of AI algorithms by these plans to determine when to cut off benefits for a customer. The lead example of their reporting was an 85-year-old woman with a broken left shoulder, whose insurer followed an algorithm that said she should be ready to leave a nursing facility and return home within 17 days.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OzD7C7">
|
|||
|
|
On the 17th day of her stay, the insurer said it would no longer cover the bills for her stay, even though her doctors and nurses observed that the woman was still in extreme pain and incapable of doing basic activities, such as dressing herself or going to the bathroom. It took more than a year, and a federal judge’s order, for the patient to receive payments for the three additional weeks she needed to stay in the nursing facility. Doctors shared other stories of patients who saw benefits withdrawn at the end of their life, leaving their families to fight over the leftover bills for years after their loved one had died.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J0CujD">
|
|||
|
|
A <a href="https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf">report from federal investigators published in April 2022</a> found that tens of thousands of Medicare Advantage customers were denied coverage for services they should have been entitled to. A significant number of prior authorization denials (13 percent) and payment denials (19 percent) reviewed by the investigators were for services that should have been covered by the program but were not.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="q3TSMd">
|
|||
|
|
“Denied requests that meet Medicare coverage rules may prevent or delay beneficiaries from receiving medically necessary care and can burden providers,” they wrote. “Even when denials are reversed, avoidable delays and extra steps create friction in the program.”
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CGij4E">
|
|||
|
|
In addition, as <a href="https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html">the New York Times reported in October</a>, most of the largest Medicare Advantage insurers have been the subject of federal audits that found they improperly billed the program and of litigation that accused them of fraud. Taken together, the plans overbilled Medicare by between $12 billion and $25 billion in 2020, depending on the estimate.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1Og1P4">
|
|||
|
|
Though Medicare Advantage was first established as a tool for reining in spending, these private plans instead seem to be perpetuating the program’s solvency crisis.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Tbq06U">
|
|||
|
|
According to MedPac, since 2004, Medicare has always paid more to Medicare Advantage plans for the cost of covering their customers than the program would have spent if the same beneficiaries had instead been enrolled in traditional Medicare. Some years, the private plans were receiving a nearly 20 percent markup compared to the original benefit structure.
|
|||
|
|
</p>
|
|||
|
|
<figure class="e-image">
|
|||
|
|
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/9qUQDxqyYiqx9XYWBXg227Eafiw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24509619/Screen_Shot_2023_03_14_at_1.00.11_PM.png"/> <cite>MedPAC</cite>
|
|||
|
|
</figure>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TRCTa9">
|
|||
|
|
Those high payments are drawing more attention with an insolvency crisis for Medicare Part A, which covers hospital bills, on the horizon. Part A is funded almost entirely through the program’s dedicated payroll taxes. If those benefits cost more than the government receives in Medicare payroll taxes in a given year, as can happen in an economic downturn, the difference comes out of a trust fund earmarked specifically for Part A. The Medicare trustees, who issue <a href="https://www.cms.gov/files/document/2022-medicare-trustees-report.pdf">annual reports on the program’s finances</a>, project that Medicare spending will begin outpacing revenue again in 2024, requiring the program to dip into the trust fund. The trust fund is projected to be fully depleted by 2028 without further policy changes.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MXT0Kg">
|
|||
|
|
The growth of Medicare Advantage is contributing to the financial crunch. Those plans receive funding based on the type of service provided to their customer, which means money for hospital care comes from Part A. Annual Part A payments to Medicare Advantage plans are expected to increase from about $176 billion in 2022 to $336 billion by 2030.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lcSggY">
|
|||
|
|
With revived concerns over Medicare’s solvency and evidence of excess spending in Medicare Advantage, policymakers are starting to look at making changes to the program. But that won’t be easy.
|
|||
|
|
</p>
|
|||
|
|
<h3 id="gSCj7u">
|
|||
|
|
The health insurance industry will resist big changes or cuts to Medicare Advantage
|
|||
|
|
</h3>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8paY1x">
|
|||
|
|
Health insurers are going to fiercely defend their Medicare Advantage business against any proposed cuts, as the recent flap over the Biden administration’s proposed payment changes reveals. That’s because Medicare Advantage is now the industry’s most profitable line of business. United Healthcare, the nation’s largest health insurer and the largest seller of Medicare Advantage plans, has been <a href="https://www.healthcarefinancenews.com/news/unitedhealthcare-expand-medicare-advantage-footprint-2022">aggressively expanding</a> its offerings for people in the program.
|
|||
|
|
</p>
|
|||
|
|
<figure class="e-image">
|
|||
|
|
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/BXKxgDOyMHFALujqGyipwKcGZR4=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24509636/gross_margins_per_enrollee_2018_2021.png"/> <cite>Kaiser Family Foundation</cite>
|
|||
|
|
</figure>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Mubt5C">
|
|||
|
|
That has made insurers very protective of their Medicare Advantage business. Insurers are not quite the lobbying force they were before the Affordable Care Act, but they remain highly influential and they have found allies among Republicans who have always preferred to see Medicare become more of a private operation.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nPkpCW">
|
|||
|
|
That alliance has targeted in the past month proposed payment changes by the Biden administration. As KFF analysts <a href="https://www.kff.org/policy-watch/is-the-biden-administration-proposing-cuts-to-medicare-advantage/">explained</a> in a recent analysis, the White House wants to crack down on overpayments with adjustments to the complicated formula that determines when Medicare Advantage plans need to pay back the federal government for improper billing. The insurance industry has painted that proposal as a cut, even though the Biden administration estimates that, when the entirety of their proposed payment plan is taken into consideration, Medicare Advantage plans will still see a 1 percent increase in payments from the federal government in 2024.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rZHmRa">
|
|||
|
|
Health insurers have warned of premium increases and benefit cuts “though there is no clear evidence to suggest that,” according to the KFF analysts. They have been joined by Republicans, who have sought to turn the tables on Biden by accusing him of proposing Medicare cuts after the president had criticized Republican plans to cut spending for the program.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CbJVfd">
|
|||
|
|
“Joe Biden is trying to gut Medicare benefits. Seniors can’t trust Democrats to protect Medicare,” one Republican campaign spokesperson <a href="https://rollcall.com/2023/02/22/insurers-republicans-square-off-with-biden-on-medicare-cuts/">told Roll Call</a> last month. The Better Medicare Alliance, a lobbying group for Medicare Advantage plans, has started running TV ads asking seniors to petition the White House to reverse the proposed payment changes.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wuddUC">
|
|||
|
|
Though independent fact-checkers have <a href="https://khn.org/news/article/tom-cotton-medicare-advantage-biden-fact-check/">concluded</a> calling the Biden proposal a cut is inaccurate, the entire episode demonstrates Medicare Advantage’s growing political clout and previews the fight that would likely meet any efforts to seriously alter the program.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eVwTFx">
|
|||
|
|
The policy structure of Medicare Advantage is not without precedent. States have outsourced much of the administration of Medicaid to managed care plans. <a href="https://www.vox.com/policy-and-politics/2020/1/17/21046874/netherlands-universal-health-insurance-private">Countries like the Netherlands</a> have set up health systems that use private insurers, operating under strict government oversight, to provide insurance benefits to their citizens. Giving people more choice and a more streamlined experience can have its benefits, as evidenced by the popularity of Medicare Advantage in the US.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3A0iHS">
|
|||
|
|
But asking private actors, with profit motivations, to administer government benefits to which people are supposed to be entitled brings risks. People are more likely to have trouble affording health care and their claims are more likely to be denied; that is true in places like the Netherlands, compared to other countries with more direct government administration, and that is true of Medicare Advantage when compared to the traditional Medicare program.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wUlqbe">
|
|||
|
|
To date, policymakers have seemed content to let Medicare Advantage grow without much moderation. Medicare beneficiaries have been attracted to its comparative simplicity. But the costs of funding the program, amid the political environment’s shift toward more fiscal restraint, and the problems experienced by patients have put the program under the microscope.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rIgcUm">
|
|||
|
|
It is difficult, at this point, to imagine the Medicare program without Medicare Advantage. The question is whether policymakers can make it more cost-effective and crack down on insurer behavior that runs counter to the program’s objectives. Recent events suggest that if they try, they will have a fight on their hands.
|
|||
|
|
</p></li>
|
|||
|
|
</ul>
|
|||
|
|
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
|
|||
|
|
<ul>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Treesa Jolly-Gayatri Gopichand enter second successive semifinal of All England Championships</strong> - World number 17 Indian pair looked solid in their defence and relentless in attack against Chinese pair of Li Wen Mei and Liu Xuan Xuan</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Christofle shines</strong> -</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Champions League QF draw | Man City faces Bayern; Real Madrid takes on Chelsea</strong> - Manchester City manager Pep Guardiola will face his former club Bayern Munich in the quarterfinals of the 2022-23 Champions League</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ind vs Aus 1st ODI | Mohammed Siraj, Mohammad Shami ground Australia for 188</strong> - The collapse was an inexplicable one as Australia lost last six wickets for only 19 runs in a space of 7.5 overs</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Former Australia test cricket captain Tim Paine retires</strong> - Wicketkeeper Paine captained Australia in 23 tests between early 2018 and 2021, playing 35 tests overall.</p></li>
|
|||
|
|
</ul>
|
|||
|
|
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
|
|||
|
|
<ul>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Central policies leading to an emergency in the country’s power sector: K. Krishnankutty</strong> - Such policies favouring entry of private monopolies in power distribution are likely to trigger an increase in power tariffs and give rise to a situation where electricity may become inaccessible to the farming community</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Scale up value addition of rubber and coir: experts at CSIR-NIIST meet</strong> - India, as the second largest producer of coconut, was exporting raw materials such as coconut husk, but the country lagged behind in promoting value-added products from coir</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tribals in Mysuru to mobilise themselves ahead of elections</strong> -</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>3 killed as truck plunges into 30 ft depth</strong> - The area has witnessed dozens of accidents in the last few years in spite of efforts to straighten the curve</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>TSPSC cancels Group-I and two other exams after paper leakage</strong> - Nine people, including TSPSC employee Praveen, arrested so far; Group-I prelims to be reconducted on June 11</p></li>
|
|||
|
|
</ul>
|
|||
|
|
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
|
|||
|
|
<ul>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Kremlin aims to destroy Ukraine jets after Poland and Slovakia pledges</strong> - Slovakia becomes the second Nato country after Poland to offer Soviet-era fighter jets to Ukraine.</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>China’s Xi to meet Putin in Moscow next week</strong> - Beijing said China would uphold “an objective and fair position” on the war in Ukraine.</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine will remember who backed us - foreign minister</strong> - Ukraine’s foreign minister tells the BBC nations that don’t back Ukraine will be held to account.</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>France pension protests: Clashes after Macron orders rise in pension age without vote</strong> - France’s president has sidelined MPs and forced through plans to raise the pension age from 62 to 64.</p></li>
|
|||
|
|
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Video shows moment Russian fighter jet hits US drone over Black Sea</strong> - US footage shows the jet apparently dumping fuel as it makes two close passes with the drone.</p></li>
|
|||
|
|
</ul>
|
|||
|
|
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
|
|||
|
|
<ul>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>PLATO: How an educational computer system from the ’60s shaped the future</strong> - Forums, instant messaging, and multiplayer video games all started here. - <a href="https://arstechnica.com/?p=1890452">link</a></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>We finally have proof of active volcanoes on Venus</strong> - Researchers pored over images from Magellan’s visit to Venus in the early 1990s. - <a href="https://arstechnica.com/?p=1924805">link</a></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Valve’s year-old Steam Deck is on sale for the first time</strong> - Save 10 percent on any hardware configuration until March 23. - <a href="https://arstechnica.com/?p=1924853">link</a></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>At least 67 people got botulism after trying to paralyze their stomachs</strong> - The aim was to slow digestion, but it instead led to life-threatening paralysis. - <a href="https://arstechnica.com/?p=1924762">link</a></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>RIP (again): Google Glass will no longer be sold</strong> - Sales have already ceased, and support ends later this year. - <a href="https://arstechnica.com/?p=1924671">link</a></p></li>
|
|||
|
|
</ul>
|
|||
|
|
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
|
|||
|
|
<ul>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A workman is 5 floors up at a construction site and realizes he forgot his hammer…</strong> - <!-- SC_OFF --></p>
|
|||
|
|
<div class="md">
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
He leans over the edge of the building and sees his friend on the ground floor. He shouts down to him “Hey buddy I need my hammer.” His friends looks up but motions to his ears that he can’t hear him.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The workman, thinking quickly, decides to sign out what he wants. He points to his eye for “I,” his knee for “need,” and then makes a hand motion for his hammer.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
His friend on the ground floor squints up, and then unzips his pants and starts furiously masturbating.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The workman, shocked, runs down the 5 flights of stairs to his friend. “Hey buddy,” he says, “I was trying to tell you that I need my hammer. What the hell are you doing?”
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
“I know!” says his friend. “I was telling you that I’m coming.”
|
|||
|
|
</p>
|
|||
|
|
</div>
|
|||
|
|
<!-- SC_ON -->
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/R3pt1l14n_0v3rl0rd"> /u/R3pt1l14n_0v3rl0rd </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/11t982l/a_workman_is_5_floors_up_at_a_construction_site/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/11t982l/a_workman_is_5_floors_up_at_a_construction_site/">[comments]</a></span></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A guy walks into a clock shop and aproaches the counter where a sales lady is standing.</strong> - <!-- SC_OFF --></p>
|
|||
|
|
<div class="md">
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
He pulls down his zipper and places his pecker on the counter.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Sales Lady stunned: Excuse me sir, This is a CLOCK shop.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Customer: Yes I know, could you please put two hands and a face on this please?
|
|||
|
|
</p>
|
|||
|
|
</div>
|
|||
|
|
<!-- SC_ON -->
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/StraightDildo"> /u/StraightDildo </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/11sxafa/a_guy_walks_into_a_clock_shop_and_aproaches_the/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/11sxafa/a_guy_walks_into_a_clock_shop_and_aproaches_the/">[comments]</a></span></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Thieves broke into my shop and stole 15 cases of Red Bull</strong> - <!-- SC_OFF --></p>
|
|||
|
|
<div class="md">
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
I don’t know how these people sleep at night
|
|||
|
|
</p>
|
|||
|
|
</div>
|
|||
|
|
<!-- SC_ON -->
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/r_spandit"> /u/r_spandit </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/11tm4sz/thieves_broke_into_my_shop_and_stole_15_cases_of/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/11tm4sz/thieves_broke_into_my_shop_and_stole_15_cases_of/">[comments]</a></span></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A man and his wife are having trouble with their sex life</strong> - <!-- SC_OFF --></p>
|
|||
|
|
<div class="md">
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
So the man goes to the new sex toy shop, walks up to the counter and explains his situation.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The clerk says “I’ve got just the thing for you, it’s called magic penis” and retrieves it from the shelf behind him.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Man: how does it work? Clerk: I’ll show you… “magic penis, counter!” <em>magic penis flips out and starts schlupping all around the counter</em>
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Man: wow! That’s great, I’ll take it!
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The man goes home and shows his wife. Man: honey I got something that will help us in the bedroom! It’s called magic penis! Wife: ok, how does it work? Man: I’ll show you… magic penis, table!
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
<em>magic penis starts schlupping around the table</em>
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The wife gets excited. The next day, the man goes to work and the wife stays home. She starts to get ready.
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Wife: magic penis, pussy!
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
The magic penis goes to work and she has the time of her life and has orgasm after orgasm… but she doesn’t know how to stop it or turn it off. So she gets into the car and starts driving to the hospital and starts to speed. A cop pulls her over, walks up to the car and says “why were you going to fast?!”
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Wife: I can explain! Cop: well let me hear it? Wife: I have this magic penis… Cop: magic penis my ass!
|
|||
|
|
</p>
|
|||
|
|
</div>
|
|||
|
|
<!-- SC_ON -->
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/SteamyPork"> /u/SteamyPork </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/11tmuhe/a_man_and_his_wife_are_having_trouble_with_their/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/11tmuhe/a_man_and_his_wife_are_having_trouble_with_their/">[comments]</a></span></p></li>
|
|||
|
|
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Genie: you have 3 wishes. What is your first?</strong> - <!-- SC_OFF --></p>
|
|||
|
|
<div class="md">
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Guy: I wish for more wishes
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Genie: you can wish for anything but more wishes
|
|||
|
|
</p>
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
|
|||
|
|
Guy: damn. I wish I could
|
|||
|
|
</p>
|
|||
|
|
</div>
|
|||
|
|
<!-- SC_ON -->
|
|||
|
|
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/weakgutteddog27"> /u/weakgutteddog27 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/11sq1fz/genie_you_have_3_wishes_what_is_your_first/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/11sq1fz/genie_you_have_3_wishes_what_is_your_first/">[comments]</a></span></p></li>
|
|||
|
|
</ul>
|
|||
|
|
|
|||
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|
|||
|
|
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