More McCain - the IED

So there continues to be some blowback related to McCain's gift of ordinance to John Stewart.

The whole thing is a little like W telling Gary Trudeau to "tread lightly" during Daddy's term in office. People who can't take a joke should acknowledge that before engaging in criticism of people who make jokes. It's grim humor, but humor just the same, and I would point out (briefly - late for lunch) that the message is not a light one - he's not making fun of death, he's making it a reality for people at home. This just doesn't seem like poor taste to me at all.

And before I start to sound like a McCainophile, I disagree with nearly everything he says about Iraq (and Iran, and probably health care). But the dude's got spirit.

McCain says Gonzales should resign...

The Chronicle has an AP blurb about Senator McCain's opinion of Alberto Gonzales' current difficulty with those pesky Democratic attorneys that the DOJ sacked last year. It's the first move regarding the current Administration debacle and a smart one on McCain's part, methinks. He again is positioning himself in the "partisanship is stupid" camp without sacrificing principles. One need only look at his most recent showdown with John Stewart on The Daily Show to realize that this guy does not relent, will not soft-pedal, and generally speaking comports himself with more dignity than many of the buffoons in the capital.

One wonders whether that is enough. After all, straight shooting didn't exactly get him anywhere in 2000, when he had substantially more chance of appearing to relate to younger generations. Still, it is a rare day when one gets to use the word statesman without cynicism.

Meanwhile, Barak Obama and Hil are getting ready for their first debate. Hmm? SIX others? Who are these people? Oh, right, VP contenders. ;)

Millions Spent, A-Rod aflame, and yet...

This is not a frequent occurence, but a quick (like, in the next day or so) peek at that link will reveal the Yankees in dead last in the AL East. Yes, that's behind the Devil Rays. Bad beats.

Mr. Rodriguez appears to have settled into a New York state of mind, slapping homers this way and that with the sort of grace that one attributes to Tiger's swing or the subtle bend of a reed in the wind. And YET. They struggle. Their closer inexplicably becomes useless. They get swept by the Sox.

All of this, of course, fills me with a quiet glee. It is not a sovereign specific for the abysmal start of the Giants, but it is some consolation.

Meanwhile, across the pond, another clash of the Titans is coming down to the final blows. England's version of Yankees v. Red Sox has been incredible to watch, and culminates with a match between the two sides on May 9. Man Utd has the much easier way out, though, and barring some calamity should hold on. More's the pity.

Okay, enough sports.

Coda - "One Window Web Development"

A new Mac OS X app called Coda may or may not be a godsend for people who aren't particularly super-skilled when it comes to web design. It seems to me to be a pretty robust web development tool that has a lot of bells and whistles, but not enough to baffle (power users, of course, will suggest that it doesn't have enough bells and whistles, but to have everything in one place seems pretty cool).

I'm going to download it and report back, but this seems good for folks like me who know enough code to get in trouble but not enough to fix it without reference to a manual. Being able to monitor the effects of your code at the same time is handy.

Nitwit - Cross-platform microblogging tool

Compatible with Jaiku, Twitter, IRC, and probably other stuff. I'd download it but putting it on my work machine seems like a recipe for disaster:

Link.

Montessori Bound

So it looks like the monkey is going to Childpeace Montessori. The switch is halfway to do with the challenges of skipping a grade in the International School, and halfway to do with our belief that Montessori method is one of the better ways to go with a gifted child. Finally, the ACCESS school (Portland's answer for exceptionally gifted kids) is stuffed to the gills, so she's waitlisted.

This has been one heck of a struggle, but at least we're settling on an option.

More Medicaid Musings

So having had a chance to read the methodology of the Public Citizen study on Medicaid, and take a closer look at the rankings, I have this to say:

The good news is that Oregon missed top 10 by a tiny amount. There was a small cluster at 8-12 that was separated by something like 10 points (out of a 1000 point scale). Hawai'i and Oregon are 11th and 12th by a hair's breadth.

The bad news is that, even if we had made the top 10 - indeed, even if we had ended up first - the top 10 is an accolade only to the extent that it indicates that those states are markedly less broken than the states in the rest of the rankings. No one reached 700 out of 1000 points. 30 states ended up in the bottom 10 in one of the statistical categories (Oregon did not - it was 31st in one, but that's as low as it went). Generally speaking, the states are not doing the job.

Across the board, the hands-down biggest problem for most states is quality of care. Actually, no one knows if that's the problem because very few people are actually attempting to measure it. Problem number one. Problem number two can be found in the lack of standards within state Medicaid programs for quality of care. In short, no one pays any attention to the problem, and even if they did, they would not currently know what to do with the data. Surely there are benchmarks for this sort of thing? Maybe the gummit is on the case? (Not exactly - it's much more about communication to served populations, but it's a start.) Actually, the AHRQ has quite the clearinghouse for information on quality standards. Oregon specifically is falling down pretty hard here, so a bit of light reading might be in order.

It's not apparent that states care much at the moment about improving their measurements of quality, let alone actually improving quality of care. But they'd better start, because the boomers are entering Medicare and Medicaid years. And ignoring the strain on the system, our elders deserve better.

PS - If you're old, impoverished, pregnant, or some combination of same, and you live in Mississippi, move.

OHP ranks 12th in the nation in Medicaid study.

Public Citizen has just released "Unsettling Scores: A Ranking of State Medicaid Programs," and Oregon came in 12th. The report notes that the state would have placed substantially higher were it not for a ranking of 31st in the "Quality of Care" area. Two things within that category dragged us down: nursing homes and percentage of youth immunizations.

Oregon actually got negative points for "Deficiencies in quality of care," and zero points for immunization percentages, which effectively tanked the overall point values. I haven't looked at the kind of stuff that allows them to award less than zero, but if I were a legislator (which I ain't) I would take a long hard look at whatever it was that was causing that particular statistical beatdown.

I also wonder what sort of impact Oregon's home health care industry has on a study like this. Like many states, home health appears to be thriving. I'd be interested to see how, if at all, that impacts the overall quality of nursing homes (fewer nurses available to staff the homes, stronger competition for dollars in the home health area, whatever).

Still and all, twelfth is pretty good. Despite repeated claims that the Oregon Health Plan is broken, it remains one of the most robust and innovative plans in the nation.

Hotel Dusk: Room 215

As always, I'm late to this party, but I've really been enjoying Hotel Dusk. It's probably too much to ask that the puzzles be a bit more difficult, since I'm only about a third of the way through the game and (one hopes) there is likely an increasing level of difficulty.

Many people (notably, Penny Arcade) have commented on the "interactive novel" aspect of this game, as well as titles like Phoenix Wright. I have to agree that the game deserves high praise for presentation and innovation in "escape the room" style puzzling out of things. But, and here's the rub, I think the dialogue drags the game down. In the same way that I sorta abhor the meaningless cut scenes in the Phoenix Wright games (and yes, I know these are meant to be enriching - but c'mon, what are we doning in the name of flavor?), I find a lot of the Chatty Kathyness of Hotel Dusk to be a little bit of a drag. Also, from my preliminary peeks into reviews of the game, it's apparent that there will be times where I'll have to backtrack, like, a long way because I chose the "be a jerk" option in a conversation at the beginning of a chapter.

I mean, am I the only one who enjoyed The 7th Guest? Can someone do that for DS, please? More puzzles, enough story to be getting on with, and then some more puzzles? Should probably go buy this title and shut up, eh?

Resisting xenophobia

My heart sank this morning when I saw that the shooter at Va Tech was one Cho Seung-Hui, a South Korean native who has lived in the U.S. since 1992. I'm not the only one whose first thought was what was going to happen to the rest of the Asian population on campus and in Blacksburg. So today, a moment of silence for race relations, if you please.

Preliminary reports indicate that Cho was a cipher, one of those students who disappears into a public school like VT and emerges either broken or not, depending on luck and personal capacity. At least the creative writing dept. was sensible enough to refer him to counseling, but somewhere and somehow he slipped through the cracks. This is not the fault of the school, of course. Even at their best, colleges and universities are too large to connect personally with every kid on campus. And it sounds as though he was not plugged into to the South Korean community all that much, so one potential source of community was not there.

Anyway, let's focus on the fact that he was crazy and not on the fact that he was from Some Other Country.

Dark day for VA Tech

By now everyone will have heard about the shootings at Virginia Tech. The BBC has a decent rundown of the goings on, while the school has two podcasts of statements from President Steiger regarding the shootings.

This is without question the worst single episode of campus violence in recent memory, and may be the worst ever on US soil. There are no words to express the sorrow and outrage inherent in such an event, and my heart goes out to all families and students of the college, past, present and future.

I'm sure we'll learn more over the coming weeks as the media invites us into the grotesquerie, but in the meantime (and perhaps instead of?), give a moment of silence to the Hokies. Ut prosim, I will stay on top of the story for ways to provide support.