Country electric guitar

Chris is trying to learn the basics of country electric guitar, so this evening he and I spent some time perusing online video lessons: chicken picking, steel guitar licks, country thirds, and the rest. Right now he is using an electric borrowed from Ron Short, along with headphones and a practice CD player that happens to have some useful guitar effects built in. This is until the small amp he ordered arrives early next week. The idea is mostly to expand his skill set, but there is also a chance that he might play some electric guitar during Possum Playboy sets.

As memories flood back, I realize that I know a lot more about country guitar than I thought I did, and it’s been fun to search up some of the classic recordings and play them for Chris. For example, this YouTube video of the first song I ever appreciated for its country guitar sound, Emmylou Harris’s "Luxury Liner," with the phenomenal Albert Lee on lead. The video performance is pure bliss, with Lee playing two breaks on his gorgeous blonde Telecaster, a twenty-second one beginning at the 1:00 mark, and then a two minute long break beginning at 2:10 that ends the song.

What does early breast cancer detection cost?

The longer I look at health care issues, the more I am convinced that there is hardly any point in discussing them, because none of us knows what we are talking about. Literally.

Chris and I just returned from a long road trip to El Paso, to spend a weekend celebrating my dad’s 80th birthday. It was two days driving out, two days back. We listened to a fair amount of NPR news programming along the way, and so got an earful of the controversy over the new guidelines for mammograms for women under fifty. In hours of talk I heard only one number that caught my attention, mentioned in passing, stating that for every 1900 women screened one case of cancer will be detected.

I immediately wanted a second number, namely the cost of a mammogram, but never heard it. Just to help with some level-setting, I assumed that it would cost $1000, not uncommon for a medical procedure. That would mean that it would cost $1.9 million to detect that case. It sounds like a lot, but I wasn’t sure how to think about it. And I had my netbook with me, so at the motel room that night I decided to spend a little time doing some research.

The first thing I found was an article somewhere that the one in 1900 number means that one case is discovered if 1900 women are screened annually for ten years, meaning it takes 19,000 scans to find that one case, ten times what I originally thought. So I was alarmed—$19 million dollars to detect a single case of cancer?

The second thing I found was what looks like a fairly useful website, CostHelper, which maintains a database of typical costs for common purchases. On the mammogram page, it says this about the cost:

For an uninsured patient, typical full-price cost of a mammogram ranges from$80 to $120 or more, with an average of about $102, according to Blue Cross Blue Shield of North Carolina. Some providers charge more, and some offer an uninsured discount. For example, at the Kapiolani Medical Center in Aiea, Hawaii, where the full price is about $212, an uninsured patient would pay about $127 to $148.

Ah, mammograms cost roughly $100. Assuming that, it costs $1.9 million to detect a case of cancer. Is that a reasonable cost for society to bear? I don’t know, but it could make sense when spread across the individuals involved—that is, any given woman might be glad to pay $100 each year for the peace of mind a scan would provide, even if there is only a one in 19,000 chance the scan will turn up something.

But then I read further down the page, which contains posts from people giving brief descriptions of what their own mammograms actually cost them, and was dismayed again. First, because the actual costs incurred ranged between about $750 and $2500, making $1000 a reasonable assumption again ($19 million per case detected).

Second, the comments from women involved made it clear that even a few hundred dollars was more than they were willing to pay out of pocket to cover the very small chance that they had cancer. This may sound miserly and unreasonable, but one of the few things I learned from the hours of radio discussion was that the early detection which a mammogram provides may not actually be worth that much—there is a natural assumption that early detection would lead to more effective treatment and a better chance of survival, but this turns out to not be true.

So, where did this all leave me? Mostly confused. Ten thousand dollars over ten years seems a lot for an individual to pay to find out if she is the 1900th woman, and nineteen million dollars seems high for society (or an insurance pool) to pay to find that one woman. One thousand dollars over ten years seems like not so much—at least it seems like a woman could fairly be expected to pay that out of her own pocket to put her mind at ease—but it would take socialized medicine to get the cost down that low, in which case she wouldn’t be paying out of her own pocket, and society would be paying $1.9 million to find her, still a high price.

It seems like an impossible question to discuss, and yet I am reminded that one group of people does discuss it, namely the plain people who eschew insurance and depend on community support to pay for medical expenses which are beyond the individual’s ability to pay. A small Amish or Mennonite community would be instantly bankrupted if they adopted the modern world’s hands-off attitude on how health care should be allocated, and so I assume that these issues are faced honestly and squarely on a regular basis.

The next real estate crash

The upcoming crisis in commercial real estate will probably be more traumatic than the residential crisis has been. It will be at least as big in terms of dollar cost—more, probably, because businesses have no notion that they are morally obligated to repay a loan if defaulting produces a better economic result for them.

Two other factors are new ones. First, this is commercial activity that is collapsing, exactly the sector we look to to provide the jobs that would pay us the money we need to dig ourselves out of our own financial pits. And second, we are a year into dire straits—the savings are depleted, the unemployment benefits have been extended further than ever before, cities and states are nearing the edge of the abyss—how many more body blows can the economy sustain before it is forced to give up on the hope of an eventual return of the status quo?

Here’s a good summary of the upcoming problems with commercial real estate loans.

Interview with Cormac McCarthy

The Wall Street Journal published a fine interview with Cormac McCarthy, just as the movie based on his book The Road is being released. I’ve never read a book by McCarthy or seen a movie based on his writings, but I thoroughly enjoyed this conversation. Highly recommended

Some highlights:

WSJ: When you first went to the film set, how did it compare with how you saw "The Road" in your head?

CM: I guess my notion of what was going on in "The Road" did not include 60 to 80 people and a bunch of cameras. [Director] Dick Pearce and I made a film in North Carolina about 30 years ago and I thought, "This is just hell. Who would do this?" Instead, I get up and have a cup of coffee and wander around and read a little bit, sit down and type a few words and look out the window.

WSJ: But is there something compelling about the collaborative process compared to the solitary job of writing?

CM: Yes, it would compel you to avoid it at all costs.

And this:

WSJ: Does this issue of length apply to books, too? Is a 1,000-page book somehow too much?

CM: For modern readers, yeah. People apparently only read mystery stories of any length. With mysteries, the longer the better and people will read any damn thing. But the indulgent, 800-page books that were written a hundred years ago are just not going to be written anymore and people need to get used to that. If you think you’re going to write something like "The Brothers Karamazov" or "Moby-Dick," go ahead. Nobody will read it. I don’t care how good it is, or how smart the readers are. Their intentions, their brains are different.

And this:

CM: Well, I don’t know what of our culture is going to survive, or if we survive. If you look at the Greek plays, they’re really good. And there’s just a handful of them. Well, how good would they be if there were 2,500 of them? But that’s the future looking back at us. Anything you can think of, there’s going to be millions of them. Just the sheer number of things will devalue them. I don’t care whether it’s art, literature, poetry or drama, whatever. The sheer volume of it will wash it out. I mean, if you had thousands of Greek plays to read, would they be that good? I don’t think so. […] Just the appalling volume of artifacts will erase all meaning that they could ever possibly have.

Tech notes

I’ve upgraded my computer to run Windows 7, and am pretty happy with it. It’s annoying that most of that happiness comes from the fact that Windows 7 is not Windows Vista, which I misguidedly installed when it first came out. Windows 7 is much better than Vista. It is a little better than Windows XP, but not so much so that it is worth upgrading the two other computers we have that still run XP.

What’s improved in Windows 7? The things I notice are: the taskbar works better; the “smart” selection of programs on the Start Menu is almost smart enough to be helpful; search is very fast; file libraries will probably be helpful if I get around to learning how to use them. Those are all power user things, and if they don’t mean much to you then you should probably save your money, even if you are using Vista.

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Our need for a cell phone is minimal, and so I’ve never been happy with the cost/benefit ratio. We had one in Colorado in 2000 when we needed one for a specific reason, but let the contract lapse when the reason went away. A few years later in Bristol I got a TracFone, thinking that pay-as-you-go would work for us, but the cost of minutes was exorbitant (a dollar per minute, as I recall, with the occasional two-for-one minutes deal); when we moved to Kentucky the phone didn’t work here, so we gave up on it.

Two years ago I thought I would be on the road regularly and would need a phone, so I looked around and found a deal that gave me 1200 minutes per month for $40. At three cents per minute, that was a good deal—if we actually had needed 1200 minutes. It turned out I mostly wasn’t on the road, and we only ever used between 100 and 200 minutes in a month. But I couldn’t find a significantly cheaper deal, so we kept the phone.

Last month my provider notified me that they were going out of business and had sold me and the other customers to Verizon, who was eager to set me up with a new phone and a new plan. That was enough to get me doing another round of research, so I looked, first considering the AT&T Go Phone for a pay-as-you-go option, but as I did the math it didn’t seem like such a good deal.

Finally I looked at TracFone again, and found that their deal had improved tremendously—twenty cents per minute with no access fee. Even better, if you took a particular phone from them you could have perpetual two-for-one minutes, making the cost ten cents per minute. That is perfect for us. The cost is low enough that it doesn’t make us hesitate (much) to make a call, but high enough that we keep the calls short and infrequent. We’ve had the phone for a month now, and used about fifty minutes. That’s five dollars. Nice.

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The investment in a portable MP3 player and a Rhapsody To Go subscription has turned out well. I periodically download batches of albums by an artist that I want Chris to hear (Ry Cooder was the latest), and we play through them on long drives. The MP3 player doesn’t get used anywhere else but in the car, but we can access Rhapsody on the main computer and the netbook, so music is also portable around the house. Last week when recording some songs Chris and I took the laptop upstairs to where we record, and used it to check melodies of songs we were not completely familiar with.

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I use LibraryThing to keep track of books, particularly books that are boxed up and in storage. When I first set up the database I had to type in the ISBN of each book—a lot easier than entering all the information by hand, but still tedious.

I should have taken them up on their offer of a CueCat scanner, only $15 for a gizmo that can scan the bar code of a book and divine its ISBN. And now that I have decided to make most of those stored books, as well as others I no longer want, available for sale on AbeBooks, I thought $15 would be a good investment. I paid them, they sent me one, it really works, it’s pretty cool. I wish I had bought one to begin with.

Proper etiquette for those on public assistance

This is a very good blog post on how public assistance has turned into a substitute for love, and is often used an an excuse for being extremely uncharitable. I’ll try to quote enough to pique your interest, but really you should read the whole thing.

The writer finds herself in unpleasant circumstances that much of the population thinks of as the result of some sort of moral failure:

Currently, myself and many of my friends are on varying forms of state aid. Taking public assistance is a daunting thing to do, generally incredibly depressing, and just all around no fun. Many perfect strangers are happy to criticize you for your dependence, regardless of the fact that they have no idea what your actual situation is.

With this in mind, I’ve compiled a simple list of rules (or perhaps, "guidelines") to help minimize the embarrassment and discomfort of taking public assistance. This list has been created based on my own experience and the experience of friends.

The rules are as follows:

1. Don’t be dirty. Present yourself in as hygenically-perfect a condition as possible. […]
2. Don’t be clean. But remember, you are poor. You shouldn’t be able to afford things like shampoo, or fresh laundry, etc. […]
3. Never engage in any luxury activity at all, ever. […]
4. Never possess any item which could be construed as you spending money. […]
5. Only purchase things deemed appropriate by the surrounding consumers. […]
6. Maintain an acceptable number of children. This number will vary between zero and 4, depending on your location–please find out what is appropriate for your own area. […]

If these rules sound overblown to you, then please read the post; the writer’s description of how those rules are applied should ring very true to you.

Some folks might say that these circumstances are just one more indication that the current approach to public assistance is wrong. Perhaps so, but public assistance has successfully supplanted the community mechanisms which once ministered to people in need, and public assistance is now the only place to which folks in need can turn. Public assistance is the reality, and it wouldn’t be very hard for those not in need of it to graciously eliminate the sorts of behavior the blog writer so accurately describes, if not the attitudes behind them.

[Side note: this blog post strikes me as using satire not only to good effect, but in a righteous manner. I was wondering if such a thing was possible; I think this is an example.]

The realities of walking away from a mortgage

Today Mish published an email from a reader who ended up walking away from his mortgage. The email is long but straightforward and detailed.

I bought a house back in 2004, having moved halfway across the country for a new job. It was a house I could comfortably afford – I made a little over $70,000 as a senior manager for a newspaper, and my mortgage was a little under $900 a month (including taxes and insurance), fixed at 5.25% for 30 years with Wells Fargo. In spite of the pressure put on me by a broker when I was buying, I avoided the no money down variable option because I wanted to do what I thought was the responsible thing to lock in my payments at a decent rate I knew I could afford and avoid the reset lotto.

In April of 2008, I was notified that the job I had moved across the country for was set to be eliminated, along with the entire staff of my department. The company I worked for was highly levered in an environment where revenues were shrinking, and ‘consolidations’ were being made across the company. The day I found out that I was going to be out of work, I called Wells Fargo to see if it would be possible to make some alternate payment arrangements until I found work, and was told precisely what the article you reference noted – that they couldn’t even discuss the matter with me until I was 30 days in arrears. I was mortified, knowing that being 30 days in arrears would leave me with the dreaded ‘mortgage late’ on what had been a pristine 800 credit score. I had been prudent and saved a fair sum of money, so I decided to try and keep the plates spinning while I looked for work.

I applied myself to the job hunt, but with nearly 50 positions eliminate from my company and a few hundred at other domestic newspapers who shared my area of specialty, it was a tough task finding work.

Then in August, Gannett, the biggest newspaper company in the world, announced that they would be laying off 1000 workers, and my sources inside Gannett told me that they were going the ‘consolidation’ route, meaning that in the course of 3 months nearly a third of the total positions in my field had gone *poof*. My prospects for finding work in the industry where I had experience had just gone from tough to Quixotic.

I again called Wells Fargo to see if there was anything they could help me with that didn’t involve damaging my credit – I still had a sizable amount of savings to negotiate with – but the answer was the same: 30 days late or no discussion. I decided I’d have to take them up on the offer.

When 30 days had elapsed, I contacted them once again, only to now be told that they couldn’t work out any arrangements until I had found work. I was angry, as one might imagine. I decided that they had received the last payment they were going to receive from me. Fourteen months later, I have kept the vow.

I’m not proud of walking away from my ‘responsibility’, but in light of the situation – nearly 18 months without finding work – it seems that it was the best thing that could have happened. If I had kept paying all along, I’d have depleted a good deal of my savings, and I’d still be facing losing the unemployment benefits that are keeping the other bills paid. As it stands, I’ve still got that nest egg to see my family through the rough days that lie ahead.

I’ve been to the housing counselors the state has set up, and the best they were able to do for me was that I could pay off the back payments, penalties and interest, and resume making payments.

My house is set to be sold at auction next week, and due to the rules in the state, the minimum price will be well in excess of what I suppose the market price would be. I expect that the bank will be the buyer by default.

If my experience is representative, walking away might be the best option.

From Wells Fargo’s perspective, this was an avoidable situation. I called them when I found out about my joblessness, and I did everything I could to avoid a default. All I wanted was some recognition that I was willing to work with them if they would work with me – maybe only paying interest until I was able to find something.

However, once I felt double-crossed, having been told to let it go into arrears so that they could work with me, and then to be told they still couldn’t work with me, I did what I thought was prudent. I decided to see how long I could live rent free. As of today, it’s been almost 14 months.

Assuming that the house sells next week and I get an order to vacate the next, I’ll be here through the end of January (it takes a minimum of 60 days to affect an eviction here). More likely, I won’t get the order to vacate until the bank sells my house as part of a package foreclosure deal for about 20 cents on the dollar. I might get to live here rent-free for a good spell longer. I could have, and probably would have, paid them nearly 50% of the house’s value as a cash settlement 14 months ago if they’d been willing to have a conversation.

The question I have is this: given that the borrower would have been forced to default on his loan in any case, having lost a job and having only limited savings, what things would an honorable person have done differently?

The critical factor in reclaiming urban areas

While doing some poking around to learn more about the disintegration of Detroit, I came across a blog post by Aaron Renn that characterizes Detroit as the new American frontier. At first that sounds exaggerated—after all, lots of American cities are decaying but in none of them do we see even the glimmer of reclamation efforts that take a post-industrial approach. But the writer shrewdly observes that Detroit has one quality that is not to be found in any other large city—namely a feeble, incompetent city government.

This piece also highlights one the absolutely crucial advantage of Detroit. It’s possible to do things there. In Detroit, the incapacity of the government is actually an advantage in many cases. There’s not much chance a strong city government could really turn the place around, but it could stop the grass roots revival in its tracks.

Can you imagine a two-story beehive in Chicago? In many cities where strong city government still functions effectively, citizens are tied down by an array of regulations and permits that are actually enforced in most cases. Much of the South Side of Chicago has Detroit like characteristics, but the techniques of renewal in Detroit won’t work because they are likely against code and would be shut down the minute someone complained. Just as one quick example, my corner ice cream stand dared to put out a few chairs for patrons to sit on while enjoying a frozen treat on a hot day. The city cited them for not having a license. So they took them away and put up a “bring your own chair” sign. The city then cited them for that too. You can’t do anything in Chicago without a Byzantine array of licenses, permits, and inspections.

In central Indianapolis, which is in desperate need of investment, where the city can’t fill the potholes in the street, etc., the minute a few yuppies buy houses in an area and fix them up, they immediately petition for a historic district, a request that has never been refused, ensuring that anyone who ever wants to do anything will be forced to run a costly and grueling gauntlet of variances, permits, hearings, etc. Only the most determined are willing to put up with that.

In most cities, municipal government can’t stop drug dealing and violence, but it can keep people with creative ideas out. Not in Detroit. In Detroit, if you want to do something, you just go do it. Maybe someone will eventually get around to shutting you down, or maybe not. It’s a sort of anarchy in a good way as well as a bad one. Perhaps that overstates the case. You can’t do anything, but it is certainly easier to make things happen there than in most places because of the hand of government weighs less heavily.

What’s more, the fact that government is so weak has provoked some amazing reactions from the people who live there. In Chicago, every day there is some protest at City Hall by a group from some area of the city demanding something. Not in Detroit. The people in Detroit know that they are on their own and if they want something done they have to do it themselves. Nobody from the city is coming to help them.

This is what I thought was Franklin Sanders’s most stunning and encouraging prediction in Heiland—that the growing inability of government to enforce its edicts would lead to large geographical areas where men were free of government interference, probably the key prerequisite to derailing the industrial juggernaut and cleaning up the mess it made.

Please take a moment to look at the original post; it includes some pictures showing how land in Detroit is opening up as the people leave.

Looking for farmland? Try Detroit.

Mark Dowie’s article is creative thinking at its best.

Were I an aspiring farmer in search of fertile land to buy and plow, I would seriously consider moving to Detroit. There is open land, fertile soil, ample water, willing labor, and a desperate demand for decent food. And there is plenty of community will behind the idea of turning the capital of American industry into an agrarian paradise. In fact, of all the cities in the world, Detroit may be best positioned to become the world’s first one hundred percent food self-sufficient city.

The picture he paints of Detroit is bleak. But Dowie deserves high praise for seeking out new ways to deal with the situation as it actually exists, rather than the usual deluded proposals for turning back the clock.

It occurs to me that, assuming that the crisis is an extended (or permanent) one and various urban areas continue to spiral downward, reclaiming the ruins in this way may be something that Christians are called to do in the years ahead, much as the early Christians made such a dramatic impact on Roman society simply by standing by urban dwellers and serving them in times of need—plagues, famine, and so on.

U.S. health care is exorbitantly priced

Ezra Klein encounters a packet of charts that bluntly illustrate a key problem with U.S. health care:

There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care. As Halvorson explained, and academics and consultancies have repeatedly confirmed, if you leave everything else the same — the volume of procedures, the days we spend in the hospital, the number of surgeries we need — but plug in the prices Canadians pay, our health-care spending falls by about 50 percent.

Here are three of the charts; you’ll find the rest in this PDF file.