Are doctors the problem and can they be the solution?

This week’s New Yorker has another article by doctor and health care policy expert Atul Gawande. In the article he attempts to probe why medical costs in this country are spiraling out of control, singling-out one particular outlier in Texas:

It is spring in McAllen, Texas. The morning sun is warm. The streets are lined with palm trees and pickup trucks. McAllen is in Hidalgo County, which has the lowest household income in the country, but it’s a border town, and a thriving foreign-trade zone has kept the unemployment rate below ten per cent. McAllen calls itself the Square Dance Capital of the World. “Lonesome Dove” was set around here.

McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami–which has much higher labor and living costs–spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns. [Link]

By systematically eliminating all the likely suspects (e.g., it’s the lawyers and their malpractice suits that cause health care costs to soar), Gawande comes to a conclusion that many doctors probably already grudgingly realize through experience. It is doctors (not all, just the ones who increasingly advocate for tests that the patient probably does not need) who are driving up health care costs for everyone:

“McAllen is legal hell,” the cardiologist agreed. Doctors order unnecessary tests just to protect themselves, he said. Everyone thought the lawyers here were worse than elsewhere.

That explanation puzzled me. Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?

“Practically to zero,” the cardiologist admitted.

“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures. [Link]
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Not another girl band!

I read about this “Pakistani girl band” a while ago last December but only got my hands on their album Chup a few months ago. Mutineers, Zeb & Haniya is not a girl band.

Zeb and Haniya are two Pakistani women cousins, Haniya Aslam and Zeb (Zebunissa) Bangash, who make fantastic music. Two weeks ago, they were awarded “Best Live Act” in the MTV Pakistan Music Awards. They are Pashtuns (Pathans) whose families are based in the town of Kohat in the North West Frontier province.


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You’re So Punk

The Taqwacores are back with a brand new chapter…

What struck me about this clip was how 9/11 really defined how the guys built their identity. I know it is a significant marker to building the identity for South Asian American of our generation, but it is surprising to see how different people have used the experience to different paths of empowerment. For some it’s voting or service work and others it’s starting punk bands.

Band members of various Taqwacore bands have started an online blog too – The Taqwacore Webzine doesn’t just talk punk, but they write about their perspective on the Lahore bombing, Cat Stevens, or South Asian poetry. But I guess all that is Taqwacore, isn’t it? Continue reading

Review: Panjabi MC’s “Indian Timing”

When I used to DJ parties here and there in the early and mid-2000s, I always had a quandary: what can you possibly play after “Mundian to Bach Ke”? It was such a floor-filling crowd-pleaser, and there was almost nothing that could come after it that kept up the energy. Granted, there were variations of the same song that lesser producers and remixers had started putting out, but no other Bhangra track quite compared. “Mundian to Bach Ke” was a singularity.

Perhaps it’s been a problem for the person who produced the song himself: how do you follow a monster hit?

After Panjabi MC became briefly huge in 2003, he went a little quiet. There was the re-release in 2004 of an album called “Desi” [from 2002], and then a studio album in 2005 (“Steel Bangle”) that was mostly recycled filler, to satisfy an earlier contract with Moviebox Records (see Sajit’s SM review here).

“Indian Timing,” which was finally released this spring on Itunes after many delays, is finally, nearly all new material, with very little filler. It’s also an actual album, unlike much of what is released by Brit-Asian producers these days (in the era of piracy and digital downloading, there is a greater emphasis on singles). In terms of the sound, PMC stays true to the combination he’s famous for — big hip hop beats with lively Punjabi bhangra vocals.

For people downloading selectively from Itunes, I would suggest starting with “Can’t Stop Us,” “Kee Lagda,” and “Punjabi Soldiers.” All are upbeat Punjabi songs over hip hop beats, with vocals by Manjit Jelhi. Pretty much any of those three would be good to follow “Mundian to Bach Ke” on a dance-floor.

Fans of Bollywood might also like PMC’s electro version of “I am a Disco Dancer,” which is somewhat of an anomaly on the record. Continue reading

We are the Champions

And by “we” I mean nerdy South Asian American kids. One sports writer seems a little bitter that his “home team” lost:
You can’t really resent 13-year old kids in the same way you resent pro athletes, but wow, the little knowing smirk the eventual champion displayed when she clearly knew just about every word she was handed was tough to take. Hey, when you’ve got the goods, might as well flaunt it. [Link]
I have been following the Twitter account of finalist Tussah Heera as well. Sweet kid and it is good to hear the unfiltered perspective from the inside. The Scripps Bee Twitter account also has lots of great pictures and info. Walk to and around the office tall today my fellow South Asian Americans. You’ve ummmmm (cough cough) earned it. And a big ups for all the participants. It was way better than the Cavs-Magic game last night.
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Red flags in North Dakota

I’ve never hitchhiked, but I’ve often wondered what it would be Harman_Singh.jpglike, sticking your thumb out at motorists, hoping one of them stops, hoping it isn’t someone who wants to take you home and introduce you to his woodchipper.

That’s a reference, of course, to the movie Fargo, set partly in North Dakota, not far from the small city of Edgeley in LaMoure County, where 16-year-old Harman Singh was an exchange student until May 16, when he apparently tried to make it on his own. He left goodbye notes and hit the road for about a week, before calling his host mother from Fergus Falls, Minn., about 130 miles away. He’s now in custody and will be sent back to India.

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An update on Sri Lanka

I woke up this morning stunned at the following news:

Sri Lanka last night scored a major propaganda coup when the UN human rights council praised its victory over the Tamil Tigers and refused calls to investigate allegations of war crimes by both sides in the final chapter of a bloody 25-year conflict. In a shock move, which dismayed western nations critical of Sri Lanka’s approach, the island’s diplomats succeeded in lobbying enough of its south Asian allies to pass a resolution describing the conflict as a “domestic matter that doesn’t warrant outside interference”.

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Handicapping the semi-finalists

This is sick. Out of the 41 semifinalists left standing today, 15 of the are Indian Americans. The Kenyans have running. The Cubans, baseball. The Chinese, ping-pong. Indian Americans own spelling.

It was a moment to savor. Of the record 293 participants at 82nd Scripps National Spelling Bee, only 41 moved on to the nationally televised semifinals that start Thursday morning (10 a.m. ET, ESPN)…

Expected to be in that final group are several returning favorites. Fourteen-year-old Keiko Bridwell of Duncan, S.C., back for the fourth time after tying for 17th last year, had no problem with “swivel” and “mahout” (one who keeps or drives elephants) in her oral rounds and breezed into the semifinals.

Is it easier now because she’s a veteran?

“More pressure,” Keiko said. “Everybody wants me to do better.”… [Link]

When ESPN calls you the Spelling Bee favorite it is just like putting an NFL player on the cover of a Madden game. You are probably cursed. Therefore, based on my own intensive scouting I offer up the following thoughts for those people who have bookies in Vegas and want to bet on these young horses. Word of advice: always bet on brown.

The first one I want you to keep an eye on is Vaibhav S. Vavilala from Indiana. Double V as he is known on the circuit is a 4 time competitor. Experience helps, but it can also prove to be a mental block because you can better visualize past failure.

Click for full profile

The next contestant I want you to watch for is Kavya “The Destroyer” Shivashankar. Like Double V above she is a four time veteran. According to her profile the thirteen year old looks forward to becoming a neurosurgeon. The Kavyas we know stop at nothing when the smell of success is in the air.

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Contemporary Art From The Desi Diaspora

Each year since 2004 the Indo-American Arts Council has put on an exhibition of contemporary art called Erasing Borders that focuses on Indian diaspora artists. News of the exhibit is always an introduction to some cool new art that I’ve never seen before. This year’s showing of 29 artists, exhibiting through the end of the year mostly at New York venues is no different.

A couple of the artists featured this year use humor or playfulness to explore issues. Indianapolis-based professor Gautam Rao (mentioned here on SM) for example, calls himself Playful Painter. His submission “Restless Portrait: A Disappearing Painting” is a time-lapse video of one of his paintings set to music, but unlike his Stephen Colbert portrait or soap bottle still life, this one is neverending. Continue reading

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Violence at the Gurdwara: A Reflection

Reading about the violence at a Sikh Gurdwara in Vienna, Austria, last weekend, and now the subsequent, extremely dangerous riots in Punjab, leaves me feeling sad though not particularly surprised.

In Austria, the violence occurred at a Gurdwara founded by members of a sect called Dera Sach Khand, a group I hadn’t heard of before this incident occurred; they are followers of Ravidas, a religious teacher from roughly the same period as official Sikhism’s founder, Guru Nanak. Ravidas was from the Chamar caste, and as I understand it most Ravidasias in Punjab today are from that caste as well. (Wikipedia describes their places of worship as “Gurdeheras” rather than “Gurdwaras,” so perhaps it might be more accurate to say that the violence at the temple in Vienna took place at a Ravidasi Gurdehera, rather than a Sikh Gurdwara.)

It is not clear to me how many followers they have, though I have read estimates that Punjab has a disproportionately high Dalit population (nearly 30%), and it is possible that some of those rioting in places like Jalandhar are not specifically followers of this sect, but rather Dalits who are rioting against what they perceive as caste violence. (See pictures at the BBC)

There is also a second, properly orthodox Sikh Gurdwara in Vienna, which has been described as being controlled by hardliners who support the idea of an independent Sikh homeland (Khalistan).

Details from the news reports have been sketchy. I do not know in very much detail how the hostility between these two groups reached this level, though I can imagine a narrative that led to these events, based on what I’ve seen here in the U.S. Continue reading