I'm not going to leave off with that one!
Light posting this month has been mostly due to the year-end silly season at work, all kinds of stress from that medical scare, and the fact that every single night for the past five weeks has included some kind of children's activity.
I'm not complaining--it's not lost on me that these are the good times, and I'm thrilled to be getting a week off to spend with my family. Merry Christmas, everyone.
It's anecdote time, everyone!
At the end of October, my grandmother proved, despite the growing evidence, the limits of her resilience. She'd shown an impressive constitution for an old lady. In her eighties, a little less than ten years ago, she broke her hip, and within a year, recovered from it. A handful of years after that, she moved from her own house in Florida to be closer to family, opting for a new life in an assisted living facility. It's not the worst arrangement for someone who is used to independence: basically it's an apartment of your own that comes with a red phone to care facilities, a common meal a day, and someone who is paid to notice if you don't show up for it. She'd been increasingly unsteady on her feet however, and five or six months ago, she fell once more, and this time broke her pelvis. At 92 years old, it really fucked her up, not just laying her flat, but taking an exceptional mental toll as well. Confusion and depression isn't something you want to see in someone in that state. I got sad emails from my mom and my aunt, fearing it was the end, but she dug in and started pulling around from this injury too. She moved in with her daughter, and when I saw her in August, she was confined to a wheelchair, showing her age, but nearly herself, despite everything. Unfortunately, a bacterial infection took root at some point in her stomach and progressed unknown on the inside for a while, and when she was rushed to the hospital intravenous antibiotics at least drove out the bugs. Amazingly, she appeared to be recovering from this too, but the 93-year-old body only had so much of a rally left in it.
[The point is that she needed care, but still had a lot of life going on. I don't want to neglect to say how great a person she was, and I miss her a lot. She was a woman who liked pretty much everyone she came across, enjoying the conversation and company, not generally thinking to notice people's flaws and issues. She had friends wherever she went, and it wasn't so much that she was sweet and nice, although she was very nice, but she wasn't about drama. My cousin said at her funeral that she was cool without having the slightest notion that she was cool. She was someone who made decency look effortless.]
Her care was financed mostly by the investments that my grandfather had put together over the years. (I think that he would have been happy to know that these did indeed provide over all that time.) Caring for her pretty much wound down the whole shebang though, including the house the old man had built with his own hands. They don't keep me in the loop with all the details, but I understand it came extremely close to breaking even. The state may have picked up a few bucks right at the end.
On the other side of the family, years before, my father's mother's odd behavior after her husband's death turned out not to be, as 25-year-old Keifus would have preferred to believe, the natural product of solitude and her own quirkiness, but rather the early stages of Alzheimer's, and it slowly worsened over a period of years. She lived by herself, with lots of visits from her children, for as long as she was capable of doing that, and afterwards moved to a nursing home when she was not so capable. I wasn't around all that much at the time (winding up grad school, moving to the DC area), but I still failed to take many of the opportunities to visit that I did have. I feel terrible about this. It may well be one of the three or four clinging regrets that I rave about when it's my turn for my mind to disintegrate. It deserves to be.
She was my family's first encounter with long-term medical finances, and, on top of watching someone's warmth and wit dissolve, I remember that it was pretty damn wrenching to have to work the system. These grandparents were also frugal (a more throwback Yankee sort of frugality), but it didn't take long at all to burn through all their assets, and after that it was years of government assistance to maintain that modest level of care.
[Both of my grandfathers, if you were wondering, were done in by prostate cancer and predeceased their wives. They'd both received hospitalization and some home care. I don't know how it was taken care of financially.]
Here's some final anecdata, what's actually driving the post. There's been a health scare from my wife's side of the family this month too, from someone not so old. Complications from routine surgery led to weeks in the ICU (a close thing, but now recovering, thanks). A completely different set of finances there (veterans and state retirement benefits), but my wife came back with tales from the waiting room of the humiliating dissolution of wealth and dignity that everyone else was dealing with as their loved ones were making the transition to state aid to cover their massive medical burden.
It's not in most of our characters to put our elders on the nearest ice floe at the first signs of impairment. We'd rather, if possible, that they decline with comfort and dignity: because we owe them, because we love them, because we'd like to limit the pain and humiliation for ourselves too when it's our turn. Because they're still human beings dammit. And if that's insufficiently cynical, then remember that the senior care industry only grows, and there's more than adequate economic motivation for the governors to allow it continue to hoover our last dimes.
In Weldon's last post, he had a line that got me. The context was different, but the point the same: A lot of people won’t get help before they’ve lost everything.
Long-term care was part of the Medicare discussion when it was drafted, but that didn't really survive into the ultimate legislation. Medicare is more designed for hospitalization and any coverage for convalescence is meant in the context of recovery from an acute illness or injury, and it only will cover limited care in this regard (a little over 3 months is all, by specialized providers, following at least 3 required days of hospitalization). Non-specialist care in an assisted living center or in a nursing home (I am not what proportion, although this is no doubt depressing too) is provided for the "medically needy" through the Medicaid program, the specific requirements and benefits of which vary by state. We all know about Medicaid for the unwashed poor, and our cracker classes are plenty indignant about that idea of course, but it's a good chance that even your typical pasty boomer, if those that hang on long enough, is going to wind up there, just like their parents did. You typically becomes medically needy by spending all of your liquid assets and all of your income on medical care. It's not a euphemism, it's actually a requirement: you have to spend everything you own before they will give you a nickel. If you were wily enough to see this coming and started giving it away, then (within three years) that's illegal too. In 2004, 56% of nursing home expenditures were provided by Medicaid, a good measure, I suspect, of how long people currently outlive that 100 days, or their fortunes.
The budget alarmists are afraid of escalating trends in medical costs, and for long-term care of the aged, and no doubt they should be. Unfortunately, the policy argument to address this tends to be between people who want to provide some level of care without using the word "Socialism" and without threatening the precious health industry with regulation, and people who flat out don't want to provide it at all. In the CBO report linked above, the prescription that it advocates, or the question it begs, is private long-term care insurance. (I realize this is Bush-era stuff, but (a) it's the damn CBO, and (b) the spectre of entitlement reform hasn't exactly disappeared with the Harvard cowboy.) After presenting its data and offering the correct observation that people are not incentivized to accumulate extra savings when the price of keeping them in pudding and rough-handed orderlies in their waning days corresponds exactly to how much they got, it then concludes that Medicaid benefits should be cut, that whatever few breaks still exist should be quickly removed in order to provide more tough-love incentives to save or buy private insurance. This is good evidence of why you should never mistake establishment-friendly economists for human beings. I mean, what the fuck else is Medicaid going to take away from you? And an automatic impoverishment in the last phase of your life is only one reason to avoid savings, but let's not pretend it's the only one: zippo return on reasonably secure vehicles, a bigger take of your life for homes and educations, and 40 years of increased credit instead of increased wages. Fuck you, the CBO.
But it'd surely be worse if we lost Medicaid, wouldn't it? For the people, yes, but more important than that, we're talking money that people are willing to pay, and that always has a voice. The way I see it, there is a constituency that stands to get rich off of expensive care (medical providers), and one that stands to get rich off of expensive administration of it (medical insurers). A push toward private long-term care insurance may be more expensive and less efficient for the people (assuming it follows other kinds of health care), but it's a win win for the favored sons.
My grandfather was a smart and resourceful guy. He got his P.E. in middle age without any of the usual college attainment and changed his career path. (I'm sincerely impressed with this--I keep some of his old-school slide rules and drafting tools to remind me what a sorry excuse for an engineer I turned out to be by comparison). He managed his savings as shrewdly as anyone who has something to manage, but who is not by any means a player, can. (That's a compliment too, but now intended a little backhandedly--having something to manage is an important part of that equation.) I didn't realize that he had help building it up in the first place with a surprise inheritance from one of his uncles. There are fewer men that are self-made than have improved their forward trajectory, but certainly either one is hard enough. The thing is, those sorts of windfalls don't float around in quite the same way as they used to, not for us little people. Too expensive to get old.
Who makes it out these days without experiencing a steady decline? I personally think it's worth it for general humanist principles that we extend quality of life as best we can, and although it's a shitty answer, Medicaid, savings and long-term care insurance are at least answers. We are priveleged to have some forward social trajectory, but inheritance is not really part of it for the middle classes these days, and we should probably count ourselves lucky that the expense is for now avoided between generations and between spouses, and that there's still a chance of keeping the house. But let's be honest here: the system as constructed is designed to consume a modest estate. This is is what happens to the net worth of the non-rich. I don't like inheritance as the mechanism to keep people less than poor, but forced liquidation on the low end adds to inequality. The next priveleged fucker who starts whining about the estate tax deserves to get hit with a bat.
Berlin: City of Stones and Berlin: City of Smoke are the first two of a series of graphic novels by Jason Lutes, depicting the city at the end of the Weimar republic.
I've started a ramble on graphic novels before, and this is a fine excuse to elaborate. I am not the best ambassador for the form. I don't read a whole lot of them, and my tastes reflect a strong imprinting on silver age styles, that happened between 1978 and 1989 maybe, starting at the point I could ever convince Mom to buy me one off the carousel and ending when I outgrew too many of the dramatic elements and finally got sufficiently disgusted with the constant disregard for Our Story So Far. The art of that era was undoubtedly marketed to teenage boys, and it came with hyperkinetic action, exaggerated perspectives, and a human form (male and female) idealized to the point of eroticism--the artistic equivalent of overacting--but there was some fabulous drawing going on, and anything I've leafed since has been sorry (certainly it hasn't been pale) in the comparison. I realize I'm biased, but I think I was lucky to catch the artistic peak, not just for the highly-detailed lines that the era favored, but I also think digital colorization turned everything to shit.
I read up: in those earlier days, artist hand-colored proofs according to an industry palate, and further indicated shading and tone for the benefit of the printers: the color plates were made up by these specifications. (Previously, I thought that colored proofs were photographed through filtered cameras to generate the plates--maybe this was done too?). Details of shading were no doubt lost, but I think that hand coloring kept the artists close to the detail work, and, I think, gave us a great deal of black-ink shading to compensate for the paucity of available colors. You know, art benefiting from constraints and all. Over the years (and at the time I was reading the things), an expanded palate emerged, and eventually (around the time I stopped), it went digital, producing as unlimited a choice as you can generate with your favorite computerized painting tool. Personally, I think old medium produced much better art than the solid photoshopped fills they use today, now paint-bucketing the careful lines with virulent computer-provided patches of monochrome. I can't look at the things these days--they're garish, and while I like to think that there's good storytelling to be developed in that medium, it's mostly the art that keeps me away.
In the small handful of "serious" graphic novels I've read since I turned 17, and most of the newspaper strips, the drawing itself appears to be less important than the art layout. How do the frames and the objects in them relate to tell the story, move along a conversation, create a kinetic sequence, whereas the drawings themselves are expected to be sylized according to the medium, about only as much as to be identifiable. And the emphasis on well organized frames is important, but I need some minimum drawing ability for my appreciation. I know it's been noted the cartoons too: I remember Bill Watterson complaining in the introduction to one of his Calvin and Hobbes anthologies about the general low quality of drawing in his medium (which he since recanted, I believe), and he had something of a point, and made up for it in some of his strips, which is no small part of why I loved 'em. (Now there was a guy who knew how to quit when he was ahead.) My tattered pile of old MADs sort of spanned the spectrum between raw art and layout.
It's a long segue, but a lot of my reaction to things like Berlin ends up closely related to how I look at them. I spent some time in the above contexts trying to pinpoint Lutes' syle. The drawing is decent, passing the art bar, and including nice scenery shots, and I think is improved by avoiding color in the first place. It's a far cry from the tradition of the gory and lascivious detail you'd get in an old black and white Savage Sword of Conan, and if it did make use of all kinds of city views, the creative layouts are rarely rolled into large complicated images, and the scene changes are more in the lines of storytelling transitions than tricky artistic ones. When he does go there--I'm remembering the way he worked in art-school technique in one series of panes about a lecture, and how in a different series, he brought some full-bacchanal scenery in his glimpses of underground nightlife, and there were a couple intrusive uses of white space--it instantly becomes more interesting. Given the clever vehicle of making one of his characters sketch compulsively, you kind of wish he worked that conceit into his own art more. I will say that I enjoyed the way Lutes moves between a character's dreams and reality as a means to shift the point of view from the dreamer to the dreamed-of, and he does a nice job of employing the comics-equivalent of a roving camera to lead us between plot arcs too, but these aren't things that are contained in the drawing. 
The usual dialogue balloons, thought balloons, and text boxes seem more ingrained to the medium to the point they're unnoticable. Lutes is big on thoughtful dialogue and faces, not really on any of the raw action and cheesey drama of the superhero tradition. He lets the characters' expressions reveal emotions most of the time, but still not in a way that feels very new. There's something familiar about doing it that way: it frequently reminded me of an old Lighter Side strip, where the point is more about writing, that is, more about setting up and delivering a piece of dialogue. The ways Lutes' conversations get spaced-out in a series of panels, the way that situations are introduced with people-free panes, and the use of facial shots with minimal background drawing, it all lends a strange quiet feeling to the book, and when Lutes falls back on comics tropes like punctuation marks over people's heads, big-graphic sound effects, and swirl lines, it feels like he's regressing. The quiet space does seem appropriate to convey the impending political fate that we know is coming for all of these characters.
Berlin did what I wanted it to do, what Sinclair Lewis failed to do, which was to set up a feeling of how it happened there. I'm falling back too much on my history-for-engineers classes here, but as I remember learning it, the usual story of the fall of the republic and the rise of fascism is told as a series of calculated political moves and power grabs by you-know-who, against a backdrop of economic depression. The classroom version sort of leaves out the city as a hub of European culture, the hopeful liberalism of the Weimar Republic, the personal wounds of the Great War, the vibrancy of urban life, and Lutes gets a good chunk of that in his comic, as well as the sense of how it is beginning to untie. Here in America, we also tend to leave out the Communist influence in prewar Germany and the National Socialist's definitional opposition to it. Lutes doesn't give up much love for the actual Reds--they're given to rallies and thuggery too--but he expends a great deal of sympathy toward those characters attracted to the philosophy, and none towards those inclined toward authoritarian Nazism. (Curiously, he has yet to draw a swastika--flags are represented with a big blank space devoid of party emblem.) A great deal of dialogue is devoted to the spectrum of characters' resistance to the growing popular ideas, and to their bonds of class, at a time, in the story so far, when they still feel free to express these things.
Berlin is advertised as a graphic novel with as much texture and depth as a regular novel. I contend that it makes good use of the comic form (with the caveats noted above) to tell the same kind of story, but if this is novel-like, then it's wicked thin. I think I knocked off each of the volumes in about an hour, less time than it's taken me to write about them, and I am not a fast reader. The art is reasonably well-done, but it's not so engaging as to make the eye linger. I think the bigger problem is that we have an ensemble cast in which none of the characters have enough pages under their belt to be especially memorable. This many people in a 150-page prose novel would be just as difficult to develop. It's worse that Marthe Muller, the closest thing we have to a protagonist, is devoid of much defining personality. She's a little introspective, and a little independent-minded, has a ghost or two, but her spontaneity, devotion, and likeability don't really seem to come from anything we can see her say or do. Worse, she's the most generically drawn of all of them (defined with a weariness in her face that marks her as slightly older than the other students, but younger than the workers and newsmen, but that level of detail varies by pane, and sometimes I was reduced to carefully checking noses to make sure I knew who the story was following at the time). The journalist Severing is a little better realized, but a downer, and mostly I wait for his descent into real depression. Marthe's friend and lover, Anna comes off the more sincere, with actual challenges with a modern identity and mixed cues in a straight socity, and the Jewish boy David is given some interesting private life beyond the external story as well. The bigger drama we see is from the folks from the working and poorer classes, but it's also a cheaper sort, more basic stories of violence and sacrifice. A runaway girl, and dead mother, and some unlikely compassion, and finally I'm finding myself engaged.
Berlin takes a look at a transitional place, and recovers the forgotten human and social elements, and I think this is very much its strength. As a comic, it's not deeply innovative, but it uses the medium well in getting this story told. As a novel, it's readable, but I can't bring myself to see it as the great black and white hope, whatever NPR would like us to believe.
[There was cleanup called on Aisle Keifus. This post is still among my most boring, not to mention borderline ignorant, but the more egregious writing errors have been corrected. It's not like this blog is going to hit the big-time, and sometimes I just have to get stuff out.]
Complicated life choices are an unavoidable consequence of living in interesting times. How can I guide the kids toward a positive life experience that doesn't charge the price of defiance (or doesn't insist on charging it), but can still minimize their indenture to the Way Things Are.* How to offer them options for success or happiness that aren't limited to the treadmill, or the rat race? Convince each of them to invest in a hundred fifty thousand dollars worth of college, with no savings to speak of, an unsure direction (as it should be at this point, before they're even in highschool), and no solid expectation of future employment? My feelings about the value of learning, the value of keeping our citizens educated, and my memories of the experience--let's face it, my elitism--are running straight at the wall of rapidly escalating costs. I prefer my kids to go if it fits into their still-hard-to-judge life plan, even if The Man callously demands it from them anyway. I just have no idea how I'm going to pay for it.
Here is a graph of college costs posted recently at the Naked Capitalism blog. 
Since the early 1980s (at least), they have been rising a great deal faster than inflation, faster even than our monstrously inflated home values did. Given what happened there, Yves Smith points out in that post her fears of a bubble. Student debt (as oppposed to mere costs) has jumped up 25%, and meanwhile, a job upon exit is harder to come by than ever. Currently, unemployment rates among 20- to 24-year-olds is up around 15%, and even with the 2005 "improvements" on bankruptcy laws, defaults on student loans are also rising. Meanwhile the lifetime net income gain of a college education is estimated at a couple hundred thousand dollars, which might leave my kids just enough dough to put my grandkids through, assuming no one in this chain plans on ever retiring, or getting sick.
At some point in our lives, we all get the "savings" spiel, how compounded growth is magical and how great it is to get in early. But exponential growth applies to negative rates too, making it so much harder to get out of the hole (especially if you get in early), and differences in those rates tends to open up chasms when they're perpetuated over years. Here is a helpful aricle by the College Board talking about rising student costs. They estimate that the growth rates in college prices from 1977 to 2007 (approximately the same range as in Yves' graph), has been about 4.5% for public schools, 3% for private ones (which remain much more expensive), and about 1.5% for public 2-year colleges ("community colleges") per year over inflation. Factoring in room and board makes the four-year schools (students are assumed to commute to two-year ones) look a little better, knocking about a percentage point off of each of those values. This tells us that tuition alone is bloating faster than the cost of dormitories or apartment rentals, but that the net effect has still been growing faster than everything else has for 35 years.
What about all that sweet, sweet financial aid? I'm glad that the College Board reports this too, and net costs show similar trends. They also break 'em down relative to household income, and here's a result that I didn't expect: according to their data, "upper middle class" folks such as me have seen no change in the percentage of their income they devote to their kids' college costs between 1992 (when my college was getting financed) and 2003 ("now" for the purposes of conversation). Although, I can still salvage a little self-pity. Here in New England, both college costs and incomes are higher than in other parts of the country, so I can look forward to increased net payout, and also life in a lower income group than the national averages suggest.
On the other hand, and as usual, it's far worse for lower income people, who are not only getting pushed into college much more than they used to, but have a bigger burden than they once did. It's not just that a matter of costs growing equally for everyone. The increase on the lower end of costs relative to income is reflective of the fact that these families have become poorer since 1992. The growth rate of income has been much different for the different qunitiles (Why the census likes to bin things up in quintiles, while the college board prefers quartiles is left as an exercise to the reader. Downloadable tabulated data could have given you a better post, but would have wasted more of my time.). Lower income people didn't benefit from a growing economy at all, while rich folks did so disproportionality, and the speed of that separation has accelerated, a grand canyon of inequality. Middle class people (at least outside of New England) have been just barely keeping up with the growing expense of those important things that are not in the CPI, which is perhaps why we don't have a revolution yet.
But anyway, the data tells me, to my surprise, that it shouldn't be any harder for me to put my kids through school than it was for my parents (who pretty much killed themselves to do it), even while great other segments of the population are getting right fucked. Even there, there are a few key omissions in that analysis: