text:
Slaughterhouse - Not Tonight Lyrics
Slaughterhouse Lyrics
Not Tonight Lyrics
[Intro: Royce]
Ladies and gentlemen (HEYYYY! HOOOO!)
Slaughterhouse (HEYYYY!)
[Chorus: Royce Da 5'9"]
Slaughterhouse in the place to be, see
And we got what it takes to rock the mic
We gon' take it back to when niggaz was rockin right
We gon' take it back, f*ck with me? Not tonight
(HEYYYY!) Not tonight
(HOOOO!) Not tonight
(HEYYYY!) Not tonight
We gon' take it back to when niggaz was ah, ah, ah
[Royce Da 5'9":]
Nickel, uhh
Round of applause for the dope boys
Here's to the phenomenal quote boys
Y'all don't understand this a phenomenal brand
The smack goin down like cube diamond on hand
Haha, if that rapper alive
He probably happy just to slap me a five
Homie the game ain't dead, it's just a couple key athletes died
It's why I'm rappin like I have to revive (Slaughterhouse!)
The mix of Magic and M.J. passion
Get in the way it's gon' be tragic as M.J. passin
With ears like D-R, the CPR
The game'll never breathe it's last breath because we are
[Crooked I:]
The house gang, rap's holy alliance
Why you so scurred? I'm only a giant
I do it late night, call me Conan O'Brien
And the nose on my gun look like Pinocchio lyin
Last king to Scotland sippin good liquor
If you're Meagan Good, I'm Forest Would-Dick-'er
Oscar winner, Oscar wiener
If you're flow's Aquafina, I'm Katrina
Uh, y'all say that your pockets are big
I'd rather say that I'm 'Pac mixed with Big
You're lookin at a microphone rocker on vodka
That's why I be walkin awkward, ya DIG?
[Joe Budden:]
(Joey!) Look, forever had to warm him
Take him to the cleaners, plastic bag on him
I ain't like y'all, I don't like y'all
Put him in lyrical jail with suicide thoughts
Kick the chair hang him from his mic cord
What's the fight for? Never back down
I'm on some bullshit, quick sippin Jack now
Royce on Patrón, Crook got the chron'
Guess what I'm tryna say is leave them boys alone
How you got hope - had nothin to prove
And had nothin to lose and now we got both
Celebration bitches, now we got toast
But with no ratchets, Joell go 'head attack it, uh
[Joell Ortiz:]
Real nigga, rhyme spitter, hoe bagger
Boast swagger, flow dagger, hip-hop toe-tagger
No slacker, I could chill but I'd so rather
Eat a nigga cause he's sweeter than a glass of Goldschläger
Poor rappers, here on y'all won't matter
And I'm out braggin every interview so you mo' matter
I'm the man in the booth
With "A Few Good Men", and "you can't handle the truth" (no!)
And y'all could say I'm nice but I'm not
I'm mean, flow coke with ice in the pot
The fiends gon' go broke, they dyin to cop
My team is so dope you like it or not!
[Outro: Royce]
We out!
Not tonight (HEYYYY!)
Not tonight (HOOOO!)
Not tonight (HEYYYY!)
Not tonight (HEYYYY!)
Not tonight (HOOOO!)
Not tonight (HEYYYY!)
Not tonight, ohh!
Heh heh...
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subset: commoncrawl


text:
The term 'social banking' has been around since the 1950s, and traditionally referred to sustainable investment. Now, however, the term is more likely to mean banking through social media, peer-to-peer (P2P) lending or the development of online financial communities. These types of lending are seen as a democratisation of finance, and are often presented as solutions to problems that the traditional banking system can't or won't address.
Convenience and communication are central to many social banking offerings. Clever use of technology has meant that borrowing, balance checks and international money transfers have become as easy as sending an email; some firms even provide smartphone-based solutions for on-the-go financial management.
Tom Blomfield, CEO of Mondo, hopes this "new type of bank" will give users an alternative to the rigid, one-size-fits-all deals that are sometimes offered by centralised outlets. The appeal of flexible arrangements isn't hard to understand, but comes into sharp relief when marginal users such as the 'unbanked' are taken into consideration.
Many commentators are excited by the possibilities associated with avant-garde banking, but others argue that new systems are vulnerable by nature. While it's true that some social banking firms aren't as strictly regulated as conventional institutions, this isn't a universal law – it simply indicates that you should research any company you're thinking of using thoroughly before taking the plunge. Moreover, If social banking does turn out to be the next big thing, an increase in investment will probably be accompanied by increased regulation.
What does the rise of new banks tell us about society? First and foremost, the surge confirms that consumers are open to change when it comes to controlling their finances. What isn't clear, however, is whether social banks are the change that people want.
If you're interested in forward-thinking financial solutions and want to know more about how money transfer is changing, check out our blogs and we'll make sure that you're ahead of the curve.


text:
WRITERS IN ALTERNATIVE Left media — e.g. Socialist Worker, Labor Notes, Jacobin and Truth Dig — have reported on what the Affordable Care Act (ACA) will mean for health care consumers (the individual family or individual shopfloor) when they sign up for health insurance.
Their reporting is thorough, but limited to how the law looks from the perspective of consumers. From this angle, the ACA appears as yet one more way for monopolies to charge their customers more, with inflated costs and inferior quality.
I hope to offer a more synoptic view of three parts of the healthcare system — healthcare production, healthcare "commerce" and healthcare finance — to situate the Affordable Care Act within the context of recent and potential changes in the industry as a whole.
Looking first at reforms aimed at "providers" — the collective name for hospitals, clinics and independent practices — we can see a longer-term trend of state regulation, standardization and consolidation of the production of U.S. health care.
Providers are developing new forms of metropolitan networks and responsive information technology to coordinate health care delivery in a way that resembles just-in-time, lean production in the manufacturing industries. But these new initiatives — and health production as a whole — will stop dead if the cash flow for the industry isn'#8221;t standardized and consolidated, too.
For this reason, ACA attempts to reform some of the industry'#8221;s largest "payers" (private insurance companies and Medicaid). Like leveling the grade in order to lay down train tracks, the Affordable Care Act grades patients and their contracts in order to smooth out the distribution of health care throughout the just-in-time healthcare system. Even though this is done to avert a potential blockage in the healthcare industry'#8221;s cash flow, it could lead to even larger financial instabilities down the road.
In a puff piece for The New York Times Magazine (November 3, 2013), Adam Davidson (from NPR'#8221;s Planet Money) reports on the capitalist entrepreneurism at the heart of the ACA, with the critical depth of a cotton swab — but for all its blindspots, his piece is looking in the right direction.
One source, Elizabeth Fowler, who helped design the ACA as a cost-saving and competition-increasing policy while working in Senator Max Baucus'#8221; office, says, "Everybody is focused on the coverage angle, but the changes in the law designed to address cost could be a bigger and longer-lasting change." (Davidson neglects to report that Fowler is also, according to Truth Out, "an insurance company executive from Wellpoint … hired by Obama'#8221;s HHS [Department of Health and Human Services] to implement the law and now works for a pharmaceutical giant.")
One such federal initiative is the Patient-Centered Medical Home (PCMH), a cozy euphemism for the large-scale vertical integration of the health care industry. The Agency for Healthcare Research and Quality is pushing it as a method for "transforming how primary care is organized and delivered." The initiative intends that the disparate medical offices through which a patient receives care become "centered" around the patient, requiring the cooperation and collusion of these formerly separate providers on a metropolitan level.
The federal government will even directly fund health care companies if they join together under regulated cartels called Accountable Care Organizations. Many large corporations, moved by the state-backed spirit of cooperation, have been inspired into what Forbes calls a "mergers and acquisitions frenzy" in the wake of ACA'#8221;s passage.
Initiatives like this, often called "coordinated care," aim to redefine the flow of patients through the healthcare delivery system in much the same way that lean, just-in-time production has redefined the flow of commodities through the global supply chain. In Charlie Post and Jane Slaughter'#8221;s words, manufacturers speed up work and cut down inventories by making sure "each phase of the production process is tightly synchronized with the next."
Healthcare CEOs are exhorting each other to apply manufacturers'#8221; lean methods to streamline use of medical equipment and supplies. The lean lessons of the Toyota Production System have been carefully studied by health informatics researchers and the National Institutes of Health, and applied in hospitals around the country.
Like lean production, coordinated care moves the patient through the health care system with much higher efficiencies. Patients may notice this more efficient care, but what appears as coordination or integration from the perspective of capital looks more like a disintegration from the perspective of patients and workers.
Industrial healthcare delivery requires a series of workers who can provide direct care for the patient or regulate the flow of patients through the clinic or hospital. PCMH will multiply this division of labor, creating new steps in the patient flow.
For example, after a doctor tells a Medicaid patient that they need an X-ray, a referral coordinator might be on hand to coordinate between the workers at the Medicaid office and the workers at the radiology department.
Under this multiplied division of labor, the patients may know nothing about this work happening behind the scenes, and the workers themselves may only know their own particular part in the chain. Nobody except the referral coordinator can determine which hospital the patient will be referred to, and the referral coordinator may know little else about the patient'#8221;s care.
This de-skilling of healthcare work — another component of lean production — may happen at every point in the patient flow, from the front desk to the operating room. The just-in-time vertical integration of healthcare requires a disintegration of the patient experience too. As care becomes more coordinated, the workers might move the patient along virtually, their chart and paperwork sent between workers at, say, the clinic, Medicaid office, and hospital. The patient herself also has less of an active role in her own health, and even less understanding of the whole process.
The patient and her virtual health can move independently of each other, the latter spirited away while the former follows in its wake. Along the way, glimpses of the patient'#8221;s health will appear to her through the intermediary and inscrutable products that her chart leaves behind: a Medicaid card, a referral, a diagnosis, a prescription, a drug. If she asks the workers to help decipher these hieroglyphs, the workers might be just as clueless about the process beyond the limited horizon of their position.
This suggests a limit to how lean production can be applied to the healthcare system. If lean healthcare hinges its profit margins on the ability to coordinate patients, what happens when patients want a say in that coordination, or make their own decisions? When patients decide to skip appointments or not to be "compliant," it can threaten the provider'#8221;s bottom line.
Lean production relies upon directing passive goods at the speed of information, while healthcare struggles with patient self-management and "compliance," pulling a lean healthcare system in two, contradictory directions. As I'#8221;ll argue below, the Affordable Care Act attempts to resolve this contradiction in capital'#8221;s favor.
Despite all the above, tangible material benefits do result from a health care industry developed by capital. Even if patients are only presented with their health as a final product, they may still notice that the product is more efficiently produced and of higher quality than they would have received in a less developed system. As an ideal, the patient'#8221;s medical chart would move seamlessly from doctor'#8221;s office to doctor'#8221;s office, and mistakes would decrease.
Healthcare reformers are quick to emphasize that more than just lives will be saved, money and time will be saved too. (Neo)liberal darling Atul Gawande, when receiving an award from the main PCMH-accreditation body, the National Committee for Quality Assurance, compared it and similar NCQA approaches to turning clinics into pit crews. Writing for the New Yorker, he turns a pleasant family trip to the Cheesecake Factory into an epiphany for "large-scale, production-line medicine."
Here we can see the danger of a half-critical, consumer-side approach to the ACA. The liberal demands for an efficient healthcare system and for controlling costs — if they do not include demands for increased worker and patient control over the system — could become the justification for treating patient flow as an assembly line, turning health workers into mechanics, and patients into lug nuts.
Meanwhile, efficiency as a whole may increase, but even a healthcare system that efficiently adapts to its own anarchic, market forces will be less efficient than one where patients and workers are developed to be conscious participants.
In a video explaining the role of NCQA, Gawande said, "We need to be able to have ways that you can see whether your local system is succeeding or failing." Of course, we'#8221;d all like a transparent system, but transparent for whom?
Gawande would limit this need to transparency for technocrats and investors who can correctly allocate resources, even if this transparency leads to further opacity for workers and patients themselves.
Meanwhile those teachers, students and parents fighting for public education will recognize the coded language of "school failure" determined by outside, privatized accreditation bodies. And healthcare workers and patients in the coming fight against "healthcare reform" will have a lot to learn from the students and teachers fighting against "education reform."
To achieve its goals for coordinated care, the healthcare system requires seamless coordination of formerly disconnected information systems. If standardized testing is the bureaucratic linchpin of education reform, the linchpin for healthcare reform will be electronic health records.
AHRQ argues, "Health IT can support the PCMH model by collecting, storing, and managing personal health information, as well as aggregate data that can be used to improve processes and outcomes. Health IT can also support communication, clinical decisionmaking, and patient self-management."
To encourage the expansion of EHR, the Centers for Medicare and Medicaid Services (CMS) introduced Meaningful Use, a method to track the clinical experience. Aside from being a source of frustration to clinical workers when the record system crashes with a packed waiting room, Meaningful Use has far more exploitative effects on healthcare delivery and coordination.
Patient care is reduced to ticking off checklists, helping to replace all healthcare workers with less skilled, less expensive staff. In addition, electric health records provide a full range of surveillance tools for Taylorizing the clinic floor. Post and Slaughter note the role that technology and computerization plays in creating a "lean workplace," replacing expert workers with "expert programs." Add some employer subsidies and incentives for rolling out these programs, and the meaning of Meaningful Use is clear: profit.
To be sure, PCMH and Meaningful Use can be real advancements. We all want to be healthy as quickly and completely as possible, and quality health care would seem to be the best way to achieve that, for as many people as possible. The automation of public health through electric records can be the basis for developing radical advancements in social health. The potential of the coordination and information technology mentioned above would be immense, if it were under the control of patients and workers.
The public health practitioners who are implementing these systems, however, regardless of their personal politics or ideals, are largely employed by private companies most concerned with maximizing profits, or governments most concerned with cutting costs. As long as capital hires the workers, owns their tools and regulates their usage, the public health outcomes will always be secondary to capital accumulation.
In our current system, what "healthy" means is determined by what clinics, hospitals and insurance companies agree is normal for you and your body. This has the potential to undercut, for example, the struggles of feminists and trans activists for control of their own bodies, in favor of distant and technocratic financial considerations. Monthly insurance premiums only promise you the right to live at a certain level of health, and to live in your body in a certain way, on a month-to-month basis. These levels and ways of living are determined by deductibles, not democracy.
PCMH may put patients at the center, if only because those patients bear a peculiarly profitable commodity, health, in their bodies. Writing about similar industrialization processes in the Socialist Register (2010) volume "Morbid Symptoms," Rodney Loeppky explains how the health industry is unique in the sort of basis it hopes to provide for a "new economy" and national wealth:
"Health represents a domain in which the maximization of returns appears limitless. There is neither a ceiling for how healthy societies should be, nor a shortage of medical conditions — real or contrived — that require diagnosis and (preferably prolonged) treatment... The various components of the health industry enjoy the luxury of self-identifying as social actors who are first and foremost in the business of meeting human needs, obscuring the reality of their enormous returns on investment and being able to represent these, when they are noticed, as being of secondary importance. Who, after all, can be against the pursuit of health?"
Often quality health care is seen as the solution to social problems. Unfortunately, the focus on quality healthcare can give a pass to what that healthcare is healing: often the slow violence of overwork or unemployment, or of living in the runoff stream of a capitalist ecological system. An injury to all cannot be solved by bandaids for each. Even the focus on prevention built into the PCMH model will never take the political step of actually preventing the real, economic causes of the majority of the world'#8221;s sickness and injury.
Instead of taking us a political step forward, the Affordable Care Act will take a deeper step into just-in-time healthcare by standardizing and consolidating its cash flow.
For the work that happens in hospitals or clinics to continue, those services need to be bought and paid for. In America'#8221;s multiple-payer system, private insurance companies and the federal Centers for Medicare & Medicaid Services form the multi-chambered heart of the healthcare industry, pumping a steady flow of payments through the entire social organism.
Payers oversee the commercial exchange of cash and claims, paying for the healthcare services and regulating their distribution, functionally analogous to the wholesalers and retailers that handle commerce and distribution of consumer goods.
But sometimes the money flow between the payers'#8221; commercial exchange and the providers'#8221; production gets out of whack. Obstructions to a steady flow can cause a crisis, and sometimes become too big for any one payer to handle. As one example, Adam Davidson parrots Republicans who have blamed the government for its Medicare fee-for-service model. The ACA will attempt to address fee-for-service as one of the market forces that has allowed exchange value to go too far astray from what is socially necessary in the healthcare system.
While designing the ACA, Obama sat down with other payers and healthcare providers to figure out how to handle another of the big obstructions to the industry'#8221;s capital flow: uninsured patients.
From the perspective of a commodified health system, uninsured who can'#8221;t pay for the healthcare they receive are seen as an economic blockage. They'#8221;re talked about as clogs that jam up the ER waiting rooms, even though they result from the same anarchic, market forces that produced those ER departments and fills them with medical emergencies.
They'#8221;re described as unable to get preventive services, which creates problems that "pile up" and become more expensive. What starts as sediment from the healthy capital flow of the health industry calcifies into a foreign mass that needs to be 'ectomied or integrated for the organism to survive. From the perspective of capital flows, the uninsured are kidney stones, blood clots.
ObamaCare will address the issue of uninsured people — but what sort of issue is this, a medical or a social one?
Some show sympathy for the uninsured by describing them as simply unfortunate, like the victims of a rare degenerative disease, when they are in fact the direct result of the capitalist insurance system. They result from socially produced inequalities, not random afflictions. A post-capitalist healthcare system will need to address the latter and their higher medical costs, but until then we should try our best to differentiate the pathologies of our social structure from those of our biology.
The Center for Medicare and Medical Services'#8221; own estimates show that 48% of uninsured adults are healthy and young, and 54% of those individuals say that premium costs are a main reason that they don'#8221;t buy health insurance. (Of those healthy and young uninsured, 9.3% have now been officially identified by federal agencies as "Hipsters," a much-blogged about target for ACA.) In fact, other segments of the uninsured are even more emphatic that the cost of health insurance is what keeps them from enrolling.
Regardless of these facts, CMS provides official marketing resources that suggest the uninsured are simply unwilling to buy insurance, needing either to be convinced or, for those who won'#8221;t listen to reason, penalized come tax time. To make them listen, the ACA has provided federal and state grants to providers and other nonprofits to hire navigators and steer people towards private insurance contracts offered on the Marketplace.website.
Navigators, though they are essentially insurance brokers, don'#8221;t receive a commission; their bosses are compensated for meeting the enrollment quotas in their grant requirements. The navigator'#8221;s role, however, is limited and transitional; at bottom, they are training patients on managing their own user account on the Health Insurance Marketplace, how to buy their own contracts, how to manage their own health information. They are even asked to train mothers to broker insurance to their uninsured adult children.
Lean production often includes workers in the "speeding up of their own jobs, through task forces and teams," write Post and Slaughter. That is definitely true in healthcare, as seen in PCMH and the related ideal of "team-based care." In addition, however, patients are included as part of the team, joining the team and managing their own health.
Ultimately, that'#8221;s how the ACA plans to integrate those stubborn uninsured patients. When insurance companies underwrite a contract, they collect personal information about the uninsured, calculate the risks and then set their costs accordingly. With the Marketplace, the underwriting of health insurance is internalized into a website and calculated according to pre-set costs in real time — if you log on during off-peak hours like one in the morning.
This automated underwriting prevents discrimination through internalized regulations, and standardizes output through different tiers of contracts: Catastrophic, Bronze, Silver, Gold or Platinum. Aside from possibly a navigator who may help the uninsured patient complete and submit their application, no humans intervene between the patient and the insurance company — or in the case of the ACA'#8221;s Medicaid expansion, the government.
By replacing the insurance brokers and public aid office workers — many of whom may be unionized women of color — with websites, the ACA also removes the element of human discretion, cutting out any supplicating power that the applicant may have. Inhospitable Medicaid enrollment websites prevent any sort of Cloward-Piven strategy of demanding public aid office workers to enroll mothers and address their needs. Instead, patients must be their own advocates as they face massive corporations and anonymous government departments, given only the options to apply for or appeal their eligibility. In checkboxes, no one can hear you scream.
What'#8221;s more, by discounting insurance patients who manage their own health, ACA is also encouraging patients to become their own health workers. In essence, patients in wellness programs and facing penalties for tobacco use are being paid to manage their own health. This resolves somewhat the contradiction between a just-in-time healthcare system that must coordinate the mobility of patients as passive containers while subject to the automobility of the autonomous patient — but it resolves the contradiction by internalizing it in the patient.
Making patients look after their own health as a commodity puts them in an alienated relationship to this expensive thing contained within their body. Further disintegrating the patient'#8221;s experience, insurance capital opens up a rift between me-as-health manager and me-as-body, and inserts a contract in the middle of the two. In Limits to Capital, David Harvey describes financial capital as the central nervous system of capitalist society, but what does it mean when financial capital fuses with the central nervous system of my body?
I will then be examining every part of myself that needs care — my teeth, my feet, my mental state — through the eyes of the insurance company, what I think they would deem medically necessary, and what the contract has decided I should pay for that body part. I relate to each part of my body not as a metaphysical relation to myself, but as a financial relation between my bank account and my organs, as a relation between money and commodities, a relation between things and things, reified innards vertically integrated into reified healthcare bureaucracies.
The ACA, together with online wellness programs and Meaningful Use, creates the framework for a lean, just-in-time healthcare bureaucracy — responsive not only to patients'#8221; vitals but also to the sudden crises and fissures that regularly appear between exchange and production. De-skilled office workers, who previously mitigated those fissures and moved the cash flow along, are replaced with patients processing their own paperwork.
It may seem like this grants patients more autonomy over their own health. But the information I provide is placed into computer systems — such as Healthcare.gov and new Medicaid electronic eligibility systems — for centralized decisions, and the health professionals who could once advocate for me are weakened and deprofessionalized. Insurance companies can depend on us self-help patients to mitigate crises and ruptures because our health is entwined with the health of the industry as a whole.
Adam Davidson lauds the ACA as the culmination of fifty years of healthcare policy intended "to make health care mimic other efficient markets." Letting slide the dubious fiction of "efficient" markets, what will be the likely outcome of this financialization of healthcare?
Fifty years ago, government policies also stepped in to make the mortgage market efficient enough for expansion, creating Fannie Mae and Freddie Mac, standardizing, rating and consolidating mortgage contracts, all of which led to the pooling, securitization and over-extension of these contracts.
After 50 years of accelerating credit flow, that market suddenly froze and contorted in a financial crisis. Is it too much of a leap to imagine that the standardized contracts that we'#8221;re buying on the Marketplace today — tranched into "metal" classes like the rating system that buttressed the secondary mortgage market — will be bundled and sold, and then cut and re-bundled and re-sold?
Risk-taking investors may even squeeze every drop of profit out of subprime catastrophic plans, the way investors bought shares of weird derivatives (CDOs and MBS'#8221;s) in the subprime mortgage market. Insurance premiums, like payments on housing debt and other "fictitious" capital, are an income stream that doesn'#8221;t actually grow the GDP or add to the fundamentals of the economy, very easily lending itself to speculation and over-leveraging.
Securitization hasn'#8221;t hit the health insurance industry yet, but there'#8221;s been peer pressure from industries on both the "health" and the "insurance" flanks. On the health care side, providers are securitizing their receivables, bundling claims on money that they get for their services. Finance lawyer and Duke University professor Steven Schwarcz wrote during the housing securitization boom of the 1990s that hospitals are among "the most promising candidates for securitization."
On the insurance side, there has been an uptick in the securitization of life, catastrophe and property-casualty insurance since 2008, prompting handwringing from the mainstream media still unable to understand why the last financial crisis happened.
Even more worrying, the descriptions of legal and economic obstacles to these trends reads like a description of recent health reforms written in reverse.
Schwarcz notes that originators of securities need to be adequately rated before investors will get in on bundling up those "most promising" promises to pay. Other lawyers writing for "Securitization Conduit" in 2000 estimated that "as health care providers consolidate and fully integrate their management information systems (including on-line, real time, accounts receivables systems) and more health care payments are made based on preset and nationally standardized reimbursement rates, more providers are likely to consider securitizing their health care receivables."
Federal laws prevent securitizing Medicare and Medicaid payments to health care providers, or laws like HIPAA (Health Insurance Portability and Accountability Act) aim to prevent the sharing of private health information, but law firms are researching how to accommodate both the letter of the law and the wallet of the investor.
More recently, a Goldman Sachs investment analyst, who views insurance securitization "as an accelerating convergence of finance and insurance," wrote up a wish list so that insurance securitization can "flourish to the extent that the [recently crashed] asset-backed markets have," in particular "increased transparency, better standardization of modeling techniques, and an improved secondary market."
These wishes for increased rating, integration and standardization have been acted on in recent years, perhaps in order to satisfy finance capital'#8221;s prerequisites. With the standardized, bronze-to-platinum contract rating system built into the ACA so closely resembling Freddie and Fannie'#8221;s ratings of home loans, it is easy to imagine the securitization of health insurance contracts, moving from the health production to the commercial exchange part of the industry.
Eventually this capital accumulation could throw exchange and production out of whack once more. What happens when all of a sudden, people realize they can'#8221;t pay their premiums or out-of-pocket costs anymore, and break their contracts? Or what happens to all that capital investment when the Baby Boom generation passes away, and that surge in patient flow peters out?
If financial analysts couldn'#8221;t manage the systemic risk generated by algorithms and computer models anchored in the housing market, a human-made and human-unmade phenomenon, could we expect those models to do any better predicting a market where the underlying fundamentals — the stochastic (probabilistic — ed.) biochemical and epidemiological processes that shape public health — are riddled with innumerable mysteries, unexplainable by human knowledge?
Given that some financial corporations, such as Blackstone Group, have profited from both the ACA mergers and acquisition frenzy and post-crisis land grabs, it is likely that health insurance securitization would be built upon the same base of information technologies and institutions as the last crisis, with equally unforeseen consequences.
Official resources on healthcare reforms mentioned:
"Defining the PCMH." Agency for Healthcare Research and Quality, US Dept of Health and Human Services. http://pcmh.ahrq.gov/page/defining-pcmh.
"Key Questions" related to Accountable Care Organizations. CRICO/Risk Management Foundation of the Harvard Medical Institutions. https://www.rmf.harvard.edu/Clinician-Resources/Article/2012/ACOs-vs-What-We-Know.
"Meaningful Use Regulations." HealthIT.gov. http://www.healthit.gov/policy-researchers-implementers/meaningful-use.
"Explore Research" on the Health Insurance Marketplace, Centers for Medicare and Medicaid Services. http://marketplace.cms.gov/exploreresearch/explore-research.html.
"The Requirement to Buy Coverage Under the Affordable Care Act." Kaiser Family Foundation. http://kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/.
Application for Benefits and Eligibility (ABE). https://abe.illinois.gov/abe/access/ (Medicaid enrollment website).
On lean production and lean healthcare:
"Lean Production: Why Work is Worse Than Ever, and What'#8221;s the Alternative?" Charlie Post and Jane Slaughter, Solidarity. (2000) http://solidarity-us.org/leanproduction.
"Lean Healthcare: Controlling Cost through Better Care" by Frank Lowe, Carlson School of Management, University of MN. (2013) http://www.carlsonschool.umn.edu/medical-industry-leadership-institute/publications/documents/FrankLoweworkingpaper.pdf.
"Inefficiently Delivered Services." The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Institute of Medicine (US) Roundtable on Evidence-Based Medicine. (2010) http://www.ncbi.nlm.nih.gov/books/NBK53938/.
"Healthcare lessons from the auto industry: S.F. General embraces 'Toyota Way.'#8221;" MedCity News. (2013) http://medcitynews.com/2013/10/healthcare-lessons-auto-industry-s-f-general-embraces-toyota-way/.
"Intermountain'#8221;s supply chain boasts efficiency, lower cost." FierceHealthcare. (2013) http://www.fiercehealthcare.com/story/intermountains-supply-chain-center-boasts-efficiency-lower-cost/2013-10-28.
"Health Care'#8221;s 'Dirty Little Secret'#8221;: No One May Be Coordinating Care." Kaiser Health News. (2013) http://www.kaiserhealthnews.org/stories/2013/april/30/coordination-of-care.aspx.
"Dr. Atul Gawande Receives NCQA'#8221;s Health Quality Award." (2013) National Committee for Quality Assurance'#8221;s YouTube page. http://www.youtube.com/watch?v=9_hr15qsTGE.
"Atul Gawande on NCQA." National Committee for Quality Assurance'#8221;s YouTube page. (2013) http://www.youtube.com/watch?v=sa485QOzwnc.
"Big Med." Atul Gawande, New Yorker. (2012) http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande.
Selected articles on the ACA and related insurance reforms from mainstream and left media:
"The President Wants You to Get Rich on Obamacare." Adam Davidson, The New York Times Magazine. (2013) http://www.nytimes.com/2013/11/03/magazine/the-president-wants-you-to-get-rich-on-obamacare.html.
"Obamacare Opens For Business, Shuts Out Labor." Labor Notes. (2013) http://www.labornotes.org/2013/08/obamacare-opens-business-shuts-out-labor.
"Coercive Wellness Programs Create Headaches." Jane Slaughter, Labor Notes. (2013). http://www.labornotes.org/2013/01/coercive-wellness-programs-create-headaches.
"Single-Payer Prescription for What Ails Obamacare." Amy Goodman, Truthdig. (2013). http://www.truthdig.com/report/item/single-payer_prescription_for_what_ails_obamacare_20131009.
"Welcome to new and unimproved health care." Socialist Worker. (2013) http://socialistworker.org/2013/10/10/new-and-unimproved-health-care.
"The sickening cost of health care." Socialist Worker. (2013) http://socialistworker.org/2013/03/18/sickening-cost-of-health-care.
"Obamacare: The Biggest Insurance Scam in History." Truthout. (2013) http://www.truth-out.org/opinion/item/19692-obamacare-the-biggest-insurance-scam-in-history.
"The Backroom Deal That Could'#8221;ve Given Us Single-Payer." Jacobin. (2013) http://jacobinmag.com/2013/12/the-backroom-deal-that-couldve-led-to-single-payer/.
"Medicare/Medicaid Reconsidering Whether to Pay for Sex-Change Surgery." CNSNews.com. (2013) http://cnsnews.com/news/article/medicaremedicaid-reconsidering-whether-pay-sex-change-surgery.
"Tenet To Buy Vanguard Health Amid 'Obamacare'#8221; M&A Frenzy." Forbes. (2013) http://www.forbes.com/sites/thestreet/2013/06/24/tenet-to-buy-vanguard-health-amid-obamacare-ma-frenzy/.
Securitization and health finance:
"The Alchemy of Asset Securitization." Steven L. Schwarcz, Stanford Journal of Law, Business and Finance. (1994) http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=1839&context=faculty_scholarship.
"Wall Street Pursues Profit in Bundles of Life Insurance." New York Times. (2009) http://www.nytimes.com/2009/09/06/business/06insurance.html?pagewanted=all&_r=0.
"Health Care Receivable Securitizations: Structuring Issues and Future Trends." Securitization Conduit. (2000) http://connection.ebscohost.com/c/articles/7559767/health-care-receivable-securitizations-structuring-issues-future-trends.
"Structuring a sound securitization of healthcare receivables." Healthcare Financial Management. (2003) http://www.ncbi.nlm.nih.gov/pubmed/12602313.
"Insurance Securitization: A Ripe Market?" CPCU eJournal. (2012) http://www.cpcusociety.org/sites/dev.aicpcu.org/files/imported/CPCUeJournalNov12Art1_0.pdf.
"It'#8221;s Not a Housing Boom. It'#8221;s a Land Grab." Colorlines. (2013) http://colorlines.com/archives/2013/05/the_dangerous_new_housing_boom.html.
May/June 2014, ATC 170
Every healthcare worker – every patient – should read this!
Greg does a uniquely thorough job of dissecting the "reforms" (PCMHs, ACOs, Meaningful Use, "coordinated care") which supposedly will help quality and cost but are in fact just the healthcare equivalent of neoliberal policies in other "industries."
I see this every day as a healthcare analyst, and the propaganda for these "reforms" is overwhelming, parallel in so many ways to education "reform" p.r.


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15 February 2008
Building a fourth nuclear power reactor at Finland's Olkiluoto site would have a positive effect on the local economy, without causing danger to the public, TVO concluded in its environmental impact assessment.
Teollisuuden Voima Oyj (TVO) submitted the EIA to the Finnish ministry of employment and the economy yesterday. The company already operates two 870 MWe boiling water reactors (BWRs) at the site, and is famously constructing a 1600 MWe pressurized water reactor (PWR) there too.
The EIA submitted by TVO specified only that a new unit would be a PWR or BWR with a power output of 1000 to 1800 MWe. Two separate locations on the Olkiluoto site were analysed for impact.
The main effects of a new large reactor at the site concern the warmer cooling water in the area of sea near the plant, the most substantial being an increased area of unfrozen water and weak ice that would limit fishing during the winter. Plant life in the water would be boosted by the slightly higher temperatures and enjoy a longer growing season.
Routine radioactive emissions from any new plant were assessed to have no harmful effects, while even emissions from a "very serious reactor accident" would have no "significant immediate health impact on even the nearest residents." Similarly, radioactive waste management arrangements were said to be adequate to avoid impacting public health or the environment. Potential employment effects were "substantial" but would come at the cost of increased traffic on certain roads.
A survey of nearby residents showed that those present all year round were more positive to the potential project than those using the area as a holiday home. Permanent residents showed a 55% level of support versus 37% for holiday residents.
TVO is continuing other studies concerning more power capacity for its shareholders, including alternatives to nuclear. The EIA submitted yesterday would have to be attached to an application for a Decision in Principle document, the next firm step on the path to a new nuclear plant under Finnish law. TVO said it has not yet chosen to apply for that.
WNN is a public information service of World Nuclear Association


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Rainbow Trout
Members of the salmon family, Rainbow Trout, Oncorhynchus mykiss, are an anadromous species, migrating up-river to spawn. They are native to cool, fresh water, thriving in habitats that do not exceed 70F. Their preference in habitat makes them indicative of clean, clear waters. Rainbow Trout are one of the most popular sporting fish and as a result, are commonly bred and introduced into non-native regions. Alternate names, associated with this species, include Redband Trout, Coastal Rainbow and Steelheads.
With an average lifespan in the wild of 4 to 6 years, Rainbow Trout may grow to an adult size of 20" to 30" and reach an average weight of 2 to 8 lbs. However, some Rainbow Trout have been known to grow as large as 48" and weigh up to 30 lbs. in freshwater and 40 lbs. or greater in saltwater1. The body of the Rainbow Trout, like the common Salmon, is torpedo shaped, featuring a squared, forked tail with 10 to 12 anal rays, and an adipose fin. Differences in geographic habitation can result in variations in coloration and increased concentrations in anal rays. Other physical variations may be brought on by season, such as the hooked jaw, or kype, seen on male fish during the spawning season2.
Coloration is determined by geography, age and reproductive activity. Typically, Rainbow Trout display a predominantly blue-green or yellow-green coloring, providing camouflage against river and lakebeds. However, Rainbow Trout may turn silver while they spend time in salt water. Distinguishing features include red/pink markings running lengthwise on the sides, a silvery-white underside, white mouth and gums, and black speckling across the fins and back.
Rainbow Trout are native to North America, found in waters west of the Rockies, spanning north to Alaska and south to Mexico. Geographic populations are commonly identified by distinct names. The term Redband typically refers to Rainbow Trout living east of the Cascade Mountains in the U.S. and in the Upper Fraser River of British Columbia. Steelheads are Rainbow Trout that migrate to the Pacific as juveniles, spending time in saltwater before returning to freshwater to spawn3.
Due to their popularity as a sport fish and their ability to thrive in hatcheries, the Rainbow trout has been introduced to streams, rivers and lakes one every continent except for Antarctica, gaining this species distinction as invasive in certain locations. In the United States, there are introduced populations in 47 states, extending from the Great Lakes region, to south central Canada to the Great Plains east of the Rockies, and southwestern Mexico4.
Rainbow Trout live in fresh, cool waters and require a temperature not exceeding 70 for survival. These freshwater bodies include headwaters, creeks, rivers, lakes, estuaries, and oceans. Preferred habitats are complex, including features that provide protection, feeding opportunities and habitat stabilization for the trout. This diverse ecosystem is comprised of submerged boulders and wood, overhanging vegetation, root masses, and beds of aquatic plants and clean gravel, interspersed between turbulent runs, slow-flowing pools, and deep water. Because trout are solitary in nature, these features also create barriers between habitats, allowing Rainbow Trout to establish territories within close proximity of other populations.
Adult Steelheads ('sea-run rainbow trout,') have been known to follow fresh water routes to the Pacific, spending up to several years in an oceanic habitat before returning to fresh water to spawn.
A large percentage of native Rainbow Trout habitats have been compromised or lost due to many factors, including soil erosion, loss of riparian vegetation (that found growing along banks,) logging, mining, pollution due to agricultural and municipal development, and dam and road construction. In addition to loss of habitats, these factors also damage migratory routes, hindering upstream migration during the spawning season. These factors have lead to a reduction of native Rainbow Trout populations, forcing nine populations of Steelheads to the federal endangered species list.
Rainbow trout are opportunistic and migratory feeders5. Their carnivorous diets consist of aquatic and terrestrial items, including Insects, crustaceans, small fish, plankton, leeches, mollusks, and fish eggs. When food supplies are limited, Rainbow Trout have been known to travel long distances in search of new sources.
Rainbow Trout typically spawn in the spring and early summer, seeking out stream riffles downstream from pools, lake inlet or outlet streams or main river channels and tributaries. During the spawning season Steelhead trout have been known to migrate from the ocean to the freshwater where they hatched, identifying them as an anadromous or migratory species. Female Rainbow Trout seek out moving water over clean, sediment-free gravel, ranging from ½" to 3" in diameter, to build their nests. The female will use her tail to dig a shallow pit, called a redd, depositing a portion of her eggs to be fertilized by a male. After the first nest has been fertilized and covered with gravel, the female will dig another redd upstream, varying the water depth and velocity of the location to increase the survival rate of the eggs. After fertilization, the eggs require consistent temperatures of around 55F and continuous oxygenation through the clean gravel and hatch within 21 days6. Young trout will remain in the gravel from which they hatched until yolk reserves are depleted, emerging to search for new food sources7.
Rainbow Trout that have been introduced to non-native environments have a diminished rate of reproduction due to improper temperatures, and spawning environments. Because of this, states, including Ohio and Texas, must continually restock trout in their freshwaters to provide fisherman with this species. The Ohio Division of Wildlife introduces young trout into Lake Erie tributaries, where they will live for 1 to 2 years before migrating to the lake. The adult trout will live in the lake for up to several years, if allusive to fisherman, before returning to the tributaries and heading upstream to attempt to spawn8.
Rainbow Trout Fishing: The Rainbow Trout's history with fisherman has made it one of "the top five sport fishes in North America, and it is considered by many to be the most important game fish west of the Rocky Mountains" 9.
"To catch a rainbow trout, an angler needs to be aware of the fish's behavior in different water conditions. In streams, rainbow trout tend to select areas with gravel or rocky bottom that have cover such as boulders, logs or deep water nearby. In ponds and lakes, rainbow trout tend to swim around looking for food, especially near cover such as a weed line.
A variety if techniques can be used to catch rainbow trout: bait, artificials and fly fishing. When bait fishing, size 6-10 baitholder hooks and 4-8 lb. test line are best to use to suspend the bait in the water or split shot can be used to keep the bait on the bottom. Baits commonly used are worms, minnows, corn, crickets, salmon eggs or commercially produced baits such as Berkley Power Bait.
Fishing with artificials is a technique that uses a non-food item to imitate a food item. Spinner and spoons 1/32-1/8 oz. are commonly used for trout. They are made of metal and imitate a baitfish. Artificials can either be cast out and retrieved or trolled. A piece of bait can be added to an artificial to enhance its attractiveness" 10.
Notes of Interest:
Symbol of: Washington State
The largest rainbow trout on record weighed 57 lbs (25.8 kg) and was estimated to be 11 years old11.
1. http://www.tpwd.state.tx.us/huntwild/wild/species/rbt/
2. www.dnr.state.oh.us/LinkClick.aspx?link=6733&tabid=6518
3. http://www.fws.gov/northeast/wssnfh/pdfs/RAINBOW1.pdf
4. http://www.tpwd.state.tx.us/huntwild/wild/species/rbt/
5. http://www.fws.gov/northeast/wssnfh/pdfs/RAINBOW1.pdf
6. http://www.tpwd.state.tx.us/huntwild/wild/species/rbt/
7. www.dnr.state.oh.us/LinkClick.aspx?link=6733&tabid=6518
8. www.dnr.state.oh.us/LinkClick.aspx?link=6733&tabid=6518
9. http://www.fws.gov/northeast/wssnfh/pdfs/RAINBOW1.pdf
10. http://www.dec.ny.gov/docs/regions_pdf/rainbowtrout3.pdf
11. http://animals.nationalgeographic.com/animals/fish/rainbow-trout/
"Rainbow Trout." National Geographic. National Geographic Society, 1996-2013. Web. 26 Feb. 2013.
"Rainbow Trout (Oncorhynchus mykiss)." U.S. Fish and Wildlife Service. Version 13. United States Department of Agrictulture: Natural Resources Conservation Service, May 2000. Web. 26 Feb. 2013.
"Rainbow Trout." ODNR Division of Wildlife. Ohio Department of Natural Resources. Web. 26 Feb. 2013.
"Rainbow Trout (Oncorhynchus mykiss)." Texas Parks and Wildlife. Texas Parks and Wildlife Department. Web. 26 Feb. 2013.
"Fishing for Rainbow Trout." New York Department of Environmental Conservation. Web. 26 Feb 2013.
Current distribution of Rainbow Trout, including native habitats and domesticate populations. Photo Courtesy of http://www.fws.gov/northeast/wssnfh/pdfs/RAINBOW1.pdf
Back to wildlife – fish page


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As I went to bed last night I wondered about the colour of the shooter's skin, and what that would mean for how we labeled his actions and what we did about them. If he was brown, we'd call him a terrorist and use him as an excuse to punish other brown people. If he was white, we'd do nothing. Since the former creates additional harm and neither is of any use, I idly hoped he was white. I never wondered if he was a man, though. I already knew he was a man.
The gender of a mass shooter isn't one of those facts we wait for in the aftermath, it's a fact that we mostly choose to ignore. In the post analysis, gun control is not the elephant in the room, because a metaphorical elephant is a big, obvious thing you don't acknowledge. Even people who don't want to make it about guns are saying "don't talk about guns."
Humans are great at seeing patterns, whether they exist or not. Loud, vocal groups of people see patterns of muslim crime, of gun crime, of looking-the-other-way when the perpetrator of gun crime is white. The most obvious pattern of all, that almost all mass murderers are male, doesn't get nearly as much airtime.
Which is not to say there aren't people drawing attention to it. Women are drawing attention to it. Women are very aware of male violence, and the reality of how deadly it can be. But those aren't the voices that get amplified. Those who control the narrative — primarily media outlets and politicians — don't talk about the gender of these murderers nearly as much as we talk about guns, or even as much as we talk about not wanting to talk about guns.
Because, what are you going to do? You can (and, to be clear, should, obviously) regulate a gun. Make the gun harder to get. Control who has access to the gun. How do you control and regulate male violence? How do you begin to address such a massive cultural problem? How do you even acknowledge it without challenging the entire male-dominated, male-centered, male-run world of government, religion, sports, entertainment, and business? Gun control, an apparent political impossibility in the United States, seems easy by comparison.
Mass shootings are male violence at scale. Gun violence is a wholly owned subsidiary of male violence. It can only exist and inflict its horror because of male violence. And it is nourished and protected by good, non-violent men, who don't talk about it. Who don't even consider talking about it. Who don't even question why they instinctively knew the shooter was a fellow man.


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Good day!! This month I'm using a set of papers from Michele R Designs called Vintage Peach. Aren't they pretty? And I have to tell you, taking a picture of this size of a card was a little challenging. LOL! My photo box isn't oblong so I hope you get the just of it. :)
I've used a cute little butterfly die and made 2 die cuts topping it off with a Tim Holtz nib. Love using this little embellishment and I'm sure you've seen me using them before. One of my fav's!
This super sweet butterfly is a Scrapiniec piece available at Noor! Design UK.
Love those too!
Thanks so much for stopping by and for leaving me your sweet comments. It means a lot to me that you take the time to say a few words. I always reply if your comment has an email address attached to it.
Have yourself a great week!


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Defining teenagers
A Teenager is...A person who can't remember to walk the dog but never forgets a phone number.
A weight watcher who goes on a diet by giving up candy bars before breakfast.
A youngster who receives his/her allowance on Monday, spends it on Tuesday, and borrows from his/her best friend on Wednesday.
Someone who can hear a song by Madonna played three blocks away but not his mother calling from the next room.
A whiz who can operate the latest computer without a lesson but can't make a bed.
A student who will spend 12 minutes studying for her history exam and 12 hours for her driver's license.
A youngster who is well informed about anything he doesn't have to study.
An enthusiast who has the energy to ride a bike for miles, but is usually too tired to dry the dishes.
A connoisseur of two kinds of fine music: Loud and Very Loud.
A young woman who loves the cat and tolerates her brother.
A person who is always late for dinner but always on time for a rock concert.
A romantic who never falls in love more than once a week.
A budding beauty who never smiles until her braces come off.
A boy who can sleep until noon on any Saturday when he suspects the lawn needs mowing.
An original thinker who is positive that her mother was never a teenager.


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2300 years ago emperor Ashoka's son, a Buddhist monk by the name of Mahinda, was sent to Sri Lanka to propagate the Buddha's message to the people of Sri Lanka. He met the king, who happened to be on a hunting expedition in a forest and was invited to the capital of the country, Anuradhapura.
In the royal park Mahamegha (lit. "great rain shower") the first Buddhist monk in Sri Lanka thought for a moment what discourse of the Buddha would benefit his audience best and then decided to recite (from memory) the Cula-hatthipadopama Sutta (which you can read here). Yes, that was it.
Within a very short time, the island of Sri Lanka adopted the original teachings of the Buddha by listening to the discourses which the monks had handed down (at that time) for a mere 250 years. With the embrace of the Dhamma an astonishing cultural blossoming ensued. Large monasteries where build, giant stupas constructed, people gave up hunting and became mostly farmers and merchants. Cave monasteries where constructed even in the most hidden jungles and corners of the island. Eventually, when Northern India lost the sources of early Buddhism through historic calamities it was Sri Lanka that became a heritage (or time capsule) for Asian Buddhists who would travel from as far as China in search of the original teachings of the Buddha.
Fast forward to the 1990's 😉
When I went to Sri Lanka in 1994 for the first time, I had no expectations as to the country except for one: it would be a great place to find printed editions of the Buddha's discourses in Pali (remember these where pre-Internet times ;-). Somehow I was under the impression it would be very easy in a Buddhist country with such an amazing history to find a set of printed Pali texts. I was in for a big surprise.
In the 1990's when you asked someone where you could buy the "Middle Length Sayings" of the Buddha, you would earn blank stares – not just from lay people, also from monks. Remember, this is similar to going to Italy and asking someone where you could by the New Testament of Lucas and nobody would have any clue what you are talking about.
Many monks then where strongly convinced that meditation would lead to mental illness and should better not be undertaken. The belief that rebirth in a divine world by offering food, money and wealth to monks was the best choice of a declined age was very prevalent.
Even though the last 100 years had seen certain waves of attempts to revive Buddhism in Sri Lanka (which I later learned from the wonderful book "Forest monks of Sri Lanka") what I found in the country was a thin shell of the Buddha's teaching mostly held together by the 2300 year old culture that showed cracks here and there but had stopped to breathe the living wisdom of the Buddha's teachings which it had enshrined, literally, behind thick vitrines but forgotten to utilize.
The Buddha's discourses had become objects of worship carefully kept behind closed bookshelves. The Pali language knowledge amongst monks (with some exceptions of course) was abysmal. The general public had almost no idea what the Buddha taught other than what the "priests" would tell them which very often boiled down to a simple idea that they had missed their chance and had to wait for the occurance of the next Buddha.
The reason why the country had sunk to a level of European pre-reformation days was (amongst many others) in my humble opinion the absolute lack of knowledge about the teachings of the Buddha.
Let me explain. When a monk entered his monastic training in those days, he was supposed to first learn the Pali of the commentaries. It would take him years to master that. At which point he could then start (!) to learn the Pali of the actual discourses of the Buddha which most never ventured into. Secondly, the only modern translation of the discourses of the Buddha which had been done in the 1950's was fabricated by a few scholar monks who sometimes would simply transpose the Pali into an archaic sanskritized Sinhalese which nobody was able to understand. This translation fostered the idea that the Buddha's teachings where simply too difficult for the ordinary person to grasp. It would be, again to use a rough simile, as if a country like the modern United States had only one bible translation available and that would be the King James Bible (or actually something even older). You can imagine how daunting the idea appeared to most Sri Lankans to "read" the teachings of the Buddha. Very soon even this first general attempt to translate the Tipitaka, the so called "Buddha Jayanthi Tripitaka" edition went out of print and dispersed over the island with very few temples or monasteries owning full collections.
It is still amazing that on top of this decline in Buddhist learning several attempts for revival were made by individual monks who tried to re-establish virtue and meditation in the Sangha. This lead to the emergence of the so called "arannya" or forest hermitages which usually where place for meditation and Dhamma study for the few monks (and sometimes lay people) who were looking for the teachings of the Buddha and tried to practice them. They usually were located in remote areas and limited as to their impact on the general public and Buddhist practice.
Then, in 1997, something amazing happened.
The Dhamma started raining again on the island of Sri Lanka. Based on the historic backdrop you might be able to understand that when a young monk one day "accidentally" ran across the word of the Buddha he was mesmerized and surprised to find that since his ordination he had never been taught or heard of the discourses of the Buddha. It sparked a decade long search in which he toured through all the contemporary forest hermitages to learn from the few living masters which the Sri Lankan forest monk tradition had timidly created. It even led him to the Himalaya's ready to learn concentration meditation from the yogi's and practice in the solitude of the mountains. Then one day he realized that all the while the Buddha himself (in form of his teaching) existed right in front of him, an untapped reservoir of wisdom, ready for anyone who would embrace it confidently – well, if you were humble enough to dedicate yourself to it.
He went back to Sri Lanka and decided to let go of his own opinions but rather try an experiment: To completely put into practice the Dhamma according to the Sutta Pitaka itself – in other words, to make the Buddha's discourses his teacher. Without help of the commentaries (which is almost a sacrilege if you know the importance which is attached to commentarial and abhidhamma literature in Theravada countries). Without looking for outside help or even trusting his own opinions – unless verified contextually by other suttas.
As samsara has it, I ran into him coincidentally that very year, when passing through a meditation monastery where he was just one among the many young monks at that time. I used to encourage Sri Lankan monks all the time to pick up reading the sutta's to which in this particular case they responded saying: "ha, you are just like this monk. he tells us the same thing. when you go to his cell, you can see the whole tipitaka nicely stacked up" (remember: which was an amazing thing at that time and meant that he had spent long time hunting down the books all over the country).
I was very keen on meeting this strange and extraordinary Sri Lankan bhikkhu who seemed to have (in my eyes) a Western approach to Buddhism in that he did the most rational thing someone would attempt in Theravada Buddhism: study the Buddha's own words – which for (all the reasons listed above) seemed to escape most of my Sri Lankan friends and thus made him very peculiar. After a short conversation and some great advice (which would alter the trajectory of my life) I left him and forgot about this episode for a long time. The name of this young monk was: Ven. Kiribathgoda Gnanananda.
Fast forward to 2010. Sri Lanka in the Age of Reformation.
You can imagine my surprise when ten years later a reform movement hit Sri Lanka which in its size, reach and quality does not seem to have an equal. Maybe it was the long span of darkness which makes its light shine so bright. Either way, what is astonishing is the impact it has had so far on society as a whole. All of a sudden young men and women (very often with a Universitybackground) give up families and possessions and ordain. Tens of thousands of lay people gather around stupas to sit for hours in the sun listening to the word of the Buddha – and mind you – not the artistic creative preaching of a modern interpreter of the Buddha's message – quite the opposite – they will listen to an almost unchanged contemplative reading of a particular sutta.
This reform movement (even though it does not consider itself a movement nor a reform, but from a Western standpoint that is how it appears to me) inspired by this young monk started very humbly. In 1997 they began with a small monastery with a couple of lay people coming to the Dhamma talks offered. However something was fundamentally different from the very beginning.
In an attempt to follow the Buddha's footsteps as close as possible the monks of this group do not present their own opinions about the Dhamma. You can see them sit with usually with an open book of some discourse of the Buddha and slowly and painstakingly careful will they take the audience through a sutta of the Buddha making sure that everyone remembers and reflects over this teaching even long after they have left the monastery. In fact, the idea of carefully reflecting over the Buddha's teaching becomes a corner stone of their method.
Not adding their own opinion but just contemplatively slow absorbing and (memorizing) the meaning and advice of the Buddha as he gave it 2500 years ago became the "brand" of this group which following in the footsteps of Mahinda who brought the Dhamma to Sri Lanka created the inspiration for the name this group is now known as in Sri Lanka: "Mahamegha" (or Maha-meo-nawa in Sinhala, which means 'rain shower' in English and was the name of the location of the first sermon of Dhamma in Sri Lanka).
Their symbol, adopted from the time of emperor Ashoka becomes the ancient Dhammawheel protected by two lions. Their admission standards (to become a monk or nun) are very high for a Theravada country – young lay men and women spend up to a year and longer in preparation before allowed to enter the order. Their emphasis on purity in conduct and virtue is exemplary, the training programs for young monks is the study and memorization of the Sutta Pitaka. Their meditation practice includes every meditation advice given by the Buddha in his discourses (from Metta, Buddhanussati, Anapanasati to Satipatthana and Aniccanupassana).
Within a short time their popularity exploded and everyone in Sri Lanka is rubbing their eyes how something like this is possible so suddenly. Ven. Gnanananda, the driving motor behind the popularization of quite ancient and original form of Buddhism in Sri Lanka published a modern translation of the Suttas in a contemporary very easy to understand Sinhala which of course helped to make Mahamevnawa even more popular. At this point in time (2012) Mahamevnawa (or Pali: Mahamegha) has reached vast portions of Sri Lanka's society. For the first time in centuries the word of the Buddha is freely available again and handed back to anybody who is interested to "see the Dhamma for himself".
Some particular characteristics of Mahamevnawa:
.) Teaching style: Similarly to the practice of the early Buddhist Sangha. Mahamevnawa's teaching style is very unique. The monks will read from the Suttas, helping to explain the Sutta by quoting from other relevant passages in the discourses of the Buddha, keeping their own commentary to an absolute minimum. Suttas are picked depending on occasion and level of training of the audience. The Suttas are read in Sinhala or English (in the native language of the audience) to facilitate true undestanding of the meaning with occasional reference to Pali when deemed helpful. Usually Dhamma "talks" like this are alternated with sitting meditations. Attention and memorization of the discourses his highly encouraged. Mahamevnawa's Dhamma talks will feature many questions to the audience by the monk which in most cases make sure that the audience follows and in fact makes an effort to memorize the key points of the Sutta in discussion. At the end of such Dhamma talks "Q&A" sessions are quite common.
.) Practice: Mahamevnawa has an extensive program for lay people which includes reading some preliminary books before everyone is encouraged to do their own Dhamma study by frequently reading suttas (according to some kind of recommendation) and contemplating the word of the Buddha. Precepts are emphasized frequently and strongly as well as is saddha, or confidence in the Buddha as teacher and the Dhamma as the raft. Mahamevnawa will point to suttas which make clear that even progress on the path is caused and conditioned. There seems to be the understanding that the Dhamma should work quite naturally: If you lay the right foundation progress is not just to be expected, positive changes and rewards of the Dhamma practice are inevitable and "quite natural". But there is no rush or "hunt for experiences" on the other hand, rather an emphasis on building a proper foundation, step by step.
.) Ceremonies. In the early days of Mahamevnawa rituals where kept to a bare minimum (This was criticized in Sri Lanka). As the popularity of the movement has reached vast parts of society some symbolic offerings have been included in their practice. (This is now criticized in Sri Lanka) 😉 The ceremonies they organize however, are always combined by recitation of discourses and verses in Sinhala/English to encourage mental qualities like confidence and inspiration which are deemed helpful for the practice of the Dhamma (in other words they are not seens as an end in and by themselves) and are usually of a style reminiscent of the Sutta Pitaka's Apadana. Just to give you another example of their philosophy: When careful analysis of the Sanchi stupa (one of the few remaining stupas in India from the time of Ashoka) revealed that the early Buddhist community worshiped the last seven Buddha's as their spiritual teachers, Mahamevnawa introduced "Sat Budu Vandanawa" or a commemoration ceremony along the lines of what we can see in Sanchi on this ancient stupa as part of their yearly programs offered in their centers. During such an event the qualities of the seven last Buddhas (which are mentioned in the suttas) are turned into a contemplative reflection in Sinhalese – so that the audience can reflect over the qualities of the Awakened Ones. This follows their credo to "model our practice closely in accordance with the early Buddhist Sangha". From a Western stand point all ceremonies will probably always seem more extravagant as we are used to (well, besides maybe Tibetan practices) but it would be misleading to judge the entire philosophy of Mahamevnawa based on this.
.) Meditation in general: They seem to be the only contemporary school of Buddhism (besides a similar small group in Germany) to my knowledge which practices meditation "directly from the book". Meaning that many of their meditations start out as contemplations (which you are encouraged to learn by heart). The contemplation is considered to be the vitakka/vicara part which will lead into jhana. Especially for lay people they are very strong on guided meditations to encourage people to meditate. Mahamevnawa monks, nuns and lay people don't just practice all kinds of meditations (whatever you come across in the suttas you can be sure a Mahamevnawa monk or nun will have experience with), they also will practice them exactly as found in the suttas while gracefully ignoring the commentarial tradition. In fact Ven. Nyanavira would be delighted to see their clipped list of books in the Sutta Pitaka which they actually pay most attention to.
.) Jhana. Exactly as in the suttas. Lay people and monks are encouraged to develop them – but not as a purpose of and in itself. They are seen as a natural outcome of all the other steps which the Buddha encourages people to practice. They are also seen as the method by which the vipassana contemplation will dramatically deepen.
.)Vipassana. Exactly as in the suttas. Here is a little story which will give you a good idea of Mahamevnawa's philosophy on this topic: One day a monk came to Ven. Gnanananda and asked him for advice for his vipassana or insight meditation. He asked whether Ven. Gnanananda had some kind of special technique or system which he could recommend (similar to the Burmese Vipassana). Ven. Gnanananda agreed very positively, took the visiting monk with him to his hut and opened the door. In the back of the hut was a copy of the Suttapitaka. He pointed to it and said: "This is my teacher who knows all about Vipassana. Everything you need you can find in there. In particular the Samyutta Nikaya (the grouped discourses) has a lot of great advice on insight meditation. All you need is right there." – the monk was disappointed, so the story and left. 😉 It is actually very impressive (though a novel idea if you have been practicing with some kind of Burmese Vipassana which I guess many of you have) that someone would take the Suttas themselves literally as blue print for insight meditation. To understand how this works let me give you an idea: Say you learn the Anatta Lakkhana Sutta by heart (or close to its meaning) and then in your mind repeatedly go over it (in that sutta the Buddha talks about the non-self characteristic of all sense impressions as a tool to attain complete liberation and freedom of the mind). While doing so your mind enters a deeply concentrated state. Now, still investigating according to the direct advice of the Buddha you practice vipassana. Et voila. I think if you boil it down to one idea, it is that "yoniso manasikara" in this sense is understood to mean "careful or radical investigation" rather than "direct attention" (which would be more the commentarial reading anyway).
.) Ordination, monasteries and nuns. At the current moment Mahamegha/Mahamevnawa is still (almost) only a Sri Lankan movement. However there are signs that that is about to change. In Sri Lanka itself they have over 40 branch monasteries and half a dozen more overseas. The overseas monasteries are where the Sri Lankan monks trained in this inspiring culture of "Let's listen to the Buddha himself for a change" meet the Western Buddhist world (or Asian Buddhists if you include Korea and other countries). There are about 600 monks affiliated with Mahamevnawa in Sri Lanka including 4 nun training centers.
.) Retreat opportunities. As is typical for Sri Lankan forest monasteries the Mahamevnawa meditation centers are usually open for the general public to join the monks and nuns in their daily practice. Typically this requires that you will take the 8 to 10 precepts during your stay at their facilities. Food and lodging will be free of charge but of course you are welcome to offer a donation (not to the monastics though! all money matters are handled by the lay organizations which run the financials of the monasteries). Make sure you inquire from the monasteries if you can stop by for a visit and also how long you are intending to stay. References which indicate a little bit about your background will help. During your stay you will receive free meditation advice, be able to regularly listen to Dhamma talks and in general follow their monastic timetable (which means getting up early, cleaning the monastery, doing meditation, helping with meal preparations, a long calm afternoon for meditation and some morning and evening chanting sessions).
What's next? If you happen to live close to one of their meditation monasteries / centers (called "asapuwa") and if you are interested in their approach to Buddhist training I would highly encourage you to join or support their communities.
Even though they are mainly driven by Sri Lankan expats at this point the overseas monks do speak English and are very eager to share the Dhamma with anybody no matter what your cultural, ethnic or religious background may be. One way to become active in their communities is to offer dana to the Sangha and thus always get an opportunity for a personal Dhamma talk with the opportunity to ask questions on meditation etc. If you are willing to help even more there is always the need in "bridging the cultures" to facilitate that the Dhamma reaches those who are eager to learn it.
As the second generation of Sri Lankans overseas blends into their new home cultures so Mahamevnawa, by bringing the fundamental principles of the Dhamma to different cultures, is also in the process of learning how to translate their direct reading of the Buddha's discourses into various cultures other than the Sri Lankan. Any help to further this development can be considered great merit and will help the Dhamma to last a little while longer (You will feel the same way once you had a chance to meet their well trained monks and nuns). Either way, their centers are definitely a great place to meet very refined human beings and find noble friendships along the path to Nibbana. Please leave comments if you have any further questions.
Further reading:
.) Newspaper article interview with Ven. Gnanananda about Buddhism in Sri Lanka
.) Gallery with pictures from some of their (branch) monasteries and here
.) Biography of the Ven. Kiribathgoda Gnanananda
.) Dhamma websites affiliated with Mahamegha/Mahamevnawa:
Ven. Anandajoti Bhikkhu's impressions