PEOPLE RESPOND TO INCENTIVES

The oldest houses in Amsterdam are generally narrow because, centuries ago, homeowners were taxed according to their width. It was cheaper to build a long, narrow house than a square one with more street frontage. ‘The narrowest house on the Begijnhof,’ reports a traveler named Andrea, ‘was only five feet wide!’

(And speaking of feet, when the Soviets judged shoe factories by the number of shoes they produced, they tended to produce just one size – it was more efficient. And when, in 1988, Massachusetts upped the threshold of medical expenses one had to incur under its ‘no-fault’ auto-insurance law from $500 to $2,000, the average number of chiropractic visits after an accident jumped from 13 to 30.)

Men may be pigs, but people are pigeons: we respond to incentives.

BUBBLE

Georgia Wong: ‘Just got word from a former neighbor that my dark, airless, viewless condo that I sold in 2003 for $327K is now worth $510K. Oy! If I’d stayed another year or so before selling!!! Arggghhhhhhhhhh.’

☞ I know the feeling! Like selling AMZN at 200 only to see it at 400 weeks later! Let’s just hope the real estate market has a softer landing – as I expect it will.

NEIGH

I have become a horse. Strong like bull, yes, but a horse. I say this because I find myself eating mainly apples and carrots. The carrots became a snack of choice when they started whittling them down to baby size and packing them in Ziploc bags. And the apples zoomed up my ingestion chart when I recently discovered bags of ‘Gala’ Michigan apples. I have no clue where they are really from in March (Mexico?) but they are crunchy, cold and juicy and turn out, astonishingly, to be an even better snack than cookies. So I started reflecting on my life and realized, with equine-imity, that all I need is a feed bag. Well, except that I eat a huge amount of salmon, which has my ‘good’ cholesterol at levels not seen since the days of Methuselah, and horses don’t eat salmon. Never mind.

AND SPEAKING OF APPLES

Does a man holding an apple weigh MORE or LESS than he will after eating the apple? The answer will not likely change the world as Isaac Newton’s apple insight did – I do not expect to be knighted for this. But once I started pondering it (as I ate an apple while weighing myself), I decided that the answer to the question is that he weighs MORE before he eats the apple.

Clearly, you could argue that he weighs less. Indeed, that is how a normal person would probably view things: you weigh less before you eat a big meal (or even a small apple) than afterward. But it is the imprecise nature of the question (‘do you mean ‘does the man-and-apple’ weigh less or just the man, not counting the apple he is holding?‘) that leads me to think that, absent the ability to receive clarification, one is called upon to take the question at its most literal: a man holding an apple. Like a man fully clothed weighs more than a man naked – even though the man does not weigh more.

Now, you say, ‘but you fool, it makes no difference whether the apple is in his hand or in his stomach – the man and apple weigh the same whether the apple is inside or out.’ But that’s not strictly true. To begin with, most men do not eat an entire apple. They toss aside the core or at least the stem, thus slightly diminishing its weight. But even a man who eats the entire thing will weigh less after eating it than he did, holding it, shortly before, because each of us loses weight continuously (until we refuel). You always awake weighing less than you did when you went to bed. Perspiration – even when not noticeable, let alone profuse – takes its toll.

I promise not to write about this again.

LIVING WILLS

Mike Mattes: ‘Please tell your readers to get living wills to avoid all this mess and have their wishes followed. They can go to agingwithdignity.org for info and the forms.’

Joel Margolis: ‘Here’s how to reduce the number of Schiavo-type cases in the future: it should be a requirement of enrollment in Medicare that the individual submit a letter from his physician stating that he has a living will and health care proxy on file. Admittedly Ms. Schiavo wasn’t eligible for Medicare but this would reduce the number of such cases among the elderly.’

Michael Rutkaus: ‘Popular conception is that a Living Will is enough, but that is mainly when death is imminent. A Medical Power of Attorney is also needed so you can assign medical decisions to someone else if you are incapacitated but not about to die.’

Eric Batson (MD, PhD): ‘A living will has problems. If you, the patient, are not conscious and able to defend your living will, a conscious and argumentative relative, who might hire a lawyer, will often get lots more attention from the hospital’s “risk management” staff. Lots of organs are not donated because a relative who is alive and talking tells a hospital NOT to harvest organs that the soon-to-be deceased (and no longer communicative) patient clearly offered for use.

‘A better document is a health care power of attorney. It gives the bearer the legal right to make all the health care decisions on your behalf. That person, as a communicative adult, can be just as vocal about threatening legal action and this gets the requisite respect from hospital administrators. This person is also empowered to make these decisions even if the situation is one not considered when the document was drawn up. Furthermore (and this is VERY useful for those in non-marriage relationships of ANY sort), the person with the power of attorney has COMPLETE access to the patient’s medical records and is obviously entitled to visit the patient (how can you make decisions for the patient without seeing him or her?). A random member of the patient’s family cannot just tell the hospital to exclude you.

‘OK, I am not an attorney, nor do I play one on TV, but I *am* a doctor and have spoken with prominent hospital administrators and organ transplant officials about this issue. I know *my* CD-ROM with ‘hundreds of legal documents for home and office needs’ includes a template for health care power of attorney. Make sure everyone in the family has swapped one with someone else. It can prevent these dilemmas from going into protracted litigation.’

☞ Click here for one of those CD-ROMs.

Alan: ‘As a native Floridian, I have to wonder whether, if this issue had came to light in any other state than one ran by a Bush, the federal government would have jumped to attention as it has? I know from personal experience the pain and heartbreak of having to decide to pull the plug. We lost my 17-year-old sister in a car accident many years ago, and luckily the government did not intervene when we had to make the hardest decision of our life. With all the Republican leadership’s devotion to the sanctity of marriage between a man and woman, why would they even choose to get involved in this intimate issue between the wishes of a wife and her obviously devoted husband?’

 

Comments are closed.