No hourly rates though
‘‘The Siesta,’’ by Janet Montecalvo, in the Duxbury Art Association’s “Winter Juried Show,’’ at the Art Complex Museum, Duxbury, Mass., through April 19.
Llewellyn King: A ‘lawless Plutocrat’/autocrat is destroying America’s sense of Mission
World War I poster
“The Fire of Rome’’ (1785), by Hubert Robert. Many have long believed that the great fire, which destroyed much of the empire’s capital, in July 64 A.D., was started by the psychotic Emperor Nero, some of whose traits may remind you of the wanna-be emperor in Washington, D.C.
WEST WARWICK, R.I.
The United States isn’t just a piece of remarkably fertile real estate between two great oceans. It is also a state of mind.
Even when America has done wrong things (think racism) or stupid things (think Prohibition), it has still shone brightly to the world as the citadel of free expression, abundant opportunity, and a place where laws are obeyed.
When I was a teen in a British colony in Africa (now Zimbabwe) long before I imagined I would spend most of my life in America, I met a man who had seen the promised land. He wasn’t a native-born American or even a citizen, but he had lived in “The States.”
I badgered this man with questions about everything, but mostly things derived from books and movies: Could ordinary people really drive Cadillacs? As a British writer later said, were taxis in New York “great yellow projectiles”? Did they really have universities where you could study anything, such as ice-cream manufacturing? Did American policemen actually carry guns?
Our adulation of America was fed by its products. They were everywhere the best. American pickup trucks were the gold standard of light trucks, and American cars — so big — fascinated, although they weren’t ubiquitous like the trucks. Brands such as Frigidaire and General Electric meant reliability, quality and evidence that Americans did things better.
No one thought that the streets in the United States were paved with gold, but they did believe that they were paved with possibility.
There was criticism, like that of the alleged American hold on the price of gold or the fear of nuclear war. The “shining city upon a hill” idea was paramount long before President Ronald Reagan said it.
And it has been so for the world since the end of World War II. For 80 years, the United States has led the world; even when it spread its mistakes, like the Vietnam War, it led.
America was the bulwark of the liberal democracies — a grouping of European nations, Canada, Australia and some of Asia — that shared many values and outlooks. Call it what it is, or was, Western Civilization, based on decency, informed by Christianity, and shaped by tradition and common expectation.
Central to this was America; central with ideas, with wealth, with technological leadership and, above all, with decency. Now, all of this may be in the past.
This structure has been shaken in less than three months of President Trump’s second administration. It is near the breaking point.
This may be the end of days for the Western Alliance, led by America in the ways of democracy and free trade.
Writing in the British monthly magazine Prospect, Andrew Adonis, a peer who sits in the House of Lords as Baron Adonis, states: “Trump doesn’t believe in democracy, just in winning at all costs. He doesn’t believe in an international order based on respect for human rights. He is an authoritarian, lawless plutocrat who admires similar characters at home and abroad.”
Additionally, Adonis says in his article that, unlike the first Trump term, the checks and balances have weakened: “The Republican Party has become a cipher.
The Democrats are shell-shocked and demoralized. The courts, the military and Congress are browbeaten, packed with Trump supporters or otherwise compliant.”
I find it hard to argue with this assessment. Why would Trump persist with a tariff regime that was proven not to work with the Smoot-Hawley Tariff Act of 1930, which helped cause the Great Depression? Why would he rile up Canada by threatening its independence? Why would he reopen, without a good reason, the issue of the control of the Panama Canal?
Why is he destroying the civil service in thought-free ways? Why is he going after the constitutional freedom of the press and the rights enshrined over millennia for lawyers to represent those who need them regardless of politics? Why is he leading us into a recession: the Trump Slump?
Either the president has no coherent plans, or those plans are devious and not to be shared with the people.
I believe that he enjoys power and testing its limits, that he has no knowledge base and so relies on hearsay to formulate policy. In the end, he may be listed along with Roman emperors who ran amok like Nero and Caligula.
The Western Alliance is at stake, and America is giving away its global leadership. When trust is lost, it is gone forever.
On Twitter: @llewellynking2
Llewellyn King is executive producer and host of White House Chronicle, on PBS, and an international energy-sector consultant. He is hased in Rhode Island.
Beats the alternative, for now?
“Being,” c. 1923–26, (oil on canvas), by Agnes Pelton, in the show “Some American Stories,’’ at the Colby College Museum of Art, Waterville, Maine.
The museum says:
“‘Some American Stories’ is a thematic presentation of works from Colby’s collection in the museum’s Lunder Wing that leads visitors on a journey from before the founding of the United States to the present day. Galleries represent a different topic within the broader narrative of American art and history, reflecting a great diversity of experiences’’
Chris Powell: Rent control won’t Build housing; Alleging ‘Meanness’ is not an argument in School-Trans-athletes issue
MANCHESTER, Conn.
Connecticut's cost of living is high, in large part because of housing prices, and nearly everyone says the state needs much more housing, especially ‘‘affordable" housing -- most of which is rental housing. But whether everyone who says that the state needs more housing really believes it is a fair question.
That's because most of the housing legislation proposed in the General Assembly wouldn't increase the supply of housing at all. Most proposals would just scapegoat landlords, though more rental housing requires more landlords. Other proposals would just increase the dependence of renters on government.
State government action that might actually get any “affordable" housing built remains too controversial, even for many Democratic legislators who ordinarily prattle about helping the poor even as many of us argue that Democratic administrations have lately been grinding the poor down with inflation, including high electricity prices, and ineffectual schools.
For example, Democratic legislators want a big increase in state government rent subsidies to tenants, which turn housing into political patronage and take tenants hostage.
Democrats want to forbid landlords from evicting tenants at the end of their leases without ‘‘just cause." End-of-lease evictions undertaken so that landlords can raise rents would be prohibited. This would be rent control, which never got any housing built but only destroyed the private sector's incentive to build rental housing.
Democrats want to forbid landlords from charging more than a month's rent for a security deposit, as if landlords shouldn't have the right to judge how much of a deposit is necessary to protect their property against damage by tenants.
Democrats want to restrict the rent increases that can be charged upon sale of a property -- more rent control.
Democrats want to require even smaller towns to establish “fair rent commissions" -- still more rent control.
Legislation called “Towns Take the Lead" would require towns to set housing construction goals, but there would be no firm enforcement mechanism for achieving them.
Democrats want state government to increase its obstruction of federal immigration-law enforcement and provide more medical-insurance coverage to illegal immigrants, thus incentivizing more illegal immigration, even as state government has never made any provision for housing Connecticut's estimated more than 100,000 immigration-law violators.
The most helpful of the Democratic housing proposals may be the one that would formally authorize homeless people to live, eat and sleep on public land.
Connecticut has many destitute, addicted and mentally ill people, and some of them panhandle and live largely out of sight in the woods or underbrush, but so far the state lacks anything like the sidewalk tenting camps of Los Angeles and Portland, Ore. Maybe that kind of visibility for the destitute and disturbed is necessary to get Connecticut thinking seriously about its housing policy, social disintegration and declining living standards.
The only sure way to get a substantial amount of new housing in Connecticut is for state government to commission it directly and let landlords charge market-rate rents.
Connecticut's cities, with their populations impoverished by state welfare and education policies and their governments surviving mainly on state financial aid, are already wards of the state. They also have large tracts of decrepit industrial and residential property already served by water, sewer, gas and power lines and public transportation -- property that practically begs for redevelopment, especially mixed-use redevelopment, with commerce at street level and residences upstairs, redevelopment that doesn't worsen suburban sprawl.
A state redevelopment authority could be authorized to purchase or condemn such properties and provide them to developers, specifying their development format and completion schedules, while leaving rents to the market so the new properties won't become more government-engineered slums. Cities might resent their loss of control to the state redevelopment authority but then few cities are operated well enough to deserve control of state housing policy any more than suburbs deserve to control it with their exclusive zoning.
Any new middle-class housing will help bring down the cost of all housing nearby, and the cost of living generally. If Connecticut's decentralized political system can't get housing built, state government will have to do it.
‘Mean’ Is No Argument
According to the leader of the Democratic majority in the Connecticut Senate, Norwalk’s Bob Duff, Republican legislators are “mean" for proposing legislation to prevent boys from participating in girls' sports when the boys think of themselves as girls.
“Mean" is pretty tame as Democratic criticism of Republicans goes these days. At least Duff didn’t call the Republicans racist, misogynist or right-wing extremists, as is commonly done by many Democrats without prompting other Democrats to call them “mean."
These days anyone who suggests, for example, that state government shouldn’t be controlled by the government employee unions anymore is bound to be called one of those things, maybe all three. For as Lenin or some other totalitarian is supposed to have observed: If you label something well enough, no argument is needed.
Calling Republicans “mean" for wanting to keep males out of female sports is not an argument. It is a distraction, because there is no argument against keeping males out of female sports, except that doing so may hurt the feelings of the males who think of themselves as female.
But keeping those males out of female sports doesn't deny them the ability to participate in sports, as is sometimes alleged, since they remain free to participate in male sports.
If anyone really needs reminding, the premise of segregating the genders in sports is that on average males are larger, stronger and faster than females, and that only such segregation can assure equal opportunity for females, which the 1972 amendments to Title IX of the Civil Rights Act of 1964 were meant to achieve.
But now that the transgenderism cult has taken over some of the Democratic Party, the party implies that physical differences between the sexes have disappeared and there is no unfairness in requiring females to compete against males, even as males competing as females have famously robbed the latter of deserved victories in Connecticut and throughout the world, sometimes inflicting physical injuries on the females.
That unfairness is what is “mean," though Duff affects not to see it.
If a male can deny biology and merely think himself female and induce government to compel everyone to pretend along with him, what becomes of reality? After all, if the adage is true -- that you’re only as old as you feel -- how can adults be prevented from playing in Little League and lording it over the kids there?
Most people know that the transgenderism cult in sports is nonsense but many are reluctant to say so lest they risk having the cult’s many demagogues call them “mean" or something worse. After all, they may figure that there is only a little injustice here -- to the few females who lose to the males who purport to have transcended their gender and its physical advantages.
Even so, it’s injustice all the same, and resolving the issue in favor of justice might be easy in Connecticut if a team competing against the University of Connecticut’s beloved women’s basketball team recruited a transgender player or two who proceeded to knock the UConn women around in a blowout on television.
The resulting popular indignation might give Connecticut Democrats some political courage.
The Biden administration turned Title IX on its head, the Trump administration is striving to put it back upright, and a few Democratic leaders may be realizing that the country is not inclined to keep pretending along with them that males belong in female sports, bathrooms and prisons, nor to pretend that immigration law enforcement should stop. Indeed, only such Democratic nuttiness could have helped to bring Donald Trump back to the presidency.
California’s Democratic governor, Gavin Newsom, who aspires to his party’s next presidential nomination, appeared to have deduced this the other day when he told an interviewer that male participation in female sports is unfair. This was amazing, since California is where much nuttiness originates.
If Newsom can repudiate the nuttiness, could Senator Duff and other Democrats in Connecticut repudiate it someday as well? Or would that be too “mean"?
Chris Powell has written about Connecticut government and politics for many years (CPowell@cox.net).
‘Individual liberty, individual power’
John Quincy Adams in the 1840’s
“My fellow citizens, your individual liberty is your individual power, and as the power of a community is a mass compounded of powerful individuals, the nation whose people enjoys the most freedom will be, in proportion to its numbers, the most powerful nation on earth.’’
-- John Quincy Adams (1767-1848), of Massachusetts. He served as sixth U.S. president (1825-1829), secretary of state (1817-1825) and congressman (1831-1848).
John Long: Ruminating on deep history amidst current beauty on a late-Winter walk
A Brandt goose
View of Gaspee Point from the north
— Photo by Magicpiano
A couple of weeks ago, in early March, the wind was west at about 10 mph, and it was 28 degrees F. I’d just begun my afternoon walk on Gaspee Point, in Warwick, R.I., and was on the southern bluff facing Greene Island, which is in Occupessatuxet Cove. The sky was a Robin’s egg blue, with not a cloud in sight. Middletown and Bristol’s Colt State Park were well defined in the distance.
Several miles away, as I looked southeast toward the shipping channel near Conimicut Point Lighthouse, I saw the tan, red and white Janice Ann Reinauer making a 90-degree turn in Narragansett Bay, She’s a Pusher-tug, built in Rhode Island, in 2020, powered by two GE (rated at 4720 hp) diesel engines, and with her pilot house rising 53 feet above the bay. She travels from Perth Amboy, N.J., along Long Island Sound to the Mobil oil and gas terminal in East Providence.
Looking east, about 30 yards off the sea wall, I see a small flock of Brandt (Branta bernicla) geese feeding on seaweed at low-low tide. Brandt are about half the size of Canada Geese, and winter on our Narragansett Bay.
However, in the summer they breed on the west coast of Greenland. Mute Swans (Cygnus olor) are swimming further out in the bay, their long, graceful S-shape necks letting them bottom-feed on plants in the shallow water.
I am intrigued by two boulders, called “erratics,’’ deposited by the retreating Laurentide Ice Sheet about 10,000 years ago. Presumably they were once one boulder, which centuries of seasonal ice slowly pried apart, eventually splitting the boulder into two, which are now 50 yards apart on tidal flats.
These erratics’ rounded “heads and shoulders” rise above the bay’s surface at low-low tide. Tidal action over millennia have moved these rocks further and further apart. A half dozen Double-Crested Cormorants (Phalacrocorax auritus) often rest on them while warming themselves by stretching their four-foot black wingspans.
Along a worn footpath above the seawall, a Robin, in a sign of spring, is feeding on berries, maybe Bittersweet, and looking for worms beneath dry leaves and bushes below sandy highlands.
As I saunter along, I occasionally hear a wind chime calling out from a backdrop of nearby houses, but mostly it’s wind whistling through oak and maple branches above me. There’s no aroma of the tidal flats here because of the wind and cold.
Tidal flats stretch out a couple hundred yards into the bay, glistening light-brown in sunlight, and revealing two abandoned 19th Century coal-barge skeletons stranded on what’s left of Greene Island. In the early 1900’s, Greene Island was about five acres, and farmers would bring herds of sheep out to it for grazing on Cord Grass (Sporobolus alterniflorus) during the summer. But on Sept. 21, 1938, a totally unexpected hurricane came with a huge tidal surge and raged across Greene Island, obliterating many summer houses on Gaspee Point. I try to envision the power that it would take to forever obliterate the island’s acres of waist-high Cord Grass. The island is now nearly submerged at high tide.
During the same storm, further south, on the bay’s West Passage, a lighthouse on Whale Rock that had been bolted to its foundation was torn off the rock; the lighthouse keeper’s body was never recovered.
In my sometimes askew imagination, there’s a snapshot of a diorama with a plodding ancient time backdrop, but immediately in front of me, a 270-degree view of the bay’s singular beauty now, with its splendid seasonal cycles. In my mind’s eye, I see reminders of Nature’s power—ice sheets that were nearly a mile thick, big boulders deposited by the sheet, and the hurricanes of 1938 and 1954.
In a month or so, folks like me will look for a pair of ospreys returning from their winter quarters, in Venezuela. We all worry about whether they’ll safely arrive here. They mate for life. The male migrates to Gaspee Point first, to begin rebuilding the couple’s nest on a telephone pole nesting platform. The female will join him a few weeks later.
It won’t be long before we see a dazzling abundance of pink Beach Roses (Rosa rugosa) above Gaspee Point beach’s high-water mark. Hooray for Spring!
John Long is a Warwick-based writer
Taking it in
“Recliner” (bronze), by Joy Brown, in her show “The Art of Joy Brown,’’ at the Hotchkiss School’s Tremaine Gallery, Lakeville, Conn., March 25-April 6.
This retrospective traces Brown’s work, from tiny clay figures to clay-headed puppets, to small statues and wall tiles, to the monumental work found in public spaces.
Richard E. Peltier: Now under threat, Clean-Air rules help health and economy
Smog in Los Angeles
From The Conversation (except for photo above)
Richard E. Peltier is a professor of environmental health sciences at the University of Massachusetts at Amherst.
He receives funding from the U.S. Department of Agriculture and the Rio Grande International Science Center.
The Trump administration announced on March 12 that it is “reconsidering” more than 30 air pollution regulations in a series of moves that could impact air quality across the United States.
“Reconsideration” is a term used to review or modify a government regulation. While Environmental Protection Agency Administrator Lee Zeldin provided few details, the breadth of the regulations being reconsidered affects all Americans. They include rules that set limits for pollutants that can harm human health, such as ozone, particulate matter and volatile organic carbon.
Zeldin wrote that his deregulation moves would “roll back trillions in regulatory costs and hidden ‘taxes’ on U.S. families.” But that’s only part of the story.
What Zeldin didn’t say is that the economic and health benefits from decades of federal clean air regulations have far outweighed their costs. Some estimates suggest every $1 spent meeting clean air rules has returned $10 in health and economic benefits.
In the early 1970s, thick smog blanketed American cities and acid rain stripped forests bare from the Northeast to the Midwest.
Air pollution wasn’t just a nuisance – it was a public health emergency. But in the decades since, the United States has engineered one of the most successful environmental turnarounds in history.
Thanks to stronger air quality regulations, pollution levels have plummeted, preventing hundreds of thousands of deaths annually. And despite early predictions that these regulations would cripple the economy, the opposite has proven true: The U.S. economy more than doubled in size while pollution fell, showing that clean air and economic growth can – and do – go hand in hand.
The numbers are eye-popping.
An Environmental Protection Agency analysis of the first 20 years of the Clean Air Act, from 1970 to 1990, found the economic benefits of the regulations were about 42 times greater than the costs.
The EPA later estimated that the cost of air quality regulations in the U.S. would be about US$65 billion in 2020, and the benefits, primarily in improved health and increased worker productivity, would be around $2 trillion. Other studies have found similar benefits.
That’s a return of more than 30 to 1, making clean air one of the best investments the country has ever made.
Science-based regulations even the playing field
The turning point came with the passage of the Clean Air Act of 1970, which put in place strict rules on pollutants from industry, vehicles and power plants.
These rules targeted key culprits: lead, ozone, sulfur dioxide, nitrogen oxides and particulate matter – substances that contribute to asthma, heart disease and premature deaths. An example was the removal of lead, which can harm the brain and other organs, from gasoline. That single change resulted in far lower levels of lead in people’s blood, including a 70% drop in U.S. children’s blood-lead levels.
Air Quality regulations lowered the amount of lead being used in gasoline, which also resulted in rapidly declining lead concentrations in the average American between 1976-1980. This shows us how effective regulations can be at reducing public health risks to people. USEPA/Environmental Criteria and Assessment Office (1986)
The results have been extraordinary. Since 1980, emissions of six major air pollutants have dropped by 78%, even as the U.S. economy has more than doubled in size. Cities that were once notorious for their thick, choking smog – such as Los Angeles, Houston and Pittsburgh – now see far cleaner air, while lakes and forests devastated by acid rain in the Northeast have rebounded.
Comparison of growth areas and declining emissions, 1970-2023. EPA
And most importantly, lives have been saved. The Clean Air Act requires the EPA to periodically estimate the costs and benefits of air quality regulations. In the most recent estimate, released in 2011, the EPA projected that air quality improvements would prevent over 230,000 premature deaths in 2020. That means fewer heart attacks, fewer emergency room visits for asthma, and more years of healthy life for millions of Americans.
The economic payoff
Critics of air quality regulations have long argued that the regulations are too expensive for businesses and consumers. But the data tell a very different story.
EPA studies have confirmed that clean air regulations improve air quality over time. Other studies have shown that the health benefits greatly outweigh the costs. That pays off for the economy. Fewer illnesses mean lower health care costs, and healthier workers mean higher productivity and fewer missed workdays.
The EPA estimated that for every $1 spent on meeting air quality regulations, the United States received $9 in benefits. A separate study by the non-partisan National Bureau of Economic Research in 2024 estimated that each $1 spent on air pollution regulation brought the U.S. economy at least $10 in benefits. And when considering the long-term impact on human health and climate stability, the return is even greater.
Hollywood and downtown Los Angeles in 1984: Smog was a common problem in the 1970s and 1980s. Ian Dryden/Los Angeles Times/UCLA Archive/Wikimedia Commons, CC BY
The next chapter in clean air
The air Americans breathe today is cleaner, much healthier and safer than it was just a few decades ago.
Yet, despite this remarkable progress, air pollution remains a challenge in some parts of the country. Some urban neighborhoods remain stubbornly polluted because of vehicle emissions and industrial pollution. While urban pollution has declined, wildfire smoke has become a larger influence on poor air quality across the nation.
That means the EPA still has work to do.
If the agency works with environmental scientists, public health experts and industry, and fosters honest scientific consensus, it can continue to protect public health while supporting economic growth. At the same time, it can ensure that future generations enjoy the same clean air and prosperity that regulations have made possible.
By instead considering retracting clean-air rules, the EPA is calling into question the expertise of countless scientists who have provided their objective advice over decades to set standards designed to protect human lives. In many cases, industries won’t want to go back to past polluting ways, but lifting clean air rules means future investment might not be as protective. And it increases future regulatory uncertainty for industries.
The past offers a clear lesson: Investing in clean air is not just good for public health – it’s good for the economy. With a track record of saving lives and delivering trillion-dollar benefits, air quality regulations remain one of the greatest policy success stories in American history.
Felice J. Freyer: Sending ‘Subacute’ patients home
UMass Memorial Medical Center University Hospital at dawn
Cxw1044 - Photo
From Kaiser Family Foundation Health News
After a patch of ice sent Marc Durocher hurtling to the ground, and doctors at UMass Memorial Medical Center, in Worcester, repaired the broken hip that resulted, the 75-year-old electrician found himself at a crossroads.
He didn’t need to be in the hospital any longer. But he was still in pain, unsteady on his feet, unready for independence.
Patients nationwide often stall at this intersection, stuck in the hospital for days or weeks because nursing homes and physical rehabilitation facilities are full. Yet when Durocher was ready for discharge in late January, a clinician came by with a surprising path forward: Want to go home?
Specifically, he was invited to join a research study at UMass Chan Medical School, testing the concept of “SNF at home” or “subacute at home,” in which services typically provided at a skilled nursing facility are instead offered in the home, with visits from caregivers and remote monitoring technology.
Durocher hesitated, worried he might not get the care he needed, but he and his wife, Jeanne, ultimately decided to try it. What could be better than recovering at his home in Auburn with his dog, Buddy?
Such rehab at home is underway in various parts of the country — including New York, Pennsylvania and Wisconsin — as a solution to a shortage of nursing home and rehab beds for patients too sick to go home but not sick enough to need hospitalization.
Staffing shortages at post-acute facilities around the country led to a 24% increase over three years in hospital length of stay among patients who need skilled nursing care, according to a 2022 analysis. With no place to go, these patients occupy expensive hospital beds they don’t need, while others wait in emergency rooms for those spots. In Massachusetts, for example, at least 1,995 patients were awaiting hospital discharge in December, according to a survey of hospitals by the Massachusetts Health & Hospital Association.
Offering intensive services and remote monitoring technology in the home can work as an alternative — especially in rural areas, where nursing homes are closing at a faster rate than in cities and patients’ relatives often must travel far to visit. For patients of the Marshfield Clinic Health System who live in rural parts of Wisconsin, the clinic’s six-year-old SNF-at-home program is often the only option, said Swetha Gudibanda, medical director of the hospital-at-home program.
“This is going to be the future of medicine,” Gudibanda said.
Marc and Jeanne Durocher were thrilled that a clinical trial at UMass Chan Medical School enabled Marc to recover from hip surgery at home, in Auburn, Massachusetts.
But the concept is new, an outgrowth of hospital-at-home services expanded by a covid-19 pandemic-inspired Medicare waiver. SNF-at-home care remains uncommon, lost in a fiscal and regulatory netherworld. No federal standards spell out how to run these programs, which patients should qualify, or what services to offer. No reimbursement mechanism exists, so fee-for-service Medicare and most insurance companies don’t cover such care at home.
The programs have emerged only at a few hospital systems with their own insurance companies (like the Marshfield Clinic) or those that arrange for “bundled payments,” in which providers receive a set fee to manage an episode of care, as can occur with Medicare Advantage plans.
In Durocher’s case, the care was available — at no cost to him or other patients — only through the clinical trial, funded by a grant from the state Medicaid program. State health officials supported two simultaneous studies at UMass and Mass General Brigham hoping to reduce costs, improve quality of care, and, crucially, make it easier to transition patients out of the hospital.
The American Health Care Association, the trade group of for-profit nursing homes, calls “SNF at home” a misnomer because, by law, such services must be provided in an institution and meet detailed requirements. And the association points out that skilled nursing facilities provide services and socialization that can never be replicated at home, such as daily activity programs, religious services, and access to social workers.
But patients at home tend to get up and move around more than those in a facility, speeding their recovery, said Wendy Mitchell, medical director of the UMass Chan clinical trial. Also, therapy is tailored to their home environment, teaching patients to navigate the exact stairs and bathrooms they’ll eventually use on their own.
A quarter of people who go into nursing homes suffer an “adverse event,” such as infection or bed sore, said David Levine, clinical director for research for Mass General Brigham’s Healthcare at Home program and leader of its study. “We cause a lot of harm in facility-based care,” he said.
By contrast, in 2024, not one patient in the Rehabilitation Care at Home program of Nashville-based Contessa Health developed a bed sore and only 0.3% came down with an infection while at home, according to internal company data. Contessa delivers care in the home through partnerships with five health systems, including Mount Sinai Health System in New York City, the Allegheny Health Network in Pennsylvania, and Wisconsin’s Marshfield Clinic.
Contessa’s program, which has been providing in-home post-hospital rehabilitation since 2019, depends on help from unpaid family caregivers. “Almost universally, our patients have somebody living with them,” said Robert Moskowitz, Contessa’s acting president and chief medical officer.
The two Massachusetts-based studies, however, do enroll patients who live alone. In the UMass trial, an overnight home health aide can stay for a day or two if needed. And while alone, patients “have a single-button access to a live person from our command center,” said Apurv Soni, an assistant professor of medicine at UMass Chan and the leader of its study.
But SNF at home is not without hazards, and choosing the right patients to enroll is critical. The UMass research team learned an important lesson when a patient with mild dementia became alarmed by unfamiliar caregivers coming to her home. She was readmitted to the hospital, according to Mitchell.
The Mass General Brigham study relies heavily on technology intended to reduce the need for highly skilled staff. A nurse and physician each conducts an in-home visit, but the patient is otherwise monitored remotely. Medical assistants visit the home to gather data with a portable ultrasound, portable X-ray, and a device that can analyze blood tests on-site. A machine the size of a toaster oven dispenses medication, with a robotic arm that drops the pills into a dispensing unit.
The UMass trial, the one Durocher enrolled in, instead chose a “light touch” with technology, using only a few devices, Soni said.
The day Durocher went home, he said, a nurse met him there and showed him how to use a wireless blood pressure cuff, wireless pulse oximeter, and digital tablet that would transmit his vital signs twice a day. Over the next few days, he said, nurses came by to take blood samples and check on him. Physical and occupational therapists provided several hours of treatment every day, and a home health aide came a few hours a day. To his delight, the program even sent three meals a day.
Durocher learned to use the walker and how to get up the stairs to his bedroom with one crutch and support from his wife. After just one week, he transitioned to less-frequent, in-home physical therapy, covered by his insurance.
“The recovery is amazing because you’re in your own setting,” Durocher said. “To be relegated to a chair and a walker, and at first somebody helping you get up, or into bed, showering you — it’s very humbling. But it’s comfortable. It’s home, right?”
Felice J. Freyer is a veteran medical reporter.
Found and lost winter
“Davis Brothers, Oxen on Pleasant Street” (Portsmouth, N.H.), circa 1867, in Lynn Cazabon’s show “Losing Winter,’’ through March 30 at 3S Artspace, Portsmouth, through March 3o.
The gallery explains that Lynn Cazabon presents a unique and site-specific “archive of memories and emotions about winter, revealing the personal and cultural ties we have to the season and reflecting upon what we are collectively losing due to climate-change impacts on seasonal patterns.’’
Sonali Kolhatkar: As Trump dismantles FEMA, etc., states need to create climate superfunds
Flooding in downtown Montpelier, Vt., on July 11,2023
Global warming has been bringing more frequent extreme weather events around America in recent years. Vermont in May 2024 became the first state to establish a climate superfund.
-Photo by Air National Guard Senior Master Sgt. Michael Davis
Via OtherWords.org
Rebuilding from California’s recent wildfires will cost more than a quarter of a trillion dollars — an unprecedented amount. The estimated damage from Hurricane Helene in the Southeast is almost as much, on the order of $250 billion.
Who will pay for that damage? It’s a question plaguing localities around the country as climate change makes these disasters increasingly common.
Some states are landing on a straightforward answer: fossil-fuel companies.
The idea is inspired by the “superfunds” used to clean up industrial accidents and toxic waste. The Superfund program goes back to 1980, when Congress passed the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). The law fined polluters to finance the clean up of toxic spills.
Thanks to the hard work of groups such as the Vermont Public Interest Research Group and Vermont Natural Resources Council, Vermont recently became the first state to establish a climate superfund in May 2024.
Months later, New York followed suit, again in response to pressure from environmental groups. Both bills require oil and gas companies to pay billions into a fund designated for climate-related cleanup and rebuilding.
Now California is considering a similar law in the wake of its disastrous wildfires. Maryland, Massachusetts and New Jersey may take up the idea as well.
It’s an idea whose time has come, especially now that states are less able to rely on the federal government. The Trump administration is disabling government agencies such as the Federal Emergency Management Agency (FEMA) with major cuts and putting conditions on other aid.
At the recent Conservative Political Action Committee (CPAC) conference, Trump aide Ric Grenell unabashedly endorsed “squeezing” California’s federal funds unless they “get rid of the California Coastal Commission.” (Trump apparently hates the commission, the Fresno Bee explains, because it prevents “wealthy people from turning public beaches into private enclaves.”)
Fossil-fuel companies — the lead perpetrators of climate disasters — spent more than $450 million to elect their favored candidates, including Trump. In return, Trump has promised to speed up oil and gas permits and stacked his cabinet with oil-friendly executives.
Why should taxpayers have to foot the bill to clean up the destruction wrought by this industry, one of the most profitable the world has ever known? As a spokesperson for New York Gov. Kathy Hochul said, “corporate polluters should pay for the wreckage caused by the climate crisis — not everyday New Yorkers.”
Not surprisingly, 22 Republican-led states disagree. They’ve sued to block New York’s law and protect oil and gas profits at the expense of ordinary people. They have no answer for the question of who pays for recovery from climate disasters or helps people reeling from one disaster after another.
Fossil-fuel companies can think of paying into a climate superfund as the cost of doing business. If they’re in the business of extracting and selling a fuel that destroys the planet, it’s only fair they pay to clean up the damage.
And the public agrees. Data For Progress found more than 80 percent of voters support holding fossil-fuel companies responsible for the impact of carbon emissions.
To be fair, a climate superfund is a “downstream” solution to the climate crisis, one that seeks to raise the costs to perpetrators. A climate superfund can pay to rebuild homes, but it cannot replace priceless family heirlooms or undo the trauma of surviving a disaster. Most of all, it cannot bring back lives lost. It is only one tool in a multi-pronged tool box to end the climate crisis.
Upstream solutions centering the prevention of climate change — that is, reducing carbon emissions at their source — must be at the center of our fight if humanity is to survive. But in the meantime, fossil fuel polluters should pay.
Sonali Kolhatkar is the host of Rising Up With Sonali, a television and radio show on Free Speech TV and Pacifica stations.
And we’re still divided
“The past is never dead. It's not even past" — William Faulkner (1897-1962) of Mississippi in his 1950 novel Requiem for a Nun
Col. John Blackburne Woodward, Maj. Joseph B. Leggett and Lt. Col. William A. McKee of the 13th National Guard Regiment, New York, ca. 1863, (oil-painted Imperial albumen print), by unknown photographer. This is in the March 21-May 10 show “A House Divided: Photography and the Civil War” at the Art Museum, University of St. Joseph, West Hartford, Conn.
The show documents aspects of the Civil War as seen through the lens of the most gifted artist-photographers of 19th Century America. All works are from the collection of Michael Mattis and Judith Hochberg.
‘Pseudo-scientific Fantasy’
David Hockney illustration for James Sellars’s film Haplomatics, in the show “David Hockney & James Sellars: Haplomatics,’’ at the New Britain (Conn.) Museum of American Art through Oct. 5
The museum says that the show “explores the wild realm of pseudo-scientific fantasy in the visual textual and musical collaboration between the artist David Hockney and the composer James Sellars.
“Their work together in the late 1980s became a synergy of art, technology, and music that resulted in a multi-media masterpiece, the animated film Haplomatics. The film introduces a genus of abstract beings called Haplomes, which come to life through Hockney’s prints and Sellars’s narration and innovative musical score.
“Haplomatics,’’ the exhibition, features Hockney’s innovations in printmaking with the thirty-five xerographic prints that were used to create the film’s visual effects.’’
In Boston, anyway, the 13th floor is losing its infamy
Aerial view of Downtown Boston in June 2017
AbhiSuryawanshi photo
Would you think twice about renting on the 13th floor?
For high rises in the United States, skipping the number 13 was once a standard convention. Many taller structures referred to their 13th floor as 14 and renumbered the rest of the building accordingly, a bizarre ruse apparently meant to save building managers from their more superstitious clients.
However, the unlucky number appears to be losing its infamy.
Most of Boston’s 20 tallest buildings do not bother skipping the 13th floor, according to a Boston Guardian review. Almost all of the city’s office skyscrapers bravely lease out space on floor number 13, and some newer residential high rises and hotels have also thrown away the practice.
Hotels may be the city’s last bastion of construction superstition. Spots such as the Park Plaza Hotel, the Custom House Tower and the new Newbury Hotel still go directly from floors 12 to 14, a comfort to triskaidekaphobic guests. It is unclear whether these hotels also ban black cats, broken mirrors or towering ladders.
Prospective hotel guests rarely fret about 13, noted Suzanne Wenz, director of marketing for the Newbury. The practice probably endures in older hotels because of tradition, she said.
“It’s just traditionally been that way,” Wenz said. “I personally have not heard of anyone complaining about being on the 13th floor.”
On the residential side, most recent developments are fearless, offering 13th floor apartments and condos with apparent impunity. Still, a few new buildings remain holdouts. The Viridian in the Fenway skips the number, and the Millennium Tower downtown cautiously avoids both 13 and 44, an unlucky number in East and Southeast Asian cultures. The developers did not respond to requests for comment.
Local real estate brokers say 13 is rarely a dealbreaker for condo owners. Most clients do not worry about the number, and 13th floor condos are unfortunately not available at a discounted rate for daring buyers willing to try their luck. That being said, some condo owners are in favor of skipping floor 13 in order to accommodate the small percentage of people who hold this superstition thinking they may as well not miss the sale.
“If you don’t have to put it in, and you can take it out because it’s your choice, why even deal with it?” said residential broker Kevin Ahearn. “It’s just a judicious thing to do.”
The practice appears to be waning. The Moxy, a downtown hotel aimed at millennials, does not skip 13, even though its older corporate siblings like the Park Plaza still follow the longstanding tradition.
For hotels and residential buildings, this change may be driven partly by consumers. Superstition is not unheard of nowadays, but few people will go out of their way to avoid an unlucky number.
“I don’t know that people give it a lot of thought these days,” said Wenz.
Note the egg prices in particular!
At Boston’s Parker House hotel in 1949. Now called the Omni Parker House, it remains a favorite meeting place for people in Massachusetts politics.The hotel was founded in 1855, with the current hotel structure dating to 1927.
Llewellyn King: We need a Magna Carta to challenge Trump tyranny
King John being forced to sign the Magna Carta.
WEST WARWICK, R.I.
Sitting behind President Trump at his inauguration were men who might well be called the barons of America: the big-tech billionaires who control vast wealth and public awe. They are so high in Trump’s esteem that he seated them in front of his Cabinet.
When King John of England was crowned, in 1199, barons also attended him. They were the barons of England, although most were of French descent — the result of the conquest of England in 1066 by William, Duke of Normandy, who defeated King Harold II of England in the Battle of Hastings.
The difference between John’s coronation and those of his father, Henry II, and brother, Richard I, was that he didn’t make the customary promises to uphold the rights and the norms of conduct that had become a kind of unofficial constitution. John neither embraced those norms then nor abided by them later.
King John was known to be vengeful and petty, tyrannical and greedy, but is believed to have been a relatively good administrator and a passable soldier -- although many of his financial problems resulted from the loss in war of English lands in Normandy.
Those wars and expenditures by his father and brother on fighting the Third Crusade meant that John had a money problem. He solved the problem with high taxes and scutage — payments that were made in lieu of military service, often by rich individuals.
John also had a “deep state” problem.
The king’s administration had become extremely efficient, bureaucratic, and especially good at taxation and coercion, which angered the nobles. They were getting pushed around.
When the barons had had enough, they told the king to behave, or they would install one of the pretenders to the throne. They met in long negotiations at Runnymede, a meadow along the Thames, 22.5 miles upriver from what is now Central London. It is pretty well unchanged today, save for a monument erected by the American Bar Association, in 1957.
The barons forced on John a document demanding his good behavior, and impressing upon him that even the king was not above the law.
The document that was signed on June 15, 1215 was the Magna Carta (Great Charter), limiting the king’s authority and laying down basic rules for lawful governance.
In all there are 63 sections in the document, which have affected Western culture and politics for almost 800 years. The Magna Carta is part of English and American common law, and was a foundational document for the U.S. Constitution.
It stated that the king was subject to the laws of the time, that the church could be free of the king’s administration and his interference, and that the rights of the barons and commoners were respected. Particularly, it said that no one should be imprisoned without due process.
Today’s barons in America are undoubtedly the big-tech entrepreneurs who have not only captured great wealth but also have an air of infallibility.
While John has been hard-handled by history, the Magna Carta has done superbly. John was saddled with the epithet “Bad King John” and no other English monarch has been named John.
When an American president is showing some of the excesses of John, isn’t it time for the great commercial and technological chiefs, who have so far sworn fealty to Trump, to sit him down beside another great river, the Potomac, and tell him a few truths, just as happened at Runnymede?
Since Trump’s inauguration, U.S. national and international status has deteriorated. Chaos has reigned — the government has nearly ceased to function, a pervasive fear for the future has settled in a lot of Americans, there is embarrassment and anger over the trashing of laws, circumvention of the Constitution, tearing up of treaties, aggression towards our neighbors, and a general governance by whim and ego.
America’s barons need to tell the president: You aren’t a king. Leave the free press free. Abide by the decisions of the courts. Stay within the law. Respect free speech wherever it is practiced. Above all, respect the Constitution, the greatest document of government probity written since the Magna Carta.
On Twitter: @llewellynking2
Llewellyn King is executive producer and host of White House Chronicle, on PBS, as well as a businessman, most notably now as an international energy-sector consultant.
White House Chronicle
Centerville Mill on the Pawtuxet River, built during West Warwick’s 19th Century heyday as a textile-making center.
‘Growth and decay’
“Kaboom!,” linocut monotype, by Julia Talcott, in her show “Subject to Change,’’ at Bromfield Gallery, Boston, April 2-27.
She says:
“This exhibition presents printmaking from 2012 to the present. My work reflects my interest in the natural world and its intersection with the man-made world. I like to observe patterns, pull them apart, and then re-imagine them as printed pieces.
“Creating them as linoleum and woodblock prints, I produce a vocabulary of images and then work intuitively to collage them back together into new forms.
“I alternate between abstraction and representational images, with color and black and white pallets to weave images together. I strive to express the vitality of growth and decay in a physical and spiritual world.’’
