#Care Management Solutions Industry

[neha24blog]

Care Management Solutions Market Segment Analysis By Component, Mode Of Delivery, End-Use, Region And Forecast Till  2030 : Grand View Research Inc.

Care Management Solutions Market Segment Analysis By Component, Mode Of Delivery, End-Use, Region And Forecast Till  2030 : Grand View Research Inc.

San Francisco, 9 Jan 2023: The Report Care Management Solutions Market Size, Share & Trends Analysis Report By Mode Of Delivery (Cloud, On-premise), By End-use (Healthcare Providers, Payers), By Component (Software, Services), And Segment Forecasts, 2023 – 2030 The global care management solutions market size is expected to reach USD 33.3 billion by 2030, exhibiting a CAGR of 14.41% during the…

[hygienix123]

Why Hygienix Hospitality is the Leading Supplier for Housekeeping Materials

In today’s fast-paced world, maintaining cleanliness and hygiene is a top priority for businesses across various sectors, especially in hospitality, healthcare, and corporate environments. For such establishments, having reliable and high-quality housekeeping materials is essential. One company that stands out in providing these critical supplies is Hygienix Hospitality.

With a strong reputation for delivering premium quality housekeeping products and excellent customer service, Hygienix Hospitality has become a leading supplier for housekeeping materials in India. This blog will explore the reasons why Hygienix Hospitality is the top choice for housekeeping supplies, how they meet industry needs, and what sets them apart from the competition.

[medical-billing-service-0]

Optimizing Financial Management with Chiropractic Billing Services

In the healthcare sector, chiropractic care plays a vital role in managing musculoskeletal conditions, improving mobility, and enhancing patients' overall quality of life. However, managing the financial aspects of a chiropractic practice can be challenging due to the unique nature of treatments, frequent patient visits, and varying insurance policies. This is where medical billing services come into play, ensuring that chiropractic practices can focus on providing care while their financial operations run smoothly. These services streamline the billing process, minimize errors, and enhance reimbursement rates, which ultimately leads to better revenue management for chiropractic practices.

What Are Chiropractic Billing Services?

Chiropractic billing services are specialized financial solutions designed to meet the unique needs of chiropractic practices. These services are a critical component of Revenue Cycle Management (RCM) services, which oversee the entire process of patient billing, from claim submission to final payment. Chiropractic billing services handle everything from insurance verification and coding of chiropractic adjustments to following up on claims and managing denials. Since chiropractic care often involves ongoing treatments and multiple patient visits, these billing services ensure that claims are submitted accurately and promptly, reducing delays and maximizing revenue.

The Importance of Medical Billing and Coding in Chiropractic Care

Accurate medical billing and coding is essential for chiropractic practices to ensure that they are compensated for the services they provide. Chiropractic care involves various treatments, such as spinal adjustments, physical therapy, and other therapeutic services, each of which requires precise coding to avoid errors. Incorrect or incomplete coding can lead to claim denials or underpayments, which can negatively affect a practice’s cash flow. By partnering with experienced billing professionals who specialize in medical billing and coding, chiropractic practices can ensure that their claims are submitted correctly and in compliance with industry standards, leading to improved financial outcomes.

Benefits of Healthcare IT in Chiropractic Billing

In the digital age, Healthcare IT has transformed the way billing services are managed, offering numerous benefits for chiropractic practices. Advanced billing software and electronic health record (EHR) systems streamline the billing process by automating tasks such as claim submission, coding, and patient record management. Healthcare IT reduces human error, speeds up payment cycles, and allows for better communication between chiropractic providers and insurance companies. Additionally, real-time tracking and reporting features enable chiropractic practices to monitor the status of claims and payments, ensuring that revenue is managed efficiently. Healthcare IT enhances both the accuracy and efficiency of chiropractic billing, leading to improved practice operations.

Chiropractic Billing Services at Mediclaim Management

Mediclaim Management offers specialized Chiropractic Billing Services designed to meet the needs of chiropractic practices. With a deep understanding of the unique challenges that chiropractors face, their team of billing experts ensures that all aspects of the billing process are handled with precision and care. Mediclaim Management’s Chiropractic Billing Services help providers reduce billing errors, increase claim approval rates, and expedite reimbursements. By partnering with Mediclaim Management, chiropractic practices can focus on delivering high-quality care to their patients while ensuring that their financial operations run smoothly in the background.

With Mediclaim Management’s Chiropractic Billing Services, chiropractic providers can optimize their revenue cycle, reduce financial stress, and ensure that their practice remains financially healthy. This allows chiropractors to focus on what truly matters—improving the health and well-being of their patients.

[abcshomecare]

ABCS Home Care

ABCS Home Care provides compassionate and reliable non-medical care services to seniors throughout Texas. We understand the desire for older adults to maintain their independence and live comfortably in their own homes. Our dedicated caregivers offer a helping hand with everyday tasks, ensuring your loved ones feel safe, supported, and respected.

Business Hours: Mon - Thu: 9am - 3pm ; Fri - Sun: Closed

Payment Methods: Private Pay, Debit, Credit, Insurance, Zelle, Square, Cashapp

Owner Name: Melanie Allen/Christopher Allen

Contact Info:

ABCS Home Care

Address: 307 S. Main Street, Ste 110, Bryan, TX, USA 77803

Phone: +1 979-599-8825

Business Email: info@abcshome.com

Website: http://www.abcshome.com

Follow On

Facebook: https://www.facebook.com/profile.php?id=61562818263415

Instagram: https://www.instagram.com/abcshomecare/

[gauricmi]

The Global Geriatric Medicines Market Growth Is Driven By Aging Global Population

The global geriatric medicines market refers to drugs and medications that are specifically formulated and developed for elderly patients aged 65 years and above. Geriatric medicines are medicines that are effectively and safely administered to the elderly population who are prone to multiple chronic diseases and conditions. The medicines are often available in user-friendly formats and doses suitable for senior citizens with challenging swallowing patterns or other health issues.

The Global Geriatric Medicines Market is estimated to be valued at US$ 1,570.18 Bn  in 2024 and is expected to exhibit a CAGR of 6.6% over the forecast period from 2024 to 2031. Key Takeaways Key players operating in the Geriatric Medicines Market are Pfizer Inc., Takeda Pharmaceutical Company Limited, Janssen Pharmaceuticals, Sun Pharmaceutical Industries Ltd., AbbVie Inc., Boehringer Ingelheim, Eli Lilly and Company, Bristol Myers Squibb, Daiichi Sankyo Company, Limited, Bausch Health Companies, Mallinckrodt Pharmaceuticals, Endo Pharmaceuticals, Eisai Co., Ltd., Ferring Pharmaceuticals, UCB, Evoke Pharma, Cadila Pharmaceuticals. The increasing prevalence of chronic and lifestyle diseases among geriatric population is expected to drive the market growth during the forecast period. Pfizer, Boehringer Ingelheim, Roche, Novartis are a few top players operating in the geriatric medicines market. The global geriatric population is rapidly increasing and is expected to witness the fastest growth in developing economies of Asia Pacific and Latin America on account of improving life expectancy and declining fertility rates. This substantial rise offers huge potential for drugs and therapeutics that are specially designed to cater to the elderly population. With a large elderly population base, there exists vast growth opportunities in countries with aging populations such as Japan, Germany, Italy, France, the United Kingdom, and the United States, among others. Market drivers The global aging population is the primary driver propelling the growth of the global geriatric medicines market. According to the United Nations, the world’s geriatric population is growing rapidly and is expected to double from 12% to 22% between 2015 and 2050. The rising prevalence of chronic diseases such as cardiovascular diseases, cancer, diabetes, arthritis, osteoporosis, neurological disorders, dental and oral diseases among geriatric population significantly contributes to the growth of the market. Manufacturers are focused on innovations to develop advanced treatment solutions for diseases predominantly affecting senior citizens. Favorable government policies and regulations further support the growth of the geriatric medicines market.

Get More Insights On This Topic: Global Geriatric Medicines Market

[health-views-updates]

Care Management Solutions Market 2023 Primary Research, Product Research, Trends and Forecast by 2030

The global care management solutions market is positioned for significant growth, with a projected value of USD 33.27 billion by 2030. This signifies a substantial increase from its 2022 valuation of USD 14.23 billion, reflecting a promising Compound Annual Growth Rate (CAGR) of 11.2% over the forecast period (2023-2030), according to a recent market analysis.

Driving Forces Behind the Care Management Boom:

Several key factors are contributing to the expanding care management solutions market:

Aging Population and Chronic Disease Burden: The growing geriatric population and the rising prevalence of chronic conditions like diabetes, heart disease, and cancer are driving the demand for solutions to manage these complex healthcare needs effectively.

Focus on Improved Care Coordination and Patient Outcomes: Care management solutions facilitate better communication and coordination between healthcare providers, specialists, and caregivers, leading to improved patient outcomes and reduced readmission rates.

Cost-Effectiveness and Value-Based Care: These solutions can help healthcare organizations optimize resource allocation, reduce healthcare costs, and align with value-based care models that reward positive patient outcomes.

Technological Advancements: Continuous advancements in cloud computing, data analytics, and mobile health technologies are leading to the development of more sophisticated and user-friendly care management solutions.

Get Free PDF Sample Copy of Report @ https://www.snsinsider.com/sample-request/1826

A Multifaceted Market Landscape:

The press release can be enhanced by incorporating a section on market segmentation, providing a more detailed picture:

Component Type: The market is segmented by the type of components offered:

Software: Care management software solutions automate various tasks like care planning, patient monitoring, medication management, and data analysis.

Services: These services include implementation, training, and ongoing support for care management software solutions.

Delivery Mode Type: Care management solutions can be delivered through various models:

On-Premise: Software is installed on the healthcare organization's own servers.

Cloud-Based: Software is accessed via the internet, offering greater flexibility and scalability.

Application Type: The market caters to various care management applications:

Disease Management: Solutions designed to support the management of specific chronic conditions.

Case Management: Software for coordinating care for individual patients with complex needs.

Utilization Management: Tools for optimizing healthcare resource utilization and reducing unnecessary costs.

End Users: Several stakeholders benefit from care management solutions:

Payers (Insurance Companies): Utilize solutions for population health management, disease prevention, and cost control.

Providers (Hospitals, Clinics): Leverage software to improve care coordination, patient engagement, and workflow efficiency.

A Global Phenomenon:

A section on the geographic landscape can be included to highlight regional trends:

The report explores the care management solutions market across different regions, providing insights for geographically focused strategies.

Looking Ahead:

The future of the care management solutions market appears bright, with continued growth expected. Rising healthcare costs, increasing adoption of telehealth and remote patient monitoring technologies, and the growing focus on personalized medicine will further propel market expansion.

[astralfortune]

You're the manager of a rising idol group. When a fan finds their apartment and posts it online, your group is forced to move to another home. Which happens to be the same apartment complex as yours.

Now, this wouldn't be a problem except for one thing. Nobody knows that you're a completely different person at home! Will you do whatever it takes to keep up the act at work or will you reveal your true self to your new neighbors?

Bridging the Gap is a simple slice-of-life story about letting down your guard and connecting with the people you're around. Play as the manager of an idol group and help them as they settle into their new home and prepare for their comeback.

Play as Male, Female, or Non-Binary

Choose between four work personalities (Stoic, Aloof, Caring, Energetic) and four home personalities (Shy, Reserved, Prickly, Easygoing)

Experience the personality gap lifestyle

Manage your idol group and build your relationship with Fortune

Perhaps find love with one of them?

Romance Options

Taeyang/Hayoon Lee

Leader of the group, Fortune

As the leader, they carry a heavy burden on their shoulders but that doesn’t stop them from pursuing their dreams and striving to be the foundation their fledgling group needs. Calm and perceptive, they take things in stride and somehow always seem to find the best solutions to any complications. Will you be the equal they need in the middle of change?

Taeyang stands at 5'9 with short black hair while Hayoon is 5’7 with long black hair. Their deep brown eyes show every emotion.

Xavier/Xanthe Cothran

Vice leader of Fortune

X is the quiet sort, preferring to let the others do the talking. They’re passionate about their work, often the last one to leave the practice room. That doesn’t mean they’re cold or distant. In fact, they love spending time with their group even if they don’t say anything. Will you be their solace from the noise of the industry?

Both Xavier and Xanthe are 6 '0 with shoulder length dark brown hair. Xavier prefers to tie it back while Xanthe keeps it loose. Their hazel eyes are deep and captivating.

Elias/Elaine Auclair

Dance leader of Fortune

The most outgoing of the group, E is very much a mood maker. They love dragging the members for outings or meals. New experiences are what motivates E to become more successful. Somehow they almost always have a smile on their face, so surely they must be hiding something underneath, right? Right?

Elias stands at 5’10 with short blonde hair, often styled. Elaine is 5’7 and her long blonde hair is well taken care of. Their blue eyes shine with life and joy.

Oliver/Olivia Harcourt

The youngest of Fortune

The youngest of the group and also the oldest of four siblings. O shamelessly takes advantage of their position now that they have others to be the responsible ones. They’re cheeky and full of life, O is often found with E coming up with a variety of shenanigans. However, underneath all the mischief O cares deeply about those they’re close to, including you. Will you find comfort and healing during your time with O?

Oliver is 5’7 while Olivia stands at 5’5. They both have blue dyed hair. Oliver keeps his short while Olivia’s is shoulder length. Their brown eyes are warm and welcoming.

Demo: Here

[belle-rosse]

I think wayyyy too much about the scene in s1x07 where Vi and Cait try to save each other from Jinx’s attack, and maybe simple thoughts have turned into a meaningless analysis. I’ll share it anyway.

The way Vi and Caitlyn try to protect each other in this scene perfectly reflects how they were raised, and I think it even works as foreshadowing for the scene in the rain.

Let’s focus on Vi first. The core part of her identity since she was a child has been to protect, which we see from the way she shields Powder from the horrifying sight on the bridge in the very first minute of the first episode, up to this very moment. Vi has a specific way of carrying out this protection. Unlike when she's on her own, Vi doesn’t jump straight into a fight—she first moves the person she wants to protect away from danger, then faces the battle entirely alone. Here, she follows the same process: her first impulse is to shield Caitlyn by pushing her out of the weapon’s range, not caring about her own safety. She only takes cover after making sure that no one can hurt Cait. This is Vi’s impulsive nature at its peak, as well as her absolute loyalty.

Now, with Caitlyn, there’s more to discuss. Caitlyn has been protected her entire life, shielded behind her parents and her last name. This sense of security has made Caitlyn a rebel, someone who pushes the boundaries of that protection (while following certain rules), but it also makes her very naive. Caitlyn doesn’t truly know the dangers of the world. Even though she tries to project confidence, she had never stepped on the other side of the bridge before. That’s why I believe her decision to step in front of Vi as a shield while also trying to protect herself with her arm is a pure act but rooted in ignorance. Caitlyn jumps into danger to keep Vi safe, but even if she managed to avoid the impact of one bullet, there would be more. Most likely, if Vi hadn’t pushed her, they both would’ve ended up hurt. This is Caitlyn’s identity: unlike Vi, she protects others by getting close, giving all of herself to push the problem away rather than fighting it alone. What she doesn’t realize is that, even when she has meticulously structured plans, some problems can’t be solved with one-sided diplomacy. Caitlyn is pure and well-intentioned but lacks a survival instinct due to her upbringing.

Now, why do I say this works as foreshadowing for their breakup in the rain? Simple—except for the weapons and general violence, it’s essentially the same scene.

Vi and Caitlyn face a problem that involves both of them, and in order to protect the other, they resort to the same methods I mentioned before.

Vi assumes that she’s the problem, that her anger with the council and Piltover in general will cost Caitlyn her well-being. So, what does she do? She leaves her in the middle of the rain, saying words she wishes weren’t true, hurting herself in the process just to make sure Caitlyn won’t try to find her. Throughout this scene, Vi refuses to look at her, because if she sees her sadness, she’ll likely give in and end up putting her in danger. After pushing her away again, Vi decides to confront (though with Jayce this time, not entirely alone) Silco’s industry, once more jumping into the fight only after ensuring the safety of the one she loves.

But Caitlyn doesn’t know this. She sees Vi’s actions as an abrupt and ungrounded change. “Why is Vi leaving?” must be her only thought, and in response, she tries to offer solutions they can face together because she’s unaware of what they’re really up against. She tries to get close to Vi several times, both in her words and her body language. Everything in her is pleading for the Zaunite to stay, to explain what’s happening so they can work together and share the weight of the problems. In the end, it doesn’t work, and respecting Vi’s boundaries, she lets her go. Though it doesn’t stop her, and that’s how we get her scene in the shower, thinking of the alternatives to that encounter.

I warned y’all that this would be a meaningless analysis, but I love and miss Caitvi too much to stay silent about them. Also, I adore episode seven.

[fatehbaz]

"Industry" as a frame of meaning is [...] relevant from the beginning of [modern-era labor advocacy and the general practice of intentionally "taking it easy" or "slowing down" while at work in order to advocate for and take care of oneself] [...], a form of "working badly" [...]. This close link is understandable given the absolute focus on efficiency that marks management thinking - Taylorism [Frederick Taylor's time studies and his support for using stopwatches to micro-manage in the workplace], the Gilbreths' time and motion studies [...]. [W]e can feel that trace of disgust, a certain sneering affect [...]. The sneer gathers around the word "motionless," [...]. The promise of the “upstanding citizen” is posed against the figure of the cripple, etymologically bound to the one who creeps, who stays low, to the one who is not proud and erect and in public view. In this way, that figure - along with the hobbled, the mute, the blind, the mad, the deaf, the chronic, and, of course, the paralyzed - becomes the exemplary negative definition. [...] [T]he only culturally sanctioned options are to be hidden from public life or recuperated [...]. That [...] fantasy of [a] return to previous levels of mobility that aligns easily with ableist conceptions of normal function and health [...] is also grounded in the specific idea of a return to ["productivity"] [...].

We can find this dynamic in especially dramatic form in the influential work of early twentieth-century “scientific management” theorists Frank and Lillian Gilbreth, known both for their time and motion studies of labor processes [...]. [T]he Gilbreths are relentlessly devoted to the reduction of inefficiency in labor to save energy, reduce unnecessary fatigue, and, above all, neutralize the fundamental “waste” of effort and time hidden within every human movement, particularly when at work. According to Frank and Lillian, “there is no waste of any kind in the world that equals the waste from needless, ill-directed, and ineffective motions, and their resulting unnecessary fatigue.” The battle against this “waste” gets posed as a civilizational battle stretching back across human history, only now conquerable with modern means, yet theirs is also a project with explicitly nationalist overtones that can be strategically couched to suit a war economy and a desire for American imperial hegemony.

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The solution they propose is a total analytical dissection of labor processes, breaking single tasks into discrete parts to detect the little gaps in time that could be closed. Such minute lags and “micromotions” will necessarily get missed without the tools the Gilbreths turn to, like moving picture cameras - turned to face workers with chronometers in front of the lens and reticular grids on the wall behind for scale - and a “chronocyclegraph,” which allowed them to zoom in on a single gesture to see its tiny deviations and wasted movements frame by frame. In their methodology, delays and breakdowns take a form almost directly counter to simple malingering or the kind of willful self-stasis that Spargo denounced. Rather, what causes the inefficiency that the Gilbreths target is too much movement, an excess of animacy and motions that need not be done to complete a task, resulting in unnecessary fatigue and wasted opportunities for profit.

Yet at the heart of this, there is one figure seen to most embody this “wasted” energy and time in full - not in a specific action, badly choreographed task, or laziness, but in their entire being. This is what they designated as the “cripple,” [...].

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“What,” the Gilbreths ask, “is to be done with these millions of cripples, when their injuries have been remedied as far as possible, and when they are obliged to become again a part of the working community?” [...] The “cripple” therefore emblematizes the waste of America’s “human resources” for the Gilbreths. It manifests a physical limit - the body that is conventionally seen to be unable to do productive work - but also a political one that they cannot even fathom, or at least allow publicly: the idea that anyone might challenge either the supposed utility of this frenzy of streamlined work or the very category of what constitutes “waste” itself. For the Gilbreths, the “elimination of waste” is not merely a project of capital. It is a civilization-scale undertaking that benefits all involved in the process: “All workers are sharing in the savings made possible by the elimination of waste.” [...]

It is not mere surveillance, increased policing, or something that openly oppresses and invites a revolt. Instead, it is a mode of management and control that seeks to saturate every step of the process, all the while insisting that what’s good for profit is good for those whose stolen time generates that profit.

---

All text above by: Evan Calder Williams. "On Paralysis, Part 3". e-flux Journal Issue #147. September 2024. Published online at: e-flux dot com slash journal/147/624989/on-paralysis-part-3/. [Bold emphasis and some paragraph breaks/contractions added by me. Text within brackets added by me for clarity/context. Presented here for commentary, teaching, criticism.]

[rjzimmerman]

Excerpt from this story from Grist:

As a prominent Democrat, Gore’s impassioned advocacy has been blamed for making climate change seem like a liberal thing to care about. To Gore, that’s an example of attacking the messenger without looking at the deeper reasons why climate change is politically contentious in the first place. “Even when Pope Francis, for goodness’ sake, speaks out on it, they attack him and say that he’s meddling in partisanship.” If there’s anyone to blame for polarization, he said, it’s the fossil fuel industry, which has tried to take control of the conversation about climate change. 

“This is the most powerful and wealthiest business lobby in the history of the world, and they spare no effort and no expense to try to block any progress,” Gore said. “Whoever sticks his or her head up above the parapet draws fire from fossil fuel polluters, and they use their legacy networks of economic and political power to try to block any solutions of any sort that might reduce the consumption of fossil fuels.”

In his decades of talking to the public about climate change, he says he’s learned a few things. You have to keep in mind a “time budget” that people will give you to speak with them, as well as a “complexity budget” so that you avoid dumping facts and numbers onto people. Finally, he says, you need to allot a “hope budget” so they don’t get too overwhelmed and depressed.

Even while progress has been slower than he’d hoped, Gore sees signs that things are moving in the right direction. Last year, 86 percent of new electricity generation installed worldwide came from renewables, for example. Not to mention that Congress, where climate legislation had long gone to die, finally managed to pass a landmark climate law in 2022, the Inflation Reduction Act, which aims to drastically trim U.S. emissions through green incentives and rebates. 

“It’s the kind of challenge that is so compelling — once you pick it up, you can’t put it back down again — because it really requires any person of conscience, I think, to keep working on it until we get the kind of progress that’s needed.”

[hygienix123]

Why Hygienix Hospitality is the Leading Supplier for Housekeeping Materials

In today’s fast-paced world, maintaining cleanliness and hygiene is a top priority for businesses across various sectors, especially in hospitality, healthcare, and corporate environments. For such establishments, having reliable and high-quality housekeeping materials is essential. One company that stands out in providing these critical supplies is Hygienix Hospitality.

[literary-illuminati]

2024 Book Review #39 – Inglorious Empire: What the British Did To India by Shashi Tharoor

I honestly forget who first recommended this book to me – quite possible I just googled ‘good indian history books’ and found it that way? - but it’s been on my TBR list for functionally forever at this point. Which meant I went into it essentially blind, with no memory of what if any details I’d been given with the recommendation. Which meant I had a moderately disappointing reading experience just because I was hoping for a narrative history and not an explicit polemical/persuasive text. Still, taken on its own merits as one of those, it’s really quite a good one.

The book is an adaptation and expansion of a performance the author gave at an Oxford debate (arguing against the notion that the British Empire was a good thing) which was recorded and went viral enough to make it a commercially viable prospect. The origin story shines through in the form – aside from an introduction and conclusion, each chapter is a clear and specific argument against some specific justification offered for the British conquest and colonization of India, full to bursting with statistics and quotations buttressing every point.

I would very much like to say that most of it is devoted to stuff the average reader will know anyway (if illustrated with clear and affecting examples), but, going by the apparent public response to the original debate and some polling cited in the conclusion, apparently not! The YouGov polls about the English public’s knowledge and opinion of the Empire are bleak enough that yeah this probably is a direly needed work of public education, if mostly for people who will not at any point read it.

Still, the fact that the British Raj was explicitly and institutionally racist and reserved functionally all positions of real power and authority for white men shouldn’t be much of a surprise, nor the fact that the ‘rule of law’ was basically a sick joke as far as crimes across the colour line went, nor the fact that the extraction of wealth from India to make fortunes in Britain was the explicit goal of policy, nor the fact that resistance (especially resistance successful enough to spook the authorities) was responded to with utter and excessive brutality. All that is basically the meat of what having been a colony means.

That said, I was taken a bit aback by the sheer rapaciousness of early Company government – it’s one thing to hear about oppressive taxation, another to get quoted the census figures of how they were so extreme that enough peasants fleeing their land and homes to look for greener pastures to show up as overall population decline in the areas under HEIC control. Similarly, my understanding of how India was turned into a captive market for British goods was much more subtle and indirect than the outright smashing of looms and legal prohibition of any attempts to compete with British industries that were actually used.

Whereas I did know about the deadly famines that kept occurring throughout the Raj, but the sheer cartoonish malevolence of colonial authorities when faced with them always manages to shock me a bit. ‘Nature’s solution to overpopulation’ was a really horrifyingly opinion at the time.

The audience of the debate performance the book’s based on definitely shines through in the choice of sources – wherever possible, Tharoor quotes from or cites western (Anglo-American, generally) sources for his eye-witness accounts and always takes care to introduce and ground them in terms of western governments or academia. The quotes themselves are all helpful illustrations, though there’s probably slightly more than are really strictly necessary – I’m pretty sure by wordcount at least a chapter of the book was actually written by Will Durant.

I’m not sure if it’s because of the original format or just how Tharoor writes, but the book also just has a great love of adjectives. Seemingly every source referenced is ‘historic’ or ‘path-breaking’ unless it is merely ‘compendious’ or outright ‘invidious’. Not a bad thing, but once I noticed it I was totally unable to stop doing so.

The book is straightforward polemic and Tharoor makes no bones about his position, so I take his verging-on-idyllic descriptions of pre-colonial Indian governance (especially regarding land tenure and caste) and the probability that India would have unified into a modern nation state without colonialism a dose pour of salt. There’s a few other inaccuracies I noticed (referring to the East India Company’s theft of Chinese tea plans as the ‘birth of agricultural espionage), for example), but it was all in the realm of little asides or colourful anecdotes rather than anything load-bearing.

It is rather funny that the book repeatedly draws comparisons with French colonies to argue that India was worst off, on the grounds that Paris at least made gestures towards integrating Indochina or Algeria and their peoples into France (however inadequate and hypocritical those efforts were), whereas in India the maintenance of total domination and the clear policy that India and Indians were things to be exploited for the benefit of England never changed. Funny, because from the book of Vietnamese history I read a few months ago the perspective of nationalists in Indochina was quite the reverse, seeing the English as at least somewhat honest brokers who were willing to grant some level of (limited and inadequate) self-government, compared to the French. Grass is always greener, I guess.

Though that does get at Tharoor’s argument as to why the British were worse not just in degree but in kind to the Mughals and any other empire-builders from outside South Asia who had come before them. The Mughals became Indian, both in the simple material sense that all their taxes didn’t end up back in Samarkand and Indian merchants were intentionally ruined for the benefit of traditional central asia trade routes, and in the more cultural sense that the ruling class set down roots and intermarried with their subjects rather than establishing a cloistered ruling class. Instead, the Raj was more akin to Tamerlane’s sack of Delhi, extended across 200 years. (One gets the sense Tharoor thinks a permanent settler population moving into stolen palaces would have been preferable to the rotation of soldiers and officials arriving from the metropole for long enough to get rich before heading back to build mansions in the Home Counties.)

Also, speaking of Vietnamese history, I only have a sample size of two but it’s interesting how in both cases a class of liberal (in the western sense) intellectuals and bourgeois emerged who tried to take the colonial propaganda at its word and enter some sustainable partnership with the imperial power – and in both cases got at best ignored and at worst imprisoned, tortured and executed for their trouble.

Anyways, interesting read, if one that makes me want something more specific and rigorous about basically any specific section of it (though, not to jump up and yell ‘Canada Mentioned!’ but every time Trudeau was used as an example of a colonial power’s leader handling the apologizing and acknowledging stuff gracefully and well I had to really try not to laugh).

[alezangona]

The Shadow of Khansar (Salaar Fic)

Part 9 - The Monster and His Master

Part 8 | Part 10

Notes: Definitely NSFW

The next few months pass by in a blur, albeit a productive one. Khansar’s funds are carefully allocated across various administrations with special emphasis placed on programs pertaining to education, public health, and infrastructure. The government’s focus on foreign policy allows them to settle contracts with various energy management companies across the world to provide solutions for the electrical and water shortages occurring in their external agricultural territories. The continuous expansion of global strategies provides opportunities for reallocation of employment through various industries including manufacturing and trade, though Khansar stays vigilant in maintaining a diplomatic image by hiding its more profitable ventures away from prying eyes. 

Change doesn’t come as fast as Varadha initially hopes, the truth being that mistakes occur more frequently than not and it is enough to give him pounding headaches that won’t subside. Moments of high stress are all it takes for him to retreat into himself, gaze faraway as he analyzes every possible solution over and over, a heaviness settling into the line of his shoulders.

During breakfast one morning, when Varadha is toying more with his food than eating it, Baba finally cracks. 

“The responsibility of this kingdom is not yours alone, Beta. There are entire organizations and administrations working alongside you to find solutions to the issues we are facing. Let them do their jobs, while you do yours. Not every burden is yours to bear.” Then he lets out a small smile. “Anyway, it’s important for you to learn the importance of a good stroll over a hasty run. What you’re doing now is establishing a strong foundation for Khansar’s growth and longevity. Take that for granted and you’ll give way for its fall.”

Varadha doesn’t finish his breakfast that morning and he doesn’t miraculously stop worrying either. Still, he begins to notice just how much people care. It isn’t just his face worn from sleepless nights and early mornings. It isn’t just his eyes that contain a spark of determination in the face of challenges. 

The reassurance is enough to let him sleep a bit more peacefully at night. It also helps that he feels less alone than he has in years. Particularly in moments of leisure that are spent in the presence of his loved ones. 

Morning garden strolls with Baba as he talks about his life and his Noor. 

When she’d leave for her business meetings, I wouldn’t know how to handle myself. So anxious and restless till she came home. Time used to stand still without her, but in her presence, every day would pass by faster than a strike of lightning, and just as beautiful too. I’ve had years with her… it still doesn’t feel like it was enough time. She’d be proud of you, if she was here to see you now.

Afternoon chaturanga sessions with Baachi as he curses out Varadha for winning every round. 

I still look over my shoulders sometimes, waiting for someone to fuck with us. We’ve endured years of humiliation and it feels like there’s more to withstand. I’m still not used to the way people look at us with respect when we leave the palace. I’m thankful for what we have Anna, and I’m scared to lose it too— Fuck! Again? What’s the point in playing with me when you keep winning anyway? 

Evening movie nights with Deva as they curl up on the couch, shedding their responsibilities and falling into domesticity. 

I don’t know how I did it, but I’ve managed to convince Amma to come back to Khansar. I think the only reason she’s even budging is because I’ve been begging her to come back with me and telling her it’ll be different under your rule. Even then, she’s hesitant about staying anywhere in the capital. I don’t know if I can convince her to stay in the palace, not without putting her ill at ease. After everything she’s done for me, I have to draw the line on her behalf at some point. I’m thinking of getting her a place at the outskirts of town. I’m going to hate not seeing you every night, though.

That doesn’t end up becoming a problem for too long. The first night that Deva stays away at his mother’s new house, Varadha tosses and turns for hours on end, restful sleep alluding him. His cranky mood the next morning has the entire palace walking on eggshells. That is, until Deva enters the council room later on in the day for one of their meetings. They stay on different ends of the room, but when their gazes meet, the exhaustion drains visibly from their bodies and the palace is able to breathe once more. 

“Come home with me tonight?” Deva asks once they leave the room, walking shoulder to shoulder. Varadha’s step falters for a second before he goes back to matching Deva’s stride. 

“What?” Varadha carefully observes their surroundings, staying alert until he’s sure there’s no one else around them. 

“For dinner, you idiot.” Deva’s lips quirk. “Not some clandestine meeting of lovers.”

“Can’t fault me for checking, Bangaram. I never can tell what’s going on in that filthy mind of yours.” Varadha shrugs, biting the inside of his cheek to hide his smile.

“Yes, because I’m dying for a chance to ravish you in my mother’s home.” Deva rolls his eyes, but takes a step closer to him anyway, bending down so his gravelly voice can whisper. “Though… why bother with the wait when I can fuck you in that closet instead?” 

~*~

The first dinner at Amma’s ends up being more awkward than Varadha thought possible. As inviting as she is, there’s a prying gleam in her eyes as she observes the two of them, trying to gauge what could’ve happened during the past few months for her son to willingly return to this godforsaken place. To move her here as well. He finds himself trying to impress her for some reason, telling her about all the changes he and his team are trying to bring about to the city. If he was being honest with himself, for a moment it felt like the words were being forcefully ejected from his mouth, anxiety refusing to let go of the trigger. However, when there is a lapse in conversation after dinner while they put away leftovers, Varadha catches a glimpse of Amma looking at him with a relieved expression. He doesn’t know what it means, but is able to breathe easier when she sends him off with a box of leftover chepala pulusu (fish curry) and tells him to come visit again soon.

The weekly dinners end up becoming a reprieve for Varadha when he starts to realize just how much he feels like a kid again under Amma’s roof. Gone are his responsibilities of being Karta when he steps into the threshold. She acts with him as she always had, feeding him exorbitant amounts of food, reprimanding him for not sleeping enough, and even going to the extent of massaging his scalp when he confesses to her of the pounding headache he’s suffered with for days. 

His eyes close at the feeling of her fingers running through his scalp, the smell of medicinal oil oddly pleasant and soothing as she works the tension out from his muscles. Amma continues to talk to him, voice low and pleasant as she urges him to take better care of himself and something breaks inside him. A ball lodges in his throat and he can feel wetness forming behind closed lids. When they flicker open, Deva is standing in front of him, a glass of water in hand. Concern immediately clouds his features and he shifts his body forward, only to stop when Varadha discreetly shakes his head, a wobbly smile forming on his lips. 

“Stay here with us tonight,” Amma commands, unaware of the plight he’s facing. “The second you go back to that palace you’ll spend the night overworking yourself and I refuse to let you run yourself into the ground. Deva, go set up the guest room and don’t let him leave till tomorrow morning.”

Later that night, once Amma is asleep, Deva sneaks into Varadha’s room, crawling into bed and holding him tight. 

“Are you okay?” Deva sighs against his ears when Varadha doesn’t answer immediately. “Amma ki chadastham ekuvara, anthe (Amma is just stubborn, that’s all). I’m sorry if what she said hurt you at all.” 

“No, she didn’t do anything wrong.” Varadha gulps, pressing back into Deva. “Amma gurthukuochindi, ra (I remembered my mom).” 

Deva doesn’t reply, choosing to press a kiss into Varadha’s hair, wrapping his entire body around his lost king and trapping him within the confines of his limbs. Varadha sleeps more peacefully that night than he ever has during the past few months.

The next morning as Amma sends them out of the house, she stops Varadha in his place, a hand wrapped around his arm. 

“I’ve been keeping an eye on you two since you were children. Karta and Salaar aside, when it comes down to it, you’re just two kids who’ve been forced to grow up too soon. Don’t let those titles define you for the rest of your life, nana. Don’t make the same mistakes as…” The way her gaze digs into his is enough to make him understand, so he nods back, a promise in his own right. 

She lets him go.

~*~

The peace doesn’t last long, it hardly ever does in a world like theirs. 

They start hearing of various raids across India that begin to interfere with their black market trade. Before they can consider taking action, casinos, brokerages, and banks partnered with Khansar are stormed in an effort to prevent money laundering and other illegal activities. Trucks containing various goods such as weapons and drugs are stopped en route, all the material seized and confiscated by the government. A frenzy erupts in the capital as calls are made to various seeds and contacts planted in India, demanding answers for the sudden crack down. The answer, it turns out, is rather simple.

The government of India aims to fight back against crime… to fight back against Khansar. 

It’s not an answer that sits well with anyone. Definitely not Varadha as everyone in his court looks to him for answers. Tensions rise every day in Kotagada as the Doralu debate with their Karta about the best course of action to take to preserve their economy. In the end, there is nothing but disdain as the court adjourns, no real solution to be found. 

For the time being, the best course of action is to be more discreet and careful than usual. They run checks on their supply chain to prevent security breaches. Only certain businesses are given access to trade after a thorough inspection process. Different routes are established, intricate and ever changing, with smaller shipments being sent out at a time. Overall, it’s not a perfect system, but it’s enough to get them by.

~*~

Deva’s eyes stay firmly planted on the ground and he hopes that Baba will finally break the silence. He doesn’t. He holds his cap in his hands, leaning back against the chair as if his age has finally caught up to him. Bilal doesn’t seem to be of much help either as he paces back and forth, carefully avoiding Rhinda who scowls at the wall with his arms crossed over his chest. 

The creak of a door opening snaps them to attention. Varadha steps out, face void of any emotion as he jutts his chin. 

“You can go see him now, if you’d like.” Baba doesn’t wait for him to finish the sentence before he disappears through the door. 

“I didn’t even know he could move that fast.” Rhinda tries to joke, but no one laughs. He doesn’t look too amused either as he falls back into his chair. 

Varadha makes his way to the large window, fists clenched at his sides. Within seconds, Deva is next to him.

“The name of Khansar was enough to stop them not too long ago. Now they’ve attacked us at the heart of it.” Varadha’s hand clasps ironclad around Deva’s tattoo. “I want them dead. Each and every person who dared to lay a hand on him.”

“As you command, Karta.” 

“The thought of Khansar alone should terrify them. Touch what belongs to us–”

“You pave the path to your own destruction.”

The Karta’s fist drops back down to his side and his weapon is released. 

~*~

Death for anyone who stops the seal. 

That is what Deva declares. No one in court bothers to argue. Not when it was a law that would benefit their own economy. Even if they did object, they wouldn’t challenge the monster who just committed a massacre to please his master. 

Rakshasudu.

That is what they begin to call him. Not to his face or the Karta’s. Not in scorn either, but in awe of the sheer power that he exudes. The new name becomes a declaration of acceptance. 

A violent man for a violent city. 

~*~

“A symbol. All that it brands, belongs to you.” 

The simple phrase from Deva’s lips ignites a raging fire within him. Varadha’s eyes darken in the confines of the room, gaze honing in on the devil’s mark stamped against Deva’s bare chest. 

“Come here.” Varadha commands. He watches as Deva saunters towards him, the glow from the lantern casting shadows onto his rugged physique. His fingers ghost against the seal, drinking in the intricate artwork that decorates tanned skin. The eyes of the devil leer into him, ferocious teeth barred in contempt. It was nothing more than a small circle of ink, able to fade away with the swipe of a finger. Yet, it possessed the ability to shake an entire nation to its core. 

So much power in such a small symbol. 

And the man who imbued it with that power stands before him, beautiful and pliant, his face sculpted to express unbounded devotion. 

Varadha’s hand darts out, fingers wrapping around the underside of Deva’s jaw as he tugs him closer. Deva breathes sharply, surprised by the action, but doesn’t move. He waits patiently, unblinking as Varadha leisurely devours the length of him. In a sudden flash, Varadha turns him around so that Deva’s back is pinned to his front. Deva catches a glimpse of the image in the mirror planted across from him, a pathetic whimper leaving him at the sight.

Varadha’s eyes penetrate through the reflective surface, dark, calculating, and aroused. His fingers dig into Deva’s pulse point as his other hand travels down the expanse of his torso, nails scraping against sensitive skin, eliciting a feeling so strong that Deva’s eyes flutter shut and he arches back into Varadha, desperate for a taste. The furthest he can get is the brush of his lips against the side of Varadha’s jaw before he draws back with a tut.

“Salaar,” The warmth of his breath fans against Deva’s ears, the smoky tone exhilarating him further. “My Salaar. So beautiful when you give yourself to me like this.” His hand slips further down, stopping at the bulge between Deva’s thighs. His fingers dance against the sensitive flesh, featherlight touches that have Deva working to hold back keens of frustration. That is, until Varadha palms him through the fabric of his jeans, the firm touch causing Deva to release a low moan. 

“Va–” The name catches in his throat when Varadha’s grip tightens around his neck significantly. Varadha’s lips begin to explore the curve of Deva’s nape, sharp bites that prick into his skin, only to be soothed by the gentle slip of his tongue. Varadha hums softly into him, slotting his hips against the curve of Deva’s ass and pressing into him just enough to let his arousal be felt. Slowly, the hand that is wrapped around Deva’s throat begins to descend. Within no time, Varadha works Deva out of his jeans, hands circling against the heavy length of him.

“Open your eyes and watch what I do to you.” He growls, teeth catching onto Deva’s ear. Deva’s eyes flicker open at the order and he digs his teeth into his lips at the debauched image of him in Varadha’s arms. Hair askew, pupils blown, skin marked by claiming bruises. He lowers his gaze to where Varadha’s hands are pumping him unceremoniously, his thumb circling against his slit, collecting precum and spreading it across the throbbing surface. It doesn’t take long for Varadha’s hands to become coated with the evidence of Deva’s arousal and the sight itself makes Deva tremble with need. “You look beautiful like this. Pliant in my hands, flushed beyond belief, desperate for release.” 

Deva hisses as Varadha tugs against his balls, the mixture of pain and pleasure overwhelming him enough to close his eyes for a chance of reprieve. 

“Open your eyes, Salaar. I won’t tell you again. Take your eyes off the image of what I’m doing to you and I won’t let you come for me tonight.” The warning incites panic and Deva’s lids snap open, catching the merciless grin on Varadha’s face. “Good boy.” 

The motions of his hands speed up around Deva’s cock with varying pressure and Deva is forced to watch himself break, tremors spreading across his overstimulated body. His chest heaves with panting breaths, muscles clenching in an effort to hold back his inevitable release. As he watches from tear-filled eyes, Varadha’s reflection reshapes itself in the mirror, a smug curl of his lips as it dawns on him what Deva is doing. 

“Such a good boy, holding yourself back for my sake. I didn’t even have to ask, did I? You’re just that desperate to please me.” The throaty chuckle causes Deva to flush deeper and dig his fingers into the soft material of Varadha’s clothes. 

“Please.” Deva groans, on edge. A tear rolls down the corner of his eye and satisfaction paints itself across Varadha’s features.

“Come for me, my beautiful Salaar.” A gasp leaves Deva’s lips, his cock twitching as the sticky residue splatters against the skin of his stomach. His eyes close and he leans back against Varadha, spent as his orgasm flows through his system. He can feel Varadha’s arms wrapping around his waist, lips brushing against his ears as he whispers sweet nothings while pleasure settles into his bones. 

By the time Deva is able to ground himself enough to open his eyes, he catches sight of Varadha’s gaze drilling into the seal stamped against his chest. A shudder of pleasure rocks through him when Varadha pushes him onto the bed, his hand curling around the dark mark, a wildness in the depth of his kohl rimmed eyes that has Deva hardening once more. 

“Mine.” Varadha places a searing kiss against his lips, stealing his soul from within the confines of its cage. Deva gives back just as much as he gets, wanting nothing more than to have Varadha understand that his entire life belongs to him and only him. By the time Varadha pulls away, stripping out of his shirt, Deva’s kiss-slick lips whisper back words of reassurance.

“Yours, always yours.”

[secularprolifeconspectus]

I sent you a question about Trump and reproductive rights, thank you!

I’m very scared on the perspective of ban of contraception and birth control, I’m terrified to lose my freedom. His VP is extremely religious (even though he loves f*cking couches, very spiritual of him😭). The thing is, that there are so many political and religious extremists (Nick F*ntes, everybody?) that already claim that “your body [his woman’s body] is MINE”, which is scary AF.

I’m disabled, and even though I love kids wholeheartedly and wish to have them in future, I can’t have those Mormon families with 5+ kids. Respectfully, I’m not a breeder. It will fully destroy my health and I feel horror inside. It may kill me. Or what about r@pe? I can’t run away on a wheelchair. Those people don’t care about babies lives, are they really pro-life? They want to make women their slaves. I highly doubt any of them care about babies fr.

What’s the realistic chance they will try to implement it or do you think it’s just a wet dreams of neo-n@zis? And do you know how I can help myself?

Thank you! I’m truly horrified. I will appreciate any help and resources.

Obviously I condemn the "your body, my choice" thing. It is scary, and disgusting. Not only does that violate bodily autonomy, but it also is a justification for abortion. I still hold that bodily autonomy does not include violence, which is what abortion is.

However, restriction of contraception is an attack on autonomy. The problem is that many people lump abortion and contraception together as matters of sexual morality, but this is a categorical error – abortion is a matter of life or death. Again, I don't actually believe the extreme right will (successfully) come for contraception. And if they get close, we won't let them succeed; I'll join you in the streets.

Of course you're not a breeder, no person is (so don't let the abortion industry use you as one for their profit). Pregnancy doesn't usually become high-risk until after viability, so keep in mind that early induction may be a solution, and many conditions are preventable/manageable well before that. Emergency contraception ought to always be available to rape victims; even the Catholic Church would object if that were to be restricted.

I personally hate equivocating on what's really "pro-life"; it means anti-abortion, no more and no less. However, I have always agreed that it's hypocritical to support prenatal protections while holding policy positions that facilitate death outside the womb. It is frightening and frustrating how many people are pro-life for the wrong reasons. That being said, I think your average conservative doesn't want to treat anyone as slaves, and is generally caring.

So yeah, I mostly think it's neo-fascist nonsense and neoliberal fearmongering. Do I think the far-right is capable of monstrosities? Yes, I believe they have that power. But I also believe the GOP base is more socially moderate than the party, as are many of its politicians personally, and we've seen it respond to that. While Project 2025 is threatening, I also don't think it's got popular support.

So while I remain wary, and I think you should too, I'm also remaining realistic, and I really do think we will be alright. And if things become not alright, I trust my comrades will mobilize, fight back, and take care of one another, and in that way we will still be alright. No need for horror. Lessen your reliance on The State. Help yourself by finding your comrades and building networks of care. Radical hope is praxis. We keep us safe.

[mariacallous]

Almost one in five Americans over age 65 are unable to manage basic activities of daily life—bathing, dressing, eating, toileting—without assistance. Among those over age 85, the proportion is closer to half. Friends and family members can and do help out, but even so, about half of people reaching the age of 65-years of age will use paid long-term services and supports (LTSS) at some point. Most Americans do not have enough income or savings to cover these costs. The private long-term care insurance industry has never worked well despite many creative efforts to fix it and to encourage enrollment. The Federal Medicare program covers only short spells of home care after a hospitalization and does not provide coverage for long-term support. That leaves Medicaid. Medicaid offers a critical long-term care safety net for people who get their healthcare primarily through Medicaid—but it isn’t a good solution for most Medicare beneficiaries as it doesn’t align with the system that manages their care and pays their providers. Moreover, eligibility for Medicaid is restricted to those with very low incomes and few assets, so few older adults qualify. It is well past time to add a universal home care program to Medicare itself.

Prior efforts to move in this direction have been stymied. Some proponents have called for a universal, open-ended benefit. Critics have argued that any universal home care benefit would be a budget buster. These tensions are ubiquitous in social program design. An additional tension in designing a program that serves people towards the end of their lives is that public funds should be focused on expanding access to necessary care rather than protecting the ability of people to leave large bequests to their children. Designing a fiscally responsible, universal benefit that does all that is a challenging task—but we believe it is not an impossible one. In this post, we describe some design options for a Medicare home care benefit that could be dialed up or down depending on the priority assigned to program generosity or fiscal feasibility. 

Several features make designing a universal home care benefit challenging.

The need for home care is based on measures of functioning, not lab tests. A program must have simple and reliable ways to measure who needs care and how much care they need.

Most people report a preference for care in their own homes over that in nursing homes or other institutional settings. This is because, unlike medical care, which is often unpleasant and painful, home care typically provides support, comfort, and a degree of safety for beneficiaries. One consequence of these preferences is that a home care benefit would be susceptible to overspending. The program will need to have measures in place to avoid overuse.

Income alone is a poor indicator of how much Medicare beneficiaries can afford to pay for home care. For example, beneficiaries who are renters may depend on their incomes to afford housing; other beneficiaries may have very large, non-liquid assets but limited incomes, leaving them ineligible for Medicaid programs while unable to pay for care. Program design will have to address the importance of assets in this population.

Much LTSS is provided through informal care. Beneficiaries often prefer care provided by family members, but paying for informal care raises the potential for overspending, fraud, and exploitation of older adults.

State Medicaid programs currently cover the cost of home care for 4.2 million people, according to KFF, though eligibility and costs vary considerably across the country. Medicaid would continue to provide home and community-based services for people who are not Medicare beneficiaries. Some of this spending could be redeployed by states to improve the quality of nursing home care and for home and community-based services for people who are not eligible for Medicaid. The federal share of Medicaid savings could be used to defray the costs of a new Medicare home care program.

None of these challenges can be ignored—but none of them are damning either. As with any program, policymakers will need to make tradeoffs across these challenges to design a program that provides the maximum benefits consistent with their budget appetite. The good news is that the current landscape of home care financial protections is so limited that even a modest program that made conservative choices across these parameters, with costs we estimate at around $40 billion annually, would make many people who currently lack services much better off. Turning the dials more generously would, of course, cost more—and it would extend more benefits to more frail and vulnerable Medicare beneficiaries. 

What might such a very-conservatively designed universal program look like? Eligibility for the program would be restricted to people who independent clinical reviewers determined were unable to perform two activities of daily living (e.g., bathing, toileting, or eating). That’s the standard that many State Medicaid programs already use, and it could be assessed annually during the initial implementation period to further develop and monitor the uniformity of functional assessments over time. Second, the program would include cost-sharing that varied according to people’s means. Medicare beneficiaries with high income and assets would receive modest assistance from the program to defray a portion of the costs of home care; those with fewer assets and less income would pay much less. Third, beneficiary contributions to the costs of their care would depend on both their current income and their accumulated assets, but through cost-sharing rather than a strict cutoff. For example, at the cost listed above, we could allow all qualifying Medicare beneficiaries to fully retain income up to 150% of the poverty line ($22,600 in 2024) and assets up to $30,000; beyond that limit, individuals would still qualify but would pay cost-sharing out of their resources to defray taxpayer costs. Fourth, only care provided by formal caregivers associated with home care agencies would be covered. Hours of support would be based on need, but provider agencies would be subject to a population-based hours of service budget. The combination of resource-based copayments with population-level budgeting will ensure that the costs of this program will not explode. Finally, Federal Medicaid savings from shifting home care benefits from Medicaid to Medicare would be used to defray the costs of the program.

The program we’ve outlined tightly focuses benefits on the most vulnerable people who currently have little eligibility for care, and few means to pay for services. But many others could also benefit from a new home care program. People who have impaired functioning that does not meet the two activities of daily living standard may also need assistance. Lower cost-sharing for middle-class people would leave them more resources to make the most of their lives. The tradeoff is simple: at a higher cost to the federal budget, more people would get more protection. We can’t define where the lines should be drawn—that’s Congress’s job—but our analysis suggests that there are programmatically tractable, fiscally feasible ways to add a home care benefit to the Medicare program.

[bright-and-burning]

some highlights from this 2004 adam norris money marketing profile:

"There are few managing directors younger than Adam Norris of Pensions Direct, the pension arm of Hargreaves Lansdown. At 33, he has achieved a higher level in the industry than most do in their entire career." "Norris quips that early retirement would be readily available to him yet it is a very unattractive option. 'I do not believe in going to the office for the sake of it. I enjoy every day of my working life. I am lucky enough that my work is also my hobby. The day I stop enjoying it is the day I will retire.'" "He also takes his hobbies very seriously and, before entering financial services, spent a year in Europe pursuing a career as a tour cyclist. He trained in Belgium with the hope of becoming a serious competitor in the Tour de France. While not making it as a professional, he did come back to the UK with a new outlook and a wife." "Yet Norris maintains he still only works regular hours and prefers not to work later than 5.30pm if he can help it. He refuses to take work home. 'It is a matter of working smarter rather than harder, which is something we need a lot more of in the financial services world.'" "Comments like these demonstrate Norris's forthright pragmatism, that seems to stem from his structured, mathematical training as an engineer and his hard-work ethic, which he says is a result of growing up with dyslexia and needing to work things through. 'I have become very good at learning and observing the world through truly different eyes to everyone else. If you cannot spell, who cares? Working out solutions to difficult problems and understanding the world we live in is vastly more important.' This is a tenet he aims to pass on to his children through real-life experience. He has bought a small farm in the West Country where he has sheep and other animals. 'Real-life experience is most important for a good grounding in anything. I am always conscious that financial services is a world unto its own and, the more of the outside world you see, the saner and more balanced you are.'" "Education: BEng, University of Leicester Career: 1993-95 financial adviser, Acuma; 1995-98 IFA for small brokerages in Bath and Bristol; 1998-present managing director, Pensions Direct, the pension arm of Hargreaves Lansdown Career ambition: To be the biggest shareholder in Europe's biggest IFA Life ambition: To enjoy every day Hero: Doesn't have one Likes: Jam sandwiches Dislikes: Marmite Drives: Porsche 911 convertible"