HEALTH CARE REFORM: Chapter 11

Division C of the bill, which begins on Page 855, is entitled Public Health and Workforce Development. The first provision gradually increases payments each fiscal year into a "Public Health Investment Fund".

Title I is about Community Health Centers. The first provision increases funding for such centers. It's actually the only provision under this Title.

Title II is about Workforce. Subtitle A deals with Primary Care Workforce. Part 1 is about the National Health Service Corps. The NHSC is appropriated funding out of the above-named Public Health Investment Fund.

Part 2 deals with the promotion of primary care and dentistry (yay dentistry!). Medical students who agree to serve for at least two years as primary care providers in the NHSC in underserved areas are eligible for loan repayments. Provisions also deal with training for general, pediatric, and public health dentists and dental hygienists. The funding for all of these things come from the Public Health Investment Fund.

Subtitle B deals with the Nursing Workforce. Nurses can enter into agreements similar to those for physicians by agreeing to serve at least two years in underserved areas. The funding is through the Public Health Investment Fund.

Subtitle C is about the Public Health Workforce. These "public health professionals" can also agree to serve for at least two years.

Subtitle D entails Adapting Workforce to Evolving Health System Needs. Part 1 deals with Health Professions Training for Diversity. Part 2 deals with Interdisciplinary Training Programs, such as cultural and linguistic competency training. Part 3 establishes an Advisory Committee on Health Workforce Evaluation and Assessment. Part 4 deals with Health Workforce Assessment. Part 5 deals with Authorization of Appropriations.

Title III: Prevention and Wellness begins on Page 930 of HR 3200. Provisions deal with appropriations, setting national priorities, creating a Task Force on Clinical Preventive Services and a Task Force on Community Preventive Services, coordinating research on prevention and wellness, establishing through grants a core public health infrastructure program.

Title IV: Quality and Surveillance begins on Page 964. The provisions deal heavily with the identification and development of "best practices".

Title V: Other Provisions begins on Page 979. Subtitle A deals with Drug Discounts for Rural and Other Hospitals. It's an amendment to an existing program. Subtitle B is about School-Based Health Clinics. The provisions establish through grants health clinics based in schools in certain medically underserved areas. Subtitle C deals with the National Medical Device Registry, establishing such a registry to facilitate analysis of postmarket safety and outcomes data on Class III or some class II devices (the FDA classes devices based on consumer safety; class I is the safest) used on or in patients. Subtitle D establishes Grants for Comprehensive Programs to Provide Education to Nurses and Create a Pipeline to Nursing. Subtitle E deals with States Failing to Adhere to Certain Employment Obligations.

Aaaaaaaaaaaaaaaaaaaand that's a wrap. HR 3200, 1017-page bill, read and analyzed, as my eyes saw it. Obviously the average American does not have time to read through the whole bill to figure out what's in it. I wish there were an official source for summaries of all (not just controversial) provisions. I believe THOMAS (http://thomas.loc.gov) provides summaries with the full text of the bill, but it's not always the easiest sort of thing to understand. Do I dare read the Senate HELP Committee's bill??? Or wait for the Finance Committee's bill?

HEALTH CARE REFORM: Chapter 10

Title VII is about Medicaid and CHIP. Subtitle A deals with Medicaid and Health Reform. Because Division A of the bill stated that all eligible Medicaid beneficiaries would be auto-enrolled absent other acceptable health insurance coverage, these provisions are important, establishing the procedure. Other provisions deal with the affordability credits discussed in Division A.

Subtitle B is about Prevention, requiring coverage of certain preventive services in Medicaid. Section 1714 contains a State Eligibility Option for Family Planning Services. States can choose to cover in their Medicaid program " family planning services and supplies...including medical diagnosis and treatment services that are provided pursuant to a family planning service in a family planning setting". Such services are only available to women who are not pregnant, so abortions definitely are not covered here.

Subtitle C deals with Access. Subtitle D deals with Coverage. Subtitle E deals with Financing. Subtitle F deals with Waste, Fraud, and Abuse. Subtitle G deals with Puerto Rico and the Territories. Subtitle H contains Miscellaneous provisions.

Title VIII, which begins on Page 819, is entitled Revenue-Related Provisions.

Title IX begins on Page 835 and contains Miscellaneous Provisions. For example, Section 1905 protects dual eligibles (at times the rules of Medicare and Medicaid can be in conflict with each other). That brings us to Page 854, the end of Division B of the bill.

HEALTH CARE REFORM: Chapter 9

Title V of this Division is about Medicare Graduate Medical Education, specifically about the redistribution of unused residency positions.

Title VI: Program Integrity starts on Page 685. Subtitle A deals with increased funding to fight waste, fraud, and abuse, appropriating an additional $100 million a year.

Subtitle B enhances the penalties for fraud and abuse. Subtitle C contains enhanced program and provider protections. Subtitle D deals with access to information needed to prevent fraud, waste, and abuse.

Title VI ends on Page 739.

HEALTH CARE REFORM: Chapter 8

Title IV is entitled Quality. Subtitle A is about Comparative Effectiveness Research. The bill calls for a study on the effectiveness of "health care items and services".

Subtitle B deals with Nursing Home Transparency. Skilled nursing facilities would be required to develop compliance and ethics programs. The Department of Health and Human Services would be required to have a comparison feature of nursing homes with the information obtained from the study mandated in this bill on their web site. The bill calls for a standardized formal complaint procedure for all skilled nursing facilities, as well as a complaint resolution process. The bill establishes some minimum and maximum civil penalties based on certain types of violations. This subtitle is very detailed.

Subtitle C deals with Quality Measurements. The bill calls for the establishment of national priorities for performance improvement, such as those that have the greatest potential to decrease morbidity and mortality.

Subtitle D is the Physician Payments Sunshine Provision. The bill calls for financial reports on physicians' financial relationships with the manufacturers and distributors of drugs and other supplies that bill under Medicare.

Subtitle E deals with Public Reporting on Health Care-Associated Infections. Title IV concludes at the end of Page 658.

HEALTH CARE REFORM: Chapter 7

Title III is entitled Promoting Primary Care, Mental Health Services, and Coordinated Care. Its first provision creates an "Accountable Care Organization Pilot Program". The second provision creates a "Medical Home Pilot Program". The third provision creates payment incentives for selected primary care services. The fourth provision increases the reimbursement rate for certified nurse-midwives (although I have to wonder how many Medicare beneficiaries utilize such providers). The fifth provision is about coverage and waiver of cost-sharing for preventive services, such as prostate cancer screenings. The sixth provision waives the deductible for colorectible for colorectal cancer screenings "regardless of coding, subsequent diagnosis, or ancillary tissue removal". The seventh provision excludes clinical social worker services from coverage under the Medicare Skilled Nursing Facility Prospective Payment System and Consolidated Payment. The eighth provision covers marriage and family therapist services and mental health counselor services. I understand that some people have latched onto the idea that the government is going to intervene in their marriage, but they don't have to receive such services and have them covered by Medicare if they don't want to. The ninth provision extends the physician fee schedule mental health add-on. The tenth provision expands access to vaccines. Those 10 brief provisions bring us to Page 501 and the end of Title III.

HEALTH CARE REFORM: Chapter 6

Apparently my numbers for the doughnut hole were low on both ends, but the size and existence of this gap depends on which Medicare Part D a beneficiary is enrolled in.

Now we're looking at Title II: Medicare Beneficiary Improvements. Subtitle A is about improving and simplifying financial assistance for low income Medicare beneficiaries. Although Medicare is generally a MUCH better deal than any private insurance, beneficiaries are still responsible for a certain number of expenses themselves, so low income individuals are eligible for some subsidies. There are the so-called "dual eligibles" who are eligible for both Medicare and Medicaid.

Subtitle B is about reducing health disparities. Provisions include insuring effective communication, such as by providing reimbursements for linguistically and culturally appropriate services.

Subtitle C contains "Miscellaneous Improvements". They do seem pretty miscellaneous. For example, the months of coverage for immuno-suppresive drugs for kidney transplant patients is extended.

That brings us to Section 1233: Advance Care Planning Consultation.

The term "advance care planning consultation" is defined as a "consultation between the individual and a practitioner...regarding advance care planning, if...the individual involved has not had a consultation within the last 5 years. Such consultation shall include the following: (A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to. (B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses. (C) An explanation by the practitioner of the role and responsibilities of a health care proxy. (D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965). (E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title. (F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include-- (I) the reasons why the development of such an order is beneficial to the individual and the individual's family and the reasons why such an order should be updated periodically as the health of the individual changes; (II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and (III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy). (ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State-- (I) in which all legal barriers have beern addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and (II) that has in effect a program for orders for life sustaining treatment described in clause (iii). (iii) A program for orders for life sustaining treatment for a States described in this clause is a program that-- (I) ensures such orders are standardized and uniquely identifiable throughout the State; (II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional's authority under State law) may sign orders for life sustaining treatment; (III) provides traning for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and (IV) is guided by a coalition of stake-holders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association. (2) A practitioner described in this paragraph is-- (A) a physician; and (B) a nurse practitioner or physician's assistant who has the authority under State law to sign orders for life sustaining treatments.".

That's a lot of text, but I think it's very important to look very closely at what the actual text says (and keep in mind the concept of an advance planning care directive was bipartisan until Sarah Palin came out with the death panel nonsense).

In the first place, these consultations are not mandatory. All the language says is that physicians can be reimbursed, no more than once every five years unless there is a serious change in medical condition, by Medicare for such consultations.

In no way is the practitioner or the government dictating end of life care. The provider is to explain the options available. How dare practitioners tell patients they can name a legal surrogate in case they are incapacitated!!!!!!

Frankly, I don't see how this is not a GREAT idea. Seniors have a right to know their rights. If they decide that they want great medical lengths to be taken to preserve their life, so be it. If they would prefer hospice care, they have a right for that preference to be known and honored.

Personally, I almost feel like I should have a living will drawn up soon. I do not want extraordinary measures to be taken to preserve my life, even as a relatively healthy 21-year-old, if its quality will be severely diminished.

Critics of these consultations say that we are "trying to pull the plug on Grandma". End of life care, particularly in hospitals, is expensive, no doubt about that. These costs will continue to go up as health care advances and the Baby Boomers continue to age. But we're not dictating care! And in no way is this euthanasia! All the bill says is that once every five years, a Medicare beneficiary can have a consultation with a physician about their OPTIONS.

Some may OPT to create an "order regarding life sustaining treatment", which is defined as "an actionable medical order relating to the treatment of that individual that-- (i) is signed and dated by a physicial or another health care professional (as specified by the Secretary and who is acting within the scope of the professional's authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care; (ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual; (iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary)".

How dare we document these preferences, which "may range from an indication for full treatment to an indication to limit some or all specified interventions".

This information would also be published in the "Medicare & You Handbook" distributed to beneficiaries.

Maybe it's me, but I don't detect anything sinister.

At all.

I think it would be a shame for someone who would want to have his preferences known not able to create such an order because he would have to pay his physician out of pocket for it.

There are a few other provisions, but basically that brings us to page 443 and Title III.

Edward M. Kennedy, 1932-2009

Obviously we must take a minute to remember the Senator who championed health care reform. Say what you will about Ted's personal life, but the Lion of the Senate was a very dedicated lawmaker, working tirelessly towards the passage of such hallmarks as the American with Disabilities Act and SCHIP. My thoughts are with the Kennedy family.

Sadly, I'm not sure what Ted's death will mean for health care reform. Many believe that if he had not been so ill, much more progress would have been made already in terms of formulating a bipartisan compromise, his forte despite being an extremely liberal senator. His death presents a banner for the health care reform reform movement, as he truly did champion health care reform his entire 47-year Senate career. Unfortunately, the vacancy will probably not be filled quickly, and Senator Robert Byrd's health is very unwell, so the 60 votes will be tricky to find.

RIP, Ted.

HEALTH CARE REFORM: Chapter 5

Division B deals with Medicare and Medicaid improvements. It really is the bulk of the bill.

Title I is entitled Improving Health Care Value. Subtitle A contains the provisions related to Medicare Part A, which is the hospital insurance aspect of Medicare. Part 1 of this subtitle deals with "market basket updates". Market baskets are a measure of inflation, so here reimbursements seem to be updated to keep up with inflation.

Part 2 of the subtitle is "Other Medicare Part A Provisions". For example, here we find a change in the "recalibration factor" for skilled nursing facility reimbursement. Another provision is a study of Medicare DSH payments (disproportionate share, extra payments to hospitals who treat a lot of Medicare and low-income patients) in light of more low-income patients being insured through Division A of the bill.

Subtitle B contains provisions related to Part B, which is the medical insurance Medicare component. The first provision here deals with sustainable growth reform. The next section singles out some potentially misvalued codes under the physician fee schedule. The third section is about incentive payments for efficient areas. The fourth section modifies the Physician Quality Reporting Initiative (PQRI). The fifth section adjusts the Medicare payment localities.

Part 2 of Subtitle B is about market basket updates. Part 3 is about other provisions, such as modifications to Medicare's involvement in the rental and purchase of power-driven wheelchairs. Another important provision calls for a study evaluating the difference between the costs incurred by cancer hospitals and the costs incurred by other hospitals when treating Medicare patients with cancer.

Subtitle C is provisions related to Medicare Parts A and B (tricksters, I was expecting Part C).

The first provision is about reducing potentially preventable hospital readmissions. I think this idea is somewhat controversial in that it seems to penalize hospitals when their patients are readmitted. However, from my understanding of the language, hospitals are paid a certain amount when their Medicare patients are discharged, and these discharge payments would be reduced. These payments will be reduced taking into account the hospital's "excess readmission ratio". Certain readmission cases for certain conditions are excluded from counting. The idea is to create an incentive to prevent, when possible, readmissions. Targeted hospitals would receive additional payments to be used for transitional care activities to address the patient noncompliance issues that result in higher than normal readmission rates.

Another provision deals with self-referrals and hospital ownership interests held by physicians. There is a prohibition on self-referrals under Medicare. There are exceptions to this exception for rural providers and in certain situations of hospital ownership.

Subtitle D is Medicare Advantage (Medicare Part C, basically private plans, often with prescription drug coverage, offered to Medicare beneficiaries) reforms. Each Medicare Advantage plan will receive a quality performance score. Improvement will also be tracked. Plans that do not provide performance data will automatically be ranked as the worst plans.

Subtitle E contains improvements to Medicare Part D (private prescription drug plans offered to Medicare beneficiaries; some Medicare Advantage plans contain a Part D component). The first provision sets out a schedule for gradually eliminating the coverage gap (known as the doughnut hole where beneficiaries have to pay out of pocket 100% of prescription drug costs once their total drug costs are over $2400 until they reach $3850; not all plans have this gap in coverage).

Subtitle F contains Medicare Rural Access Protections. The first provision is about telehealth expansion. Telehealth already seems to be utilized, especially in rural areas, and the bill creates a Telehealth Advisory Committee to establish what services are appropriate to be delivered in this manner.

This subtitle brings us to page 385 and the end of Title I of Division B. I haven't gone in to a lot of details on these provisions, largely because they all seem to be pretty non-radical (no death panels, that's coming up) amendments to Medicare that will probably get passed even if the health care reform bill dies. But I really want the government to stay away from my Medicare! That would be awful!!

HEALTH CARE REFORM: Chapter 4

Title IV is amendments to the Internal Revenue Code of 1986, starting with Subtitle A: Shared Responsibility.

Section 401 establishes a tax on individuals without acceptable health care coverage. The tax is 2.5% of the taxpayer's modified adjusted gross income for the taxable year, over the amount of gross income to be established later. The tax imposed cannot exceed the applicable national average premium for the year. The tax can be prorated for part of the year. There are exemptions for individuals living outside of the U.S. and individuals living in possessions of the U.S. There's even a religious conscience exemption.

Section 411 gets into the employer's responsibulity. These items are the same as in Title III.

Section 421 is about a credit for small business employee health coverage expenses. Section 431 is about disclosure of return information for health insurance exchange subsidies. I read that some opponents were concerned about the Health Choices Administration having access about tax return information, but the solution is simple. If you are eligible but don't want them to see your tax return, don't opt to apply for an affordability credit. The provision provides for sufficient restrictions when handling personal information.

Section 441 calls for a "surcharge" on high income individuals. The provision establishes new tax of 1% of an individual's modified gross income exceeding $350,000 but not exceeding $500,000; 1.5% of income exceeding $500,000 but not $1,000,000; 5.4% of income exceeding $1,000,000. In December 2012, if the excess Federal health reform savings is more than $150,000,000,000 but not more than $175,000,000,000 (not likely, folks) 2% will be substituted for 1% and 3% will be substituted for 1.5%. If excess federal health reform savings are more than $175,000,000,000 as of December 2012, the 1% and 1.5% taxes will be eliminated completely!

Translation: upper income folks, your taxes are going up.

There are a few other Internal Revenue Code amendments, but they really didn't seem like they were making big changes.

In summary: you can be taxed if you do not have health insurance; your employer must offer coverage or pay contributions to the Health Insurance Exchange; taxes are going up at least 1% on annual incomes over $350,000.

We're on Page 215, and already next up is Division B: Medicare and Medicaid Improvements.

HEALTH CARE REFORM: Chapter 3

Title III of this bill is Shared Responsibility. Subtitle A is about individual responsibility.

Section 301 states that individuals will have a responsibility to obtain coverage. Details to come later in Section 401 as an Internal Revenue Code Amendment.

Then we get right into Subtitle B, employer responsibility. Section 311 establishes that employers must offer each employee individual and family coverage under a QHBP.

Section 312 establishes the required employer contribution. The employer's required contribution towards a part-time employee is a proportion of the required contribution towards a full-time employee. Keep in mind that a proportion can be 0. Employer contributions cannot come as salary reductions.

Section 313 establishes the possibility of employer contributions in lieu of coverage. The contribution must equal 8% of the average wages paid by the employer during the period of enrollment. The money will be paid into the Health Insurance Exchange Trust Fund and will not be applied against the employee's premium. "Small employers" contribute less, if anything. If the annual payroll of such employer for the preceding calendar year exceeds $350,000, but does not exceed $400,000, the contribution is 6%. If the payroll exceeds $300,000, but does not exceed $350,000, the contribution is 4%. If the payroll exceeds $250,000, but does not exceed $300,000, the contribution is 2%. If the payroll does not exceed $250,000, no contribution is required.

Section 321 amends ERISA, the Employee Retirement Income Security Act of 1974. Section 323 amends the Public Health Service Act. These items bring us to page 167 and the beginning of Title IV.

Title III is not long. Its substance is that employers would be required to offer health insurance coverage to their employers, or pay a contribution to the Health Insurance Exchange Trust Fund. The idea is to get all employers to offer coverage, exempting the smallest businesses. Since this reform is working within the employment-based insurance model, it seems logical to mandate that individuals get coverage as well as encourage all employers to offer coverage.

HEALTH CARE REFORM: Chapter 2

Welcome back. Today's order of business is Title II: Health Insurance Exchange and Related Provisions of HR 3200, the health care reform bill under consideration by the House of Representatives.

The first Section 201 establishes a Health Insurance Exchange "in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option". It seems the Administration has all but backed off the public option (although that will play out interestingly if the liberal members keep their promise to vote against any legislation without the public option), but I'll consider the text of the bill as it is now.

A big fear out there seems to be that you will be required to participate in whatever program the government comes up with. However, the bill defines "Exchange-participating health benefits plan" as a QHBP "that is offered through the Health Insurance Exchange", which right there in the definition makes it sound as though all plans will be part of this Exchange.

Section 202 states that all individuals are eligible to obtain coverage through the Exchange "unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage". Again, the Exchange will not be the only option. The bill further defines "acceptable coverage", which includes grandfathered health insurance coverage, aka coverage under a current group health plan, Medicare (we're not abolishing Medicare, Grandma, don't worry), Medicaid, military coverage, and the VA, among other acceptable forms of coverage.

At first, individuals and small employers would be eligible to participate in the exchange, and by the third year of the program larger employers would begin to be eligible to participate. The language states that employers may offer the Exchange to their employees, and those employees may choose this coverage. Choice is heavily emphasized.

Section 202 ends with, what else, a survey to study the Exchange.

Section 203 is about benefit package levels. The first provision is that "The Commissioner shall specify the benefits to be made available under Exchange-participating health benefits plans during each plan year".

For example, in each "service area", there can only be one basic Exchange-participating health benefits plan offered by an entity under contract with the Commissioner. That entity also has the option of offering an enhanced, premium, or premium-plus plan in that service area if it wishes. The Commissioner will establish standards for the benefit levels of these categories. The Commissioner will also establish the permissible range of variation in cost-sharing for the various types of plans.

Section 204 is about contracts to offer Exchange-participating plans. The only potentially controversial requirement is for "culturally and linguistically appropriate services and communications", as apparently to some people that sets of an ILLEGAL ALIENS siren. Actually, cultural and linguistic sensitivity is becoming a more and more important part of medical training, as you're more likely to trust your doctor if you feel they understand you and where you come from. Thus, it makes sense that insurers could be required to provide such services and communications should they choose to participate in the exchange.

The Commissioner will evaluate the adequacy of any provider networks used by the entities offering plans through the Exchange.

Section 205 deals with outreach and enrollment of eligible individuals and employers. Outreach would be needed to advise people of their eligibility to participate in the Exchange. Vulnerable populations cited as needing specific outreach are children, individuals with disabilities, individuals with mental illness, and individuals with other cognitive impairments.

The open enrollment period for Exchange-participating plans will be September through November of each year. Under special circumstances, such as loss of other coverage or change in marital/dependent status, special enrollment will be possible at other times.

An important provision calls for the establishment of a process through which Exchange-eligible individuals are automatically "enrolled under an appropriate Exchange-participating health benefits plan". However, as you may recall, you are not an Exchange-eligible individual if you have other coverage. But, yes the idea is that there is an insurance mandate. But, if you think about it, we mandate auto insurance, and I doubt that anyone would suggest we end that policy. It's scary enough to have some people illegally driving around uninsured. And if anyone takes issue with the idea that we have a problem with too many Americans being uninsured or underinsured, well then we would need to have a conversation that doesn't even have anything to do with the bill.

There seems to be agreement that we have a problem.

Some individuals would be eligible for affordability credits.

Any premiums will be paid directly, not through the Commissioner or the Health Insurance Exchange. This provision makes sense to me, seeming to prevent absolutely unnecessary additional bureaucracy.

Medicaid-eligible individuals who do not elect to enroll in an Exchange-participating plan will be automatically enrolled in Medicaid. Again, auto-enrollment provisions seem to be sticky issues, but if people are eligible for Medicaid and don't have other insurance, they will be enrolled in Medicaid.

The bill establishes an Office of the Special Inspector General for the Health Insurance Exchange, headed by a Special Inspector General, whose duties include conducting, supervising, and coordinating audits, evaluations and investigations of the Exchange, to protect the integrity of the Exchange and more importantly the health and welfare of participants in the Exchange.

Section 207 creates a Health Insurance Exchange Trust Fund. Payments to this Fund will come from taxes on individuals not obtaining acceptable coverage, taxes on employers not providing acceptable coverage, and excise taxes on failures to meet certain health coverage requirements.

Section 208 gives the states/groups of states the option, once certain requirements are met, of establishing state-based Health Insurance Exchanges. Only one Health Insurance Exchange can operate in any one state.

This brings us to Subtitle B of Title II. Public Health Insurance Option time!!!!!!!!

Section 221 establishes within the Exchange a public health insurance option. This public option would ensure "choice, competition, and stability of affordable, high quality coverage throughout the United States...In designing the option, the Secretary's primary responsibility is to create a low-cost plan without compromising quality or access to care". This first definition doesn't seem to contain anything too sinister, including choice, competition, affordability and quality.

The public option will include basic, enhanced, and premium plans. It may include premium-plus plans.

An office of the ombudsman for the public health insurance option is established, using as its model the existing Medicare Beneficiary Ombudsman.

The premium rates for the public option will comply with the same rules for all Exchange-participating plans.

For start-up funding, the bill appropriates $2,000,000,000 out of unappropriated Treasury funds. That's a lot of zeros, but $2 billion in start-up costs is far from unreasonable.

The public option is intended to have competitive rates. Its initial "provider network" will be any Medicare provider who does not otherwise opt-out, although the bill cites pediatricians as providers who do not traditionally participate in Medicare who would be encouraged to participate.

Section 224 is about modernized payment initiatives and delivery system reform. For example, one provision states: "To the extent allowed by the benefit standards applied to all Exchange-participating health benefits plans, the public health insurance option may modify cost sharing and payment rates to encourage the use of services that promote health and value".

Section 225 is about provider participation. It establishes two classes of participating physicians: preferred physicians, for whom the agreed payment rate is payment in full, and participating, non-preferred physicians, who agree not to impose charges above a ratio established in the Social Security Act. Health care providers other than physicians can participate only if the payment shall be accepted as payment in full.

We've now arrived at Subtitle C of Title II: Individual Affordability Credits. Section 241 states that individuals eligible for affordability credits will have such credits either applied against their premiums or as a reduction in cost-sharing. Such eligibility would be determined on an application basis.

You are not eligible for the affordability credit if you are a full-time employee enrolled through your employer. Your family income would have to be below 400 percent of the Federal poverty level for a family of that size, and you cannot receive an affordability credit if you are eligible for Medicaid.

Section 243 is about the affordable premium credit, establishing limits on premiums based on income tiers. Section 244 is about the affordability cost-sharing credit, similarly reducing cost-sharing amounts based on income tiers. Section 245 establishes the procedures for determining income and thus eligibility for affordability credits.

I will reproduce Section 246 in full: "Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States". We are now on Page 143 of the bill, and at the end of Title II.

What I've analyzed here is really THE controversial part of the bill (again, there are no death panels...), and it's only about 70 pages long. To my untrained eye, it doesn't seem unreasonable. Especially if you do consider its content without the public option.

What we hear is that the public option is "not fair" to the insurance industry. Well, in the first place, why do we need to be "fair" to the insurance industry? Supposedly, the public option will completely eliminate all other participants in the exchange and eventually the entire market. People are attached to the coverage they have and wary of it getting worse.

But the system we have isn't great. People end up attached to their jobs because they don't want to lose their health insurance coverage. Providing insurance is destroying small businesses. Trying to find individual coverage? Have a pre-existing condition? Good luck to you.

Certainly the costs of establishing the Exchange, public option or not, will probably exceed the $2 billion appropriated for start-up costs in getting the public option off the ground. Still involved in Iraq and Afghanistan and heavily in debt, it seems we can't afford to get involved in such a massively expensive undertaking. Unfortunately, we also can't afford not to do something DRASTIC. If this bill (and we still have almost 900 pages to go) gets gutted to a few paltry savings here and there, Congress and the Obama Administration will have done this country an extreme disservice, even if the public opinion seemed to be clamoring for that disservice. Am I actually nostalgic for Cheney and friends in the Bush Administration who did whatever they pleased, public opinion be damned???

In any case, I hope that this actual Title of the bill gets debated, not the rumors that are flying around.

HEALTH CARE REFORM: Chapter 1

First of all, I would like to the point out the title of this blog. What I post here is my personal opinion.

My personal opinion is that there has been a lot of serious misinformation going around regarding health care reform. That irritates me. If we're going to make a lot of noise, let's make noise about the facts. There are debatable things up for discussion. But there are also heinous lies being irresponsibly fed to people. And people believe them.

I am not a health care provider. I am not an insurance agent. I am not even a policy wonk. I am a 21 year old intern and student. But I have enough time to read these health care bills (something not a lot of people have done) and analyze them. I am not an expert. But I have an opinion, and hopefully it is somewhat informed.

For today, I present the first 71 pages (less, really, considering the table of contents) of one bill. HR 3200: America's Affordable Health Choices Act of 2009 is the House bill, and it's over 1,000 pages long.

Division A of the bill is titled "Affordable Health Care Choices."

Today, I'm analyzing Title I: "Protections and Standards for Qualified Health Benefits Plans."

I would like to start out by saying that I never found a clear and satisfying definition of "qualified health benefit plan," or QHBP as it is referred to, although that is probably because it will refer to whatever ends up in the final bill.

In Section 102, we find the language, "grandfathered health insurance coverage." Meaning: the current coverage you have, you can keep. The argument of course is that the public option (which we haven't come to and will probably NOT be in the final bill) would run other insurance companies out of business with an unfair advantage. But let the record show that the bill does not say that you MUST abandon your current coverage (if you are so lucky to have adequate coverage).

Section 111 is one that contains a lot I hope we can agree on: the so-called QHBPs will not have exclusions for pre-existing conditions.

Section 122 establishes what will be in an essential benefits package, i.e. the minimum coverage. It limits cost-sharing, which prompted me to ask, what is the difference between "cost-sharing," "copay" and "coinsurance"? I did not look into these definitions, but I plan to do so at some point.

Section 123 establishes a "Health Benefits Advisory Committee" to recommend benefit standards. The Committee is ADVISORY and will make RECOMMENDATIONS.

Section 132 calls for a fair grievance and appeals mechanism, which I think is necessary.

Section 141 expands government, creating an independent agency in the executive branch, the Health Choices Administration, which will be headed by a Health Choices Commissioner. Section 142 establishes the duties of the Commissioner: QHBP standards, the Health Insurance Exchange, and affordability credits, with a focus on accountability.

Section 144 calls for a QHBP Ombudsman.

Section 152 prohibits discrimination in health care.

Section 162 ends insurance recission abuse. Your coverage, under the language of this bill, could only be rescinded by the insurance company upon clear and convincing evidence of fraud.

Secion 163 deals with administrative simplification, with such goals as enabling the real time or near real time determination of an individual's financial responsibility at point of service and near real time adjudication of claims, requiring timely and transparent claim and denial management processes, including tracking adjudications and appeal processing.

Section 164 is about reinsurance for retirees, which entails employment-based plans for retirees 55 or older not yet eligible for Social Security.

And that's Title I. I can't promise a thorough and complete analysis, but nothing too earth-shattering.

Up next is Title II: "Health Insurance Exchange and Related Provisions." That's where all of the new, really controversial ideas are, so I'm really looking forward to reading through that. Maybe a career in health policy could be in the cards for me?

Tell all the Truth but tell it slant

by Emily Dickinson

Tell all the Truth but tell it slant --
Success in Circuit lies
Too bright for our infirm Delight
The Truth's superb surprise

As Lightning to the Children eased
With explanation kind
The Truth must dazzle gradually
Or every man be blind --

Frigid air

I'm no fan of extreme temperatures at either end. I'm always cold, except when I'm hot. I've always been amazed at those people who show up to the first day of school in August in jeans and a sweater and then claim in January that a North Face fleece shell is outerwear. Sweaters are a must for me, but I am constantly taking it on and off.

Given the choice of a cold, cold winter and a hot, hot summer, I'd choose winter in a heartbeat. Why? AIR CONDITIONING.

In theory, air conditioning is pretty cool. And I've grown up with it my entire life. What's not to like about being able to control the indoor environment?

Well, picture this: me, on an average summer day, heading to my internship, probably in pants and a short sleeved blouse. And then putting on two sweaters when I get inside. And sitting on my hands to keep warm.

I can't even wear skirts really. With tights even, that would be pushing it. So much for the fun sundresses I bought in Spain.

There's really no need to control the indoor environment so that snow seems feasible indoors.

Here in Chicago, the summer has been quite cool. Record-setting in fact. However, it seems buildings just have one setting: SUMMER AIR CONDITIONING BLAST. Not good for the sneezing intern, shivering her way through spreadsheets. Not good for the environment (global warming, man). And certainly not good for the bottom line. We are in a recession, you know!

I'm not sure if this cool Chicago summer is worse than last summer in DC. Built on a swamp, our nation's capital is famous for it's humidity. So, this freezing intern experienced quite a shock every day at 4:30 upon being exposed to sunlight and an environment in which it was too hot to even touch a jacket.

I realize that not everyone is quite as sensitive to temperature as I am (last summer someone called a technician to the room where my desk was to test the temperature after hearing me suffer. No difference in temp from the rest of the office), but can't we find middle ground? Turn the thermostat up 2 degrees and give yourself a raise!

In Spain, you really don't find air conditioning many places. Hotels where American tourists stay. Some stores and museums. And I suppose more and more office buildings as they modernize. The humidity is low, so the nighttime temperature drops off blessedly after dark. Even in June, the weather is pretty miserable, and in August the entire city of Madrid is on vacation somewhere near a beach. But, you know what? We were all suffering together! We may have been a little sweaty after we ran to catch that Metro, but we all made it.

Not everywhere in America has air conditioning, either. August 9, for example, was the hottest day on record for the summer. I was in my brother's piano teacher's unairconditioned home for a concert, with minimal fan action. I was ready to go the SECOND the regularly scheduled musical program was over.

You see, I'm not advocating an OVERTHROW of air conditioning. There's nothing quite like it on that hottest day of the year when you wouldn't dream of going outside and the grid is stretched to the max but doing its job.

But PLEASE I will not stop until office buildings can adjust the thermostat. We can't be stuck with the same temperature all summer whether it's a scorcher or barely a summer at all. And, even when the temperatures are outrageously hot, let's not keep it cold enough to need a parka indoors. After all, we've only got three months for our summer wardrobe!

----------------------
Thanks for putting up with that. I really needed a forum.

I deleted all but the first line of the poem at the top. The layout looked terrible.

Coming up: Health Care Reform. I've now at least skimmed the first 500 or so pages of H.R. 3200. Surprisingly little of the 1,000+ manuscript is about the so-called public option and the health care exchange, which together are probably the most revolutionary pieces. The public option is probably off the table at this point. That leaves us with a lot of cleaning up things like Medicare (OMG death panels killing Grandma and Palins with a vengeance!). We'll see what happens.

A new vision...

Apparently it's really hard to customize a blog on Blogger! As far as I can tell, you are required to use one of their templates, and there really aren't many of those available. It also seems like it's very hard to customize the elements of those templates. For example, the subheading of this newly fashioned blog is an eight-line poem. I made the text giant so at least the first line could be on its own. The rest kind of just flows together, but luckily it's Emily Dickinson, so that almost makes sense.

Although I will soon be leaving the ORD for DCA (I'm actually flying MDW to IAD because Southwest has the cheapest one-way fares. I've never been to Dulles before. Adventure!), the ORD DCA MAD concept is a bit old, as my life is no longer quite as exciting. I suppose there is some inherent excitement in being a senior at Georgetown University, but not the same jet-setting excitement that necessitates a breathless narrative account of my every move.

But I've still got to write, don't I?

Therefore, my new angle is "The Slant." Every blog has its own slant, derived from the blogger, and I'm embracing my own, inspired by Emily Dickinson's poem, which I first discovered in Barbara Kingsolver's fantastic novel, The Poisonwood Bible. Read it. Seriously. The poem and the book.

What can you expect to see on my new blog? My first post will likely be about how I can't stand overdone air conditioning. I expect I'll also digest political news and goings on, and throw in a bit of funny/awkward events from my life. As I get closer to graduation, which keeps getting closer and closer and therefore much more intimidating, you'll probably get some self discovery. And desperation.

As a final note to anyone who may be reading this:

MY LIFE GOAL IS TO HAVE RICK STEVES' JOB. IF YOU CAN MAKE THAT HAPPEN...

P.S. I just listened to Shakira's new single, She Wolf, 20 times. It's a pretty fantastic track, and the video is...edgy. Check it out!

Back in Chicagoland

Happy 4th of July!

So, yes, I have now been "home" for over a week. Quotations necessary because I haven't been here this long since the summer after freshman year. It feels pretty weird to be back.

The internship is good so far, and in a really nice location downtown. Conceptually, I now feel like I understand at least the downtown part of Chicago a lot better after seeing so many cities this year.

I guess for now I should try to pick up where I left off in narrating my solo travels before I forget the details.

I checked out of my hostel in Munich on Sunday morning and planned on visiting three museums before my afternoon train to Interlaken because the state museums are only 1 euro on Sunday mornings. My first stop was the Alte Pinakothek. I first made the unfortunate realization that because of an exhibit, admission was not 1 euro.

I made a much more unfortunate realization: my cell phone was not in my purse.

I tried not to be too worried about it and went into the museum.

The collection was pretty good. They had A LOT of Rubens paintings. The exhibit was recreating the cabinet of some count with all of its paintings. It was a kind of cool idea, but in my opinion not worth paying extra, especially because the descriptions were all in German only and most of the paintings by famous artists were not included.

My next stop was the Neue Pinakothek, whose collection includes classicism through art nouveau. I enjoyed it. I also went to the Pinakothek der Moderne, which has contemporary art. It is a large museum, also featuring design and architecture. I didn't see everything there because I wanted to take a look in the hostel to see if I could find my phone.

No one had turned a phone into the front desk, and they let me back into my room, but my cell phone was nowhere to be found. I'm pretty sure that I must have left it on my bed in the morning while I was trying to pack, and someone must have taken it. The phone only worked in Spain, so no one was going to be able to really use it in Germany. I suppose they could try to take out the SIM card. It was just really frustrating for me because I had been renting the phone in Spain, so I was losing the deposit on a very cheap phone that I had been paying a monthly fee to use all year. For what I paid, I could have bought that phone five times over. My record of never losing or breaking a cell phone has ended. It also made the last week of my trip trickier because I was primarily using it as an alarm clock.

I got on the first of my three trains from Munich to Interlaken. My first change was in Ulm. From Ulm to Basel, I was taking a tiny regional train. I was really pretty lucky to get a seat, as there were people standing the whole time. The train was late arriving in Basel, which, judging from the general discontent of the other passengers, is unusual even on regional trains in Germany. As the minutes went by I became more and more nervous because while I had 25 minutes to make the connection, the train to Basel was running over 20 minutes late. I ran for it and made it with little time to spare.

I was glad that I made my connection because as it was I was arriving in Interlaken at 10 p.m. Interlaken is a small town in the Jungfrau region of Switzerland that, as you may guess from the name, is between two lakes. The buses weren't running by the time I arrived, so I walked to the hostel. I stayed at the Interlaken Backpackers Villa, which was very nice. Compared to a lot of hostels, it really did feel like a villa. Included in the price of the hostel was bus travel and admission to a pool, which I probably would have taken advantage of if I had been there longer.

Monday morning I woke up and, even without my glasses on, I could see mountains under a cover of mist. I went out on my room's balcony and was rewarded with a spectacular view. I had a train to Milan that afternoon, so I didn't have that much time in Interlaken, which was unfortunate. Interlaken is the adventure sports capital of Europe, although I doubt I would have been too adventurous on my own. I decided to go for a hike.

My page from Let's Go Western Europe recommended two hikes. The first it described as the most popular, and easy...with hiking boots and poles, two things I did not have, so I opted for the second, flatter hike. I stopped at the grocery store to buy an extra bottle of water and some lunch and set out.

Everything I saw was absolutely gorgeous, clear blue lakes spread before green snow-capped mountains. I do kind of wished that maybe I had planned my partial day in Interlaken more and maybe taken the Jungfraujoch railway up to the highest rail station in Europe, but I enjoyed my day nonetheless. I never bothered taking out any Swiss money, but I had some because I made a purchase in euros and got that as change and found a coin on my bed in the hostel which luckily enabled me to use a locker for the day, so I spent what I had left on chocolate at the grocery store. Even the store brand of milk chocolate was REALLY good.

I had two small changes in Switzerland before boarding my train for Milan. The seating was all in compartments and the train just seemed really dirty and smelly, making me miss German trains.

In Milan for two nights, I was treating myself to my own room (Rick Steves' hostel was booked so I went for Let's Go's hotel) at Hotel Eva. It was nice, although I was nervous because the next morning was my pricey city tour that enabled me to see the Last Supper, which I absolutely could not miss. I had a really tasty dinner at Osteria Lazzaretto, the restaurant next door recommended at the hotel.

I then walked to the Piazza del Duomo. I had just wanted to see the cathedral at night, but I was in for a treat: the U.S.-Italy match of the Confederations Cup was being broadcast on a large screen in the plaza. I got some Grom gelato (I obviously looked up the address) and enjoyed the game and the ambiance, even if the U.S. lost.

Luckily, I woke up in plenty of time the next morning. I had to switch my online printout for a voucher at the TI, and I wasn't sure I was in the right place at first, but I was. The tour was very ambitious for what it covered in three hours...I would say they should either cut something out and go over things more or they should make it an hour or two longer and charge a little more. We started by touring the Duomo, then walking through the Galleria, where most of the high-end shops in Milan are located. All of the women in Milan are so well dressed and put together!

Next we visited the Scala Opera House, which never would have been on my to-do list, as I am not that big of an opera fan, but some of the other people enjoyed it more. We got to peek in from a glassed-in balcony at a rehearsal (it was the same production of Aida Kayleigh took me to see in Prague) and then went through the museum...which I found pretty dull.

Our next stop was Sforza Castle. We really only had enough time to peek at the exterior of the building to make our appointment to see the Last Supper. To care for the work, only 25 people with a reservation are allowed in at a time (perhaps thanks to Dan Brown, you need to make reservations many months in advance, so the tour was my only chance to see the work). First you show your ticket and enter one chamber. Then the door closes when everyone for that time slot has entered and at the other end the door to another chamber opens. From there, you enter the room where the painting is as the previous group exits, into another chamber with the same two-door system. What can I say about the Last Supper? Time has been cruel to the Last Supper, and of course there is the debate as to whether the last restoration was good or bad. What is left should be what is left of Leonardo da Vinci's original paint, but unfortunately not much is left. It was still incredible to see.

After that, the bus deposited us back in the Piazza del Duomo. I had some lunch and took the elevator the Duomo roof. Rick Steves promised that the experience would be one of the most memorable in Milan, and he did not lie. At this point, I have been on the top of a lot of cathedrals, both roofs and bell towers, and this one was particularly enjoyable.

My next stop was the Pinacoteca Ambrosiana, which was an enjoyable art gallery surrounding a historic library. The highlight was probably Raphael's sketch for School of Athens. I want access to the library! At this point, even though I was in Northern Italy, the heat started getting to me. Not even Grom gelato was enough to cool me down.

Sforza Castle houses several unexciting museums which we had not been able to see that morning. The only real highlight was a Michelangelo Pieta. I shouldn't have spent so much time there, as I was probably just wearing myself out unnecessarily.

I also went to the Pinacoteca di Brera, which was much more enjoyable. The gallery's highlight for me was Mantegna's extremely foreshortened Dead Christ (I literally think I've seen that in the dictionary next to foreshortening. Literally). The gallery is attached to an art school, which means that the students can get hands-on experience restoring artworks. In one gallery, there was an interesting 20-minute English and Italian powerpoint presentation on the restoration of Raphael's Marriage of the Virgin. I sank into the guard's chair, enjoyed the presentation, and felt restored after sitting in the cool for a while when I was done. I was very disappointed in the bookshop though: no postcards of Mantegna, and no postcards of the full painting of Raphael. After learning that much about it, I was willing to buy an image, but none of the ones available were to my liking.

I went back to the hotel and packed a little before eating dinner at the same place. I also went to the Piazza del Duomo and got Grom gelato...for the third time in 24 hours. I would like to make a comment that contrary to what Rick Steves wrote, I did NOT find the Milan metro easy to use. At the Duomo and Milano Centrale stations, which were the stations I, and probably all tourists, used the most, there were a lot of exits but no signs telling you what street you were exiting to. Also, not all of the machines could sell single ride tickets.

My train to the Cinque Terre the next morning was pretty early. I took the train to La Spezia and then caught a local train through the Cinque Terre. The Cinque Terre are five gorgeous towns set on mountains overlooking the Ligurian Sea in the Italian Riviera. I was very much looking forward to this part of the trip. I checked into my hostel, Ostello 5 Terre in Manarola, my town, shortly after noon. That hostel might be my favorite I've stayed in this year, but it had some strange rules: there was a seven-hour room lockout from 10 a.m. to 5 p.m., and the whole hostel closes from 1 p.m. to 5 p.m., which means no check-in. There was also a curfew, which really didn't bother me, and it was the first time I stayed in a hostel with actual tokens for the shower. You got five minutes of water, but the box was outside the shower, which meant you either put in the token in the nude or wasted some of your time.

Liguria is the part of Italy where pesto and focaccia originated. For lunch I had a piece of pesto pizza and some amazing focaccia bread...for about three euros. I took the train from Manarola to Monterosso al Mare, the farthest of the five towns, and the one with the best beach, so the most touristy.

You can hike between all five towns in four-five hours. The whole area is a national park, so you have to pay a small fee to hike. The hike betweeen Monterosso and Vernazza is the toughest. I started with that one intentionally. The uphill was a little rough, but it was well worth it from the top. The day had started out overcast, but during this leg of the journey the sun came out. From Vernazza I hiked to Corniglia, where I got some delicious honey gelato. The hike from Corniglia to Manarola isn't bad except that from the town itself you have to go down these intense stairs to the train station where the trail to Manarola picks up. In Manarola I stopped where I had gotten my lunch to get some farinata, a type of chickpea pie that is also a specialty of Liguria, which was good, but not as good as the focaccia. The hike from Manarola to the last town, Riomaggiore, really shouldn't even be called a hike. It is about 15 minutes of flat walking through the "Via dell Amor."

I went back to my hostel and took a well-deserved shower. The hostel had a restaurant, and I figured I'd give it a try, for convenience's sake. I ordered gnocchi pesto with a green salad and was VERY pleasantly surprised. The pesto sauce was AMAZING. Apparently the hostel's restuarant has some fame. After dinner, I walked out onto the Via dell Amor and ordered a glass of white wine in one of the two bars on that trail to watch the sunset. I had to trade in my Rick Steves' French, Italian, and German Phrasebook to get a novel to read.

The next day, I decided to tackle the hike in reverse. I was wearing my swimsuit under my clothes, with the intention of going for a swim as soon as I made it to Monterroso. I saw some nice rocks between Manarola and Corniglia and decided to just go for a swim then. It was very nice, and the area was in shade while I was there which was good. As it turns out later, I was very glad I went in the water then.

I dried off on the rocks before heading back to the trail, where I met up with three Australian women who were in my room at the hostel. We walked together for a while, past some abandoned structures that one of them said had been a thriving bar before the area was designated a national park and UNESCO world heritage sight. Apparently abandoned buildings have more character? I lost them on the stairs up to Corniglia, where I got myself some focaccia and another water bottle. In Vernazza, I had a lunch of focaccia and gelato.

Everything was going well, and I was already thinking about where I wanted to go swimming by some rocks I had seen the day before. Until I out of nowhere fell on the trail. Luckily, I wasn't that badly hurt, just scraped. I did pretty seriously scrape up my knee (in the same place I had bruised it three weeks ago crossing the street in Madrid), but also luckily I fell in front of an American family and a German couple who both whipped out their first aid kits to see who was better equipped to patch me back up. Bleeding and covered in dirt, I had no choice but to (but was also determined to) finish the hike to Monterosso.

Swimming was pretty much ruled out. I did strip to my swimsuit to shower on the beach. I thought about swimming anyway when I saw the blue blue water, but I had to settle for reading my novel on a rock with my feet in the water. I caught the train back to Manarola and went to their main "beach," where I was even more tempted to go for a swim. I'm kind of disappointed that I didn't, because who knows when I will be able to swim from rocks in clear blue water again, but the fact that my wound was bleeding through the bandage was probably a sign. I went back to the hostel and took an even more well-deserved shower.

I had dinner at the hostel again, having absolutely divine walnut ravioli, sitting with the Australian ladies. We had breakfast together again the next morning before heading our separate ways.

That Friday, I was headed to Rome by way of Pisa. I'd heard that Pisa was somewhat overrated, and that other than the Leaning Tower and the Duomo there wasn't much to see, but I wanted to see that. I followed a self-directed walking tour of Rick's to Campo dei Miracoli. FYI, the Tower is actually leaning. I made a beeline to the ticket office to get my timeslot to climb the tower. I surprisingly didn't have to wait that long. I visited the Duomo (a bargain at 1 euro), went to the bathroom (they really shouldn't charge you when you are paying 15 euros to climb the tower...), checked everything but my camera, and then it was my turn.

The steps are made out of marble, which means that they are very well-worn and slippery. They made us all get out and wait at the first landing. Some people were experiencing motion sickness, and I was pleased that I was not among their numbers. The view from the top of the Campanile was nice but not spectacular. Once back down on the ground, I got a sandwich and went back to the train station. The automatic machine wouldn't let me buy tickets on the next train to Rome, apparently because only 1st class seats on the leg of the journey from Florence to Rome were available. I decided it was probably worth it.

It was pleasant changing trains in Florence, being able to see the Duomo and Campanile from the train station. I boarded the train to Rome. From what I can tell, the only difference is that the seats are a little bigger (three across instead of four), and you get drink service and a snack included.

In Rome, I checked into my hostel Fawlty Towers, which was a little weird. They were cash-only, but they didn't have change, so I had to promise to come back before a certain time with three euros, which was kind of annoying. I was in a four-person dorm...for which there was only one key. Which means that you can't lock the door until all of the people are out of the room during the day and in the room at night. If it had been for more than a night I would have been even more weirded out I'm sure.

I didn't want to waste any precious time in Rome. I took the metro out to the Ara Pacis. There was also an art exhibit in the basement that seemed pretty random to me. From there I walked to Santa Maria del Poppolo, home to two Caravaggio paintings: Crucifixion of St. Peter and Conversion of St. Paul. From there I got some gelato and walked to the Trevi Fountain to toss another coin. My coin in April obviously worked.

I went back to the hostel. On my way out, I ran into a random religious procession. Only in Rome. I really do like Rome and all of its Roman craziness. I then went to a restaurant recommended by Rick. I had a nice pizza and then decided to order the tiramisu because Rick said it was really good. I was disappointed. Maybe I should have tried the strawberry flavor instead of the traditional coffee?

That night I met Meghan, my friend who is doing Georgetown's summer program in Rome (originally supposed to be in L'Aquila...) in Piazza della Repubblica just to catch up, which was nice.

The next morning, I visited several churches, including one with a Caravaggio chapel. I got to see The Calling of St. Matthew! I tried to buy a postcard in one of the machines, but it ate my money as well as that of the girl behind me who tried to buy a postcard out of a different slot. Typical Catholic church.

By that time, the Galleria Doria Pamphilj, the main event of the morning, was open. The gallery is in the palace of the Doria Pamphilj family and is their private collection of art. I had really wanted to go to see Velazquez's influential Portrait of Pope Innocent X, who was a member of the Doria Pamphilj family. Apparently the term "nepotism" comes from his family's relation to the papacy. After I was done, I had enough time to grab a sorbet-gelato (very tasty), catch the bus, grab my suitcase, and catch the train to the airport. 11 euros...

I had lunch at the airport, bought some wine for my host family, and I was back in Madrid in no time. It was nice to be back, and it was especially nice to catch up with my host family after their trip to New York. Apparently they had a really great time on their first trip to the U.S., which makes me glad.

I really didn't have very much time in Madrid before leaving, for the final time. Packing was no fun, complicated by the temptation of serious summer sales (I found some sundresses for decent prices which made the last couple of days of Spanish summer bearable). I enjoyed the Sorolla exhibit at the Prado and said goodbye to the museum (I had planned a walkthrough of everything seen in class this year, but Vera Cruz de Maderuelo, the Romanesque chapel housed in the Prado, was closed. I went to Salamanca for a daytrip. The highlight of my final days in Madrid was when my host dad Miguel took me around Madrid on his moto! It was a lot of fun. He said of all of the American girls he's taken on his moto, I was the least scared, which I find somewhat incredible. I was scared before the ride started, but once we were off (we were going pretty slow) I wasn't scared.

It was hard saying goodbye after a year.

But now I'm back here in real life.

WHAT

At this time tomorrow, I will be on a plane, probably somewhere over Ohio. WHAT.

Last night in Germany

Hey guys.



So I went with New Berlin out to Sachsenhausen, which is at the end of one of the S-Bahn lines. Sachsenhausen was the first concentration camp established in Nazi Germany and was used as a model for later camps. Until 1938, the prisoners were primarily political prisoners, not Jews. The forced labor erected the facade of Berlin that the world saw during the 1936 Olympics. The camp was designed around complete control of the prisoners, in a triangle shape. Next door was the SS Training Camp.



In 1938, the camp was expanded, with the so-called Jewish barracks added. After the Israeli prime minister spoke at the camp in the early 1990s, young neo-Nazis burned these buildings down, which have been reconstructed but with part of the charred walls remaining as a reminder of the antisemitism still found in society.



Sachesenhausen is particularly interesting because it was used by the Soviets for 5 years after the war, first for former Nazis and then just for anyone not in step with their Communist ideals. In the center of the camp is a giant memorial to the Communist prisoners under the Nazi regime.



Sachsenhausen was a work camp. When prisoners were killed, they were primarily shot. Guards were starting to have a hard time carrying out these killings, so the following method was developed: prisoners were taken to what looked like a medical waiting room, where loud music was playing; a guard in a doctor's uniform would examine the prisoner's teeth and make an X on the hand if there were any gold fillings; the prisoner was taken to another room to be weighed and measured; as the measuring stick was brought down, a window behind the prisoner's neck was slid open, through which the guard would shoot the inmate; another inmate would collect the body and prepare it for cremation after removing any fillings. In this way each guard was only involved in a small part of the killing process, making it easier psychologically. I thought I was going to vomit when I saw the ovens. I couldn't take any photos. Also, while gassing was not the method of choice, experiments were carried out.



Visiting the concentration camp was an experience, to be sure. I'm glad I went, to see. It's important not to forget.

Back in Berlin, I had to keep up my frantic tourist pace. As I said, state museums are free in Berlin from 6-10 on Thursdays, so I had three on my list. I started at the Gemaldegalerie, where the highlight was Vermeer's Woman with a Pearl Necklace. There was a Van der Weyden exhibit that I don't think was free...but the guard was not paying attention when I entered. I was looking at an Anunciation scene for a long time that looked very familiar...obviously on loan from the Prado.

My next stop was Doner Kebap for dinner. There are a lot of Turks in Germany, so it is supposed to be the best kebab outside of Turkey. It was indeed very good (I've reached the point where I'll only eat falafel at such establishments in Spain), although there was some red cabbage on it that to me only detracted from it.

My next stop was the Pergamon Museum which was NOT free because of an exhibit. I almost skipped it, but I'm glad I didn't. The museum is named after the Pergamon Altar from Turkey, which was incredibly impressive, more so than even the Parthenon Marbles in London (I suppose not surprising since the actual Parthenon is still in Greece). I went into the exhibit, which was on "Berlin's Olympus," basically displaying the museum's collection of statues of gods. At the end, I just wished I had seen it in its original more impressive location in Brazil. There was a free audioguide, which I need to make those sorts of museums interesting, but in the exhibit it draggggggged on. There should be two versions: one for history buffs and one for people who jsut want the highlights.

My final stop was the Alte Galerie, basically the 19th century art museum. I enjoyed it, especially the room of Manets, Monets, Renoirs, etc. I had planned on crashing in that gallery until the guards kicked me out, but I was tired so I actually left the museum before closing time.

I went back to the hostel and got some internet. I tried to have an early night, but someone far more obnoxious than the Spanish guys had invaded: American girls, in the bunks below and next to me. At least for a while there were two of them in the bed below me. And they kept giggling and saying things like OMG it's 3 a.m. Seriously.

My train was at 7:37, so I had to leave the hostel early. I had to change trains in Fulda (still not quite sure where that is). My original train was actually headed to Munich as its final destination, but via Frankfurt and Diane's new hometown of Mannheim, so it would have taken an extra two hours to arrive. I was surprised there wasn't a fast direct train between the two cities, since they are the centers of tourism in Germany. I mean, both trains were ICE (InterCity Express), so they were fast. My only complaint is that the trains were COLD. And I was wearing both my sweater and my jacket. I had a surprisingly nice meal on the train, an inexpensive combo of a meatball sandwich and a large beer.

I arrived in Munich at about 1:45. My hostel, Euro Youth Hostel, is close to the train station. Aside from one unfortunate detail, it's an excellent hostel setup, one of the nicest I've ever seen. The bunk beds are wood, with a shelf, reading light and outlet next to each bed, and the lockers are big enough to accomodate just about any suitcase. The unfortunate detail is that in my 10-bed dorm, there are two sets of bunk beds pushed next to each other to accomodate couples. Ewww.

I planned to take the New Munich free tour at 3 p.m., so I made my way on foot. Once you get away from the train station, Munich basically looks like Disneyland: giant pedestrian-only shopping streets and cutesy buildings. In the Marienplatz, where the tour starts, I took an elevator to the top of the Rathaus, or town hall.

My guide for the tour was the least inspired of any of my New Europe tours. She was very enthusiastic though. Similar to Berlin, Munich was about 80% destroyed during World War II. A lot of the themes are the same in Munich as in Berlin. While Berlin was where Hitler was when he was in power, he got his Nazi political start in Munich. One thing about Munich is that they aren't as blatant with memorials or anything of that kind. Munich has a very strong identity as a city and as part of Bavaria (after a while you stop taking photos of people in traditional dress, realizing that's just how a large portion of the population dresses for normal occasions), which means they don't feel as much of a need as Berlin to atone for the Nazi past.

I made my way back to my hostel and joined their "beer crawl" at 7 p.m. It was...fun. I met a lot of Australians who are all on this bus tour-ish thing called BusAbout that more Americans, Canadians, and English should invade. We visited two biergartens.

This morning I was a champion, making it to the train station by 9:15 a.m. without being hungover. I was going with New Munich by train to Fussen, a small town at the foot of the Alps, where there are two gorgeous castles. I had a bratwurst AND a tomato and mozzarella sandwich right before hiking up, which was not the best life decision, but I made it up. We visited the interior of Neuschwanstein, a castle built in the late 19th century by Bavarian King Ludwig II (lots of fun history there). Basically, more than the Segovia Alcazar, this palace probably inspired Walt Disney. On the way up, "When You Wish Upon A Star" was stuck in my head. Ludwig was obsessed with Wagner and opera-worthy stories. The main deocrative theme to the palace is swans. Ludwig was an eccentric character (his likely undoing), but the end result is incredible. The setting is unbelievable, this gorgeous castle nestled in the mountains in a forest overlooking the most gorgeous lakes (obviously one of them is Swan Lake). You never want to leave.

So I made it back to Munich, had some Doner Kebap for dinner, and walked around. There was a lot of music, dancing, beer, etc. in the street. I don't think that it is a special occasion, I think that's just a normal Saturday in Munich.

New life goal: make it back to Munich one day for Oktoberfest. Maybe coupled with a holiday based at least partially on cycling through Bavaria, Austria, and Switzerland? When I'm a fabulously wealthy late 20something jetting around the world...

Tomorrow I am leaving Europe! Well, the European Union, as perenially neutral Switzerland is not in the EU.

Greetings from the Disneyland of Europe

Hello all, I am currently in Munich.

I left off my tale in Berlin at about 4:30 a.m. I let myself sleep in rather late, in time to grab a coffee and croissant and meet the New Europe free tour at 11 a.m. in front of the Brandenburg Gate. Berlin is where the free tour company started, so this tour was very popular and I would have to say very excellent.

My guide, Mary, was very infectiously interested in German history. From the Brandenburg Gate, we made our way past the "Memorial to the Murdered Jews of Europe". I put that in quotations because I think it is significant that the memorial only commemorates a certain group. The memorial consists of stone blocks of varying heights on uneven ground, probably to make the viewer feel uncomfortable. A central theme in the tour was the way that German society grapples with the theme of the Holocaust and how best to remember what happened.

Our next stop was the remaining section of the Berlin Wall. Not going to lie, I was actually kind of disappointed! There is so much buildup for the Berlin Wall that it is almost impossible for the remaining segment to meet your expectations. We also saw "Checkpoint Charlie", among other sites. Our tour took place almost exclusively in East Berlin, which is where more of the sites are. It is hard to actually imagine, a city divided by a wall, West Berlin in the middle of Soviet East Germany. I'm not the world's biggest history buff, but it was pretty incredible to be walking the streets of probably the most influential city of the 20th century. 90% of the city's buildings were destroyed in World War II, and you can very definitely still see the scars. I guess that's a major contradiction; I was underwhelmed by seeing the Berlin Wall yet seeing the history on the streets of Berlin was amazing.

One of our next stops after a lunch break was Bebelplatz, the square outside the library of Humboldt University where students and professors started burning books that went against the ideals of the Nazi regime. The memorial is underground, visible through a window in the middle of the plaza and consists of empty bookshelves, that would be filled by the destroyed books.

The tour was three hours and I'm not looking at a map of Berlin, so I don't remember every stop in detail, but the tour definitely communicated strong themes. I suppose the free tour in Amsterdam tried to show how the "openness and toleration" of that city seen today in coffeeshops and the Red Light District evolved from its history, but in Berlin you really felt like you understood the city so much better after the tour. Berlin is not the most beautiful city in Germany, but it is very real and liveable, and it probably is the most interesting city in Germany.

From there, I made my way out to the Olympic Stadium. It was my first experience with the public transportation system in Berlin, which is quite obviously excellent. On my way out to the stadium I noticed the destroyed Kaiser Wilhelm II Memorial Cathedral and hopped off the train to have a look. The church was severely damaged during World War II and has been left as is, its damaged towers a beautiful reminder of that era. There is now a separate sanctuary built in a very different modern style, but there is an interesting exhibit of "before and after" photos below what remains of the towers.

I got back on the train and got off at the Olympic Stadium. As I approached, I noticed there were a lot of people dressed in all black. When I saw a young child with an extreme mullet, I started to think that there must be some sort of event at the stadium. Indeed, there was a Depeche Mode concert later that evening, so I couldn't get in. I made my way back to the S-Bahn, disappointed but amused by the crowd chanting "Depeche Mode" in a very German accent.

I went to the exhibit in the Memorial to the Murdered Jews of Europe, which is free. The intent is to make the stories personal, centering on individuals and families rather than throwing out the mind-boggling statistics, which we can become numb to after a while. In one room, it is dark, with names and dates projected onto the walls. A narrator tells a brief story about that individual. I was very disappointed when a group of high school students was being obnoxious. The guard had to ask them to leave, and one of them made a commotion. I would say, ah, teenagers, what can you expect, but I really can't understand because even as a "rowdy teenager" I was very quiet...especially in such situations that really warranted such respect. There is really nothing funny about hearing the life story of someone who died in a concentration camp.

From there I walked to the Reichstag, the German parliament building. The Reichstag was not really used until the Weimar Republic. A suspicious fire in the early 1930s was used as pretext by Hitler to seize power as a dictator. It sat unused again until Germany unified. Today, there is a striking glass dome on top, that is supposed to represent "the transparency of democracy". Anyone can take the elevator up to the top for free. There is also a free audioguide, and I SWEAR mine wasn't working. I went back to the desk, and the employees didn't believe me, laughing and telling me that it was automatic. It is more high-tech than your average audio guide, but I did exactly what they said multiple times and nothing happened. I was so frustrated that the employees couldn't even be bothered to try to help me. It colored my experience on top of the Reichstag, which affords you a panoramic view of the entire city.

After that, I got some falafel for dinner and just made my way back to the hostel. I used the internet for a while and went to sleep...or as much sleep as you can get in a room with 49 other people. It actually was a decent setup, all of my stuff was in my locker on that floor. The only problem is that, as in any hostel dorm, your roommates and their consideration of your need to sleep determines your ability to sleep. That night the annoying Spanish guys from the night before decided to call it an earlier night...and had a long conversation in the dorm. Earplugs are a godsend, but they don't block out everything.

I got up early the next morning to go to the Olympic Stadium again. Berlin is my host mother Cristina's favorite city in Europe, and she has told me many times how the thing that impressed her the most was seeing the track where Jesse Owens ran in 1936, winning the gold medal and challenging Hitler's theory or Aryan superiority. I arrived at the stadium at 9 a.m., just as it was slated to open. It had been raining when I left the hostel, but I hadn't gone back to get my umbrella, or stopped for any coffee or breakfast, to make it there at that time. That morning I noticed a sign that had been blocked by the concertgoers the night before: the Olympic Stadium is closed to visitors from June 5 to June 15, because of two events, one of which was the Depeche Mode concert. I couldn't believe it. I could understand the day of, maybe even the day before or after having to close, but...

As luck would have it, I had been making my contingency plan on the way there on the S-Bahn. Most state museums are open until 10 p.m. on Thursdays and free after 6, but the Hamburger Bahnof, the contemporary art museum closed at 6. I ran back to the hostel for my umbrella (good life decision), and would have made it to the museum shortly after it opened at 10 a.m. except in my fury I couldn't spot the entrance and ended up walking the entire perimeter of the building first. The building is in a former train station (no d'Orsay though), and is under construction, so only a portion of the museum was open. They have a good collection of Warhol, and some Kiefers for Diane. There is a big section on fluxus, so there was a lot of Beuys. I wish I'd had more time to look at the pieces in detail, but I didn't. Patrick, look up "I like America and America likes me" and let me know your thoughts.

I ducked out of the museum at 10:45 to make it back to the Gate with a coffee to meet another New Berlin tour. That day I took a paying tour, again with Mary, to Sachsenhausen, the model concentration camp outside of Berlin. I'm going to stop here so I can devote enough time to writing about that, but it was quite an experience, probably furthered by the gray skies and off-and-on rain.

On the road

Greetings from Berlin! I am in my hostel using the internets so I thought I would try to make a dent in starting to blog. I arrived in Amsterdam Monday afternoon. I caught a train to Central Station, where I decided to buy my train ticket to Germany for Tuesday night. It took a maddeningly long time.

From the train station I walked to my hostel...which was in the Red Light District. I decided to stay in Shelter City, a Christian youth hostel with a no drinking/drugs policy. I thought that would be a good balance since it would be well-located but without any shenanigans so I could sleep. Not sure that was the best choice, as you'll see later. After unsuccessfully messing around with my locker for a while, I decided it didn't matter since I lock my suitcase anyway and marched to the Van Gogh Museum, making it there about 5. They close at 6. The hour was about enough time to see the permanent collection, although I definitely was the one the guards had to push out of the museum come closing time.

I wouldn't have been able to see everything in an hour if I had been in Amsterdam a day earlier. That was the final day of the big exhibition titled something along the lines of "Van Gogh and the Night". It was pretty epic, with works such as The Potato Eaters and Starry Night (which I missed when at MoMA). I knew I was missing it, but the exhibit title was on my bag in the shop, which made me sad. One thing about Van Gogh that is interesting that is easy to forget is that he really only was productive for about ten years. Few other artists have the same cultural prominence without having a much larger body of work.

From the museum, I made my way to the Anne Frank House, which is usually open until 10 pm, but obviously since I was there they decided to close early that day at 5. I was hungry so I got some fries: not as good as in Belgium, fyi. I pretty much just started walking back towards my hostel. I opted for a meal on the streets. I was enjoying a piece of pizza and people watching. I had just about finished when a creeper started bothering me. I said "no" and walked away. I went into a shop for a while, but either he was following me and waited outside or I just had really bad timing because he saw me again and started bothering me again. I jaywalked away and decided I needed a chocolate-covered waffle for my trouble. I made my way back to the hostel. I wanted to leave again after dark, to see the Red Light District all aglow, but I just didn't feel comfortable going outside again on my own so I called it a night early. No Bible study.

The next morning I had a bit of an issue checking out. I was certain I had paid 10€ deposit, but they were convinced it was only 5€. Guess who was right after they pulled the tape out of the cash register. Breakfast was included, and it was actually a cute setup. There were several options, and you also got a drink; I got muesli and yogurt with a piece of fruit and coffee.

I wanted to arrive at the Anne Frank House by 9 but got a little lost and didn't get there until 9:15, meaning I was right behind a bunch of school groups- joy. I never used public transportation in Amsterdam, opting to walk everywhere. Firstly, the city center is pretty small, so since I was always rushing about it was faster to walk. But Amsterdam is a series of canal rings, so it can be pretty easy to get lost.

Seeing the Anne Frank House was a treat. When I was younger, Holocaust lit really interested me, and obviously The Diary of Anne Frank is the major work in that genre. The biggest group of schoolkids was British, and the kids were probably about 10, so they were at the perfect age to appreciate the story. In general, they were kind of bored and antsy, but one boy you could tell was very interested and knew a lot about Anne. At one point he called some kids out for not paying attention, and kept making comments like, "Wow, three people shared this room, and it's smaller than my sister's room". Adorable.

From there, I marched to the Rijksmuseum. The state art museum is for all practical purposes closed, but they have a small exhibition of the masterworks in the collection. Unfortunately they still charge full price...and don't have a student discount. The treasure of the collection is Rembrandt's The Night Watch. They also have four Vermeers, although the most interesting was on loan to somewhere else.

I had lunch on the street, having a hot dog and a waffle with strawberries. In Dam Square, there was a sand court set up and I saw kids so at first I thought it was beach volleyball. Then I looked a little closer and realized I was in Europe...definitely beach football.

In Dam Square I met my Sandemans New Europe free tour. I'd heard of these tours from friends. The guides work on a tips-only basis (although apparently the guides have to give the company a certain amount of money per head as overhead to cover the cost of flyers, etc., so you definitely have to pay something.) It was unfortunate that the tour was one of the last things I did in Amsterdam, since I felt like I had walked around most of the places we saw already, although I still got a lot out of it.

I was supposed to pick up my suitcase from the hostel by 6, which was ok, since my train was at 7 anyway. However, by the time the tour was over it was about 4:30, and I still hadn't done the Heineken Experience, which even someone who doesn't drink beer told me was a highlight of her time in Amsterdam. I did it, rushing a bit, but it was still fun; it definitely was the kind of thing that would have been much more fun with a travel buddy, though. I made it back to the hostel more or less at 6, not that it mattered because there was only one person at the desk and she was pretty busy.

I got myself some deliciously cheap made-to-order pasta and some Heineken at the station and waited for my train. I was a little nervous because the sign said the destination was Moscow...and none of the intermediary stops were Berlin. Some other people were also confused. The signs on the train when it pulled in were partially in Russian. However, they later changed it, and the train was going to end up in either Prague or Warsaw.

For the "overnight" train that left Amsterdam at 19:01 and arrived in Berlin at 4:23, I opted for a six-person bunk. Surprisingly it wasn't too much more expensive than a seat; I can't understand why some people opted for the regular seats for a long journey. I had been in four-person compartments on trains before but never for six. Of course I got stuck with one of the tops. There were four Americans going to Prague who all knew each other and some other guy who got on shortly after Amsterdam and fell promptly asleep with his shoes on.

Luckily I got some sleep so I wasn't too dead when the train threw me out at the crack of dawn. I had made a hostel reservation for Tuesday night because I knew I would want to sleep. I grabbed a cab to baxpax Downtown Hostel. The epic battle began.

Baxpax is a new, pretty highly rated hostel, but I especially chose it because of its 24-hour reception. However, the clerk informed me that I had to check in by 3 a.m. I was staying in the "K Studio", a 50-bed dorm (not for novice hostellers but surprisingly livable), and he said he couldn't let me in because I would never find my bed and would make too much noise etc. etc. However, I would still be charged for the night since they considered it a cancellation. The only open beds were in that room, so I was going to be on the hook for a bed he wouldn't let me into until 8 a.m. I was furious. Finally, he let me in. I left my bag in a locker outside the room, so I don't think I made too much noise and my bed was right by the door. I would have been so mad if he hadn't let me in because there were some REALLY loud Spanish guys who were obviously much more disruptive. So I finally got some sleep.

I'm about to run out of Internet time so I'll pick this up later. I leave for Munich tomorrow. I've enjoyed Berlin, but I'm exhausted from going so many places. Also, I haven't forgotten my trip to the Balearic Islands...

Already almost too late for typical Colleen end-of-something nostalgia

I was so busy in May that I couldn't devote my usual effort to blogging so I just gave up altogether.

You missed:
Daytrip to Toledo (to be honest I wasn't overly impressed)
País Vasco (Bilbao is Bilbao, Guernica was kind of creepy, Elantxobe was gorgeous, San Sebastián was gorgeous and I ate the best tapas of my life)
Copenhagen and Stockholm (beautiful and a lot of fun, we explored both cities by bike)
Group trip to Córdoba and Granada (Gran Mezquita, Alhambra, etc.)
Barcelona with my brother and dad
Diane visiting while I was taking finals
Me teething (one of my 12-year-old molars is finally coming in all the way)
Me having a pedestrian crash (I still have a giant yellow and purple bruise)
La cena de despedida (some of my friends are already back in the States!)
Colleen finding an internship last minute

Now I am done with finals and waiting for my tutor to get back to me so I can get my last paper done. Tomorrow I am meeting Diane in Palma de Mallorca and then we're taking the ferry to Ibiza for a day and a half. We'll get back to Madrid either very late Friday or very early Saturday, depending on where you break the days. That Saturday my host family leaves for the U.S. for the first time, heading first to New York City and then down to New Jersey to attend the wedding of one of their former Georgetown students.

I can't believe the program is for all practical purposes over! The fact that our departures are spread out over a month makes it seem slightly less dramatic (aka I only cried a little on Saturday night), but I probably won't see most of the people in the program until next year at Georgetown, even if they are here all month. The second semester definitely went by faster (I guess that is somewhat a statement of the obvious since there was no three week Christmas break in the middle). I can't believe how little time I have left in Madrid, especially since I've got a pretty hefty travel agenda. An entire (academic) year in Spain is over! I am almost a senior in college! I need to figure out what I want to do with my life after graduating... I'm taking the LSAT in September and also considering signing up for the Foreign Service Officer exam, but we'll see.

ahhhhh

Too busy to post. See you in June.

HAPPY GEORGETOWN DAY

Happy Georgetown Day, friends.

I got all of my preregistration requests for next year, although there are only two people in my Spanish class, so we'll see if that still runs.

All of a sudden the semester is feeling like it's going by really quickly (except of course when I'm sitting in certain classes).

Tomorrow the Georgetown group is going to Toledo. The next weekend I think I'm going to País Vasco. The weekend after, I'll be in Scandinavia. The subsequent weekend, the Georgetown group is going to Córdoba and Granada. That Sunday, my Dad and Patrick arrive and want to go to Barcelona the next weekend. I'm also expecting Diane around the same time frame. Then it's exams, and then it's June.

I have three exams the last week of May. For one class, I have a paper instead of an exam. For my last class, I was expecting an exam June 10, but this week in class the professor said something about "no hace falta hacer el examen si participáis en clase", which would mean I would have pretty much all of June to bum around Europe. I still don't have a return ticket...

My plan for my last hurrah is to start in the Netherlands, see Germany (definitely at least Berlin and Munich), Salzburg, Austria, Interlaken, Switzerland, and then in Italy Milan, Cinque Terre, and I was thinking about flying out of Pisa, but that might turn into Florence or Rome because I love Italy so much. I might also throw in a weekend to a week in Ireland, or maybe another trip to Morocco if I could find someone to go with.