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"The reason that fiction is more interesting than any other form of literature, to those who really like to study people, is that in fiction the author can really tell the truth without humiliating himself." — Jim Rohn
Echoes of the Great Farewell
Edge of the Bleeding Abyss
Plight of the Humans
Singularity Night Fever (which does not yet exist)
Mindplex (which does not yet exist either)
The Last Aphrodisiac
Thanatopticon
Ladies Night #3
Assorted Random Juvenilia
for the brave and tolerant soul with way too much time to waste…
Amazingly enough, in 2006 at age 39, after decades of farting around with fiction-writing in my spare time, I finally finished a novel!
OK, arguably it's more of a prose poem than a typical novel per se … but it's novel-length and with a novel-like complexity of plot and characterization, even though the style as often as not veers into surrealism and stream-of-collective-unconscious and such….
Anyway: this book is definitely not for everyone. You've got to like avant-garde, experimental literature. But if you do like experimental writing, and have a taste for sex, AI, mushrooms, superintelligent elfin aliens and the (real and imagined) End of the World, then Echoes may well amuse you.
You can download Echoes of the Great Farewell right here, in PDF form.
If you want a nicely bound paper copy you can buy one via Lulu.com or Amazon.com.
After writing Echoes, I decided to strike out in a somewhat different fictional direction.
It's here, in PDF form.
Edge of the Bleeding Abyss is a sort of meta-novel, structurally inspired by the Arabian Nights. It's a series of short-stories dealing with radical-futurist themes: advanced AI's going bonkers and/or doing naughty things, Singularitarian transcension events, the impending irrelevance of humanity, superhuman intelligences from other dimensions and so forth. But there is also a meta-story, involving some folks telling these short stories to a potentially destructive AI.
The stories are all quite different from each other in style, form and content. But some of them interconnect in various ways, including some common characters, universes and themes.
I wrote this stuff during 2007-2008, and finally finished it off during January 2009.
Brief descriptions of the main parts of the book follow:
Meta-story
The mad scientist's daughter Shahrizad is railroaded by a quasi-sane, superhuman AI her father and husband have created, into telling it a series of stories in order to potentially avert it from destroying humanity.
Edge of the Bleeding Abyss (the story)
The last 1/3 of the book comprises the title story, which unlike the preceding stories is told in Echoes of the Great Farewell style hallucinogenic prose, rather than literary-SF style prose. This story is properly conceived of as a sequel to Echoes, conceptually and artistically (though it's more precisely structured than Echoes, due to its diaristic format). It plays a key role in the meta-story.
Capsule summary: mad scientist gets trapped on an Arctic island all winter without his meds, hides in a hole in the ground wrapped in sealskin going insane in the dark winter, and comes into contact with superintelligences from another dimension, some of whom adopt the form of midget Elvis Presleys, and who communicate to him copious information regarding the true nature of the universe.
Bunnocalypse
The second longest and most complex story in the collection, Bunnocalpyse is based on a bedtime story I told my daughter Scheherazade some time ago.
The setting is post-apocalyptic: the human race has annihilated itself via engineered nanobiopathogens, but fortunately, just before the end, some scientists used nanotech to create a family of highly intelligent rabbits … who turn out to be immune to the nanopathogens, and move surprisingly quickly toward their own Bunny Singularity, aka "The Bunnularity."
However, half the tale is occupied with the other ramblings of Goran Badunovich, the mad scientist who hallucinates the Bunnularity on his deathbed — including a fake preface to a book, which includes a fake book review of another book (devices I borrowed shamelessly from Stanislaw Lem).
Badunovich develops the amusing mental issue of perceiving all humans as apes, with rare exceptions.
Coauthored with Stephan Vladimir Bugaj, The Big Questions is perhaps the closest thing to conventional SF I've ever written.
However, it's still rather odd, with multiple sections told from different perspectives, and a lengthy intellectual dialogue with a superintelligent AI….
This story was also published in three sections in the Journal of Science Fiction and Philosophy, spread across three issues.
The intro paragraph at the start of the story, setting the stage for the action of the story itself, is as follows:
Life on Earth had been generally positive since the Transition: war, famine, aging and disease were things of the long past. A complex system of technological restrictions imposed by a sentient global computer network, created at the time of the Transition, prevented the various risks earlier futurologists had foreseen as potentially accompanying the advent of advanced nano-bio-info-cogno capabilities. Rogue wireheading was avoided via restrictions on mind-altering technologies, those that were available being carefully controlled by The Guardian. Most humans happily occupied themselves via social and sensory pleasures, but a significant subset also enjoyed more intellectual pursuits: mathematics, science, literature, art. A small minority, on the other hand, chafed at the restrictions placed on them and, for various reasons, wished that the advanced technologies that had enabled the Transition had been used for purposes more ambitious than the creation of a carefully-controlled human utopia. Post-Transition society tolerated this level of malcontentment due to the general value it placed on freedom of thought; and also because the overall socio-technological system in place was so powerful and robust as to render the odds of this malcontentment having any practical impact almost vanishingly small….
The story tells the tale of one of these malcontents and how he nearly brings down the whole system via cleverly exploiting a natural catastrophe, with a goal that is not destructive in orientation but rather aimed at resolving various philosophical questions.
Enlightenment 2.0
Not a conventional story, but an interview between two journalists and a superhuman AI, followed by some stream-of-consciousness angst lifted from one of the journalist's minds.
As well as highlighting the familiar issue of the dangers of superhuman AI — even when said AI is well-intentioned according to its own ideas — this story manifests my ambivalent, complex feelings toward spiritual "wisdom traditions" in general and Zen Buddhism in particular. The AI in the story is an AI Zen Master, but using his superior architecture and processing power to intensify the glory of his Enlightenment, he arrives at conclusions different from human Zen masters, and not terribly palatable to his human creators….
My Spurious Self
This is contained within Bunnocalypse, but I'll describe it here separately anyway — what the hey.
After reviewing a lot of papers for the AGI-08 conference (many of which were in fact extremely excellent, both in content and in style), I was feeling incredibly fed up with academic prose, especially in its more bloviatorial incarnations.
So I decided to write a story in an incredibly convoluted and annoying prose style.
If you can bear to get through it, it actually makes some interesting points about the future, and comes to a fairly humorous punchline by the end.
Philosophically, the essential question posed by this story is whether, if we do choose to arrest the development of advanced technologies due to fear of existential risks, we'll be dooming ourselves to eons of soul-killing boredom.
Taking a cue from some of Stanislaw Lem's later works, the story is written in the form of a review of a fictitious book, by a fictitious reviewer. However, as it progresses it diverges a fair bit from the Lem inspiration into regions that might be considered more Dostoevskyan — or even Goertzellian….
Two Actual Dreams
These two constructs aren't technically fiction, as they are accurate recountings of dreams I had.
After writing so much dreamlike fiction, I found it interesting to spend a little effort writing down actual dreams, rather than just semi-dreamlike imaginations. For sure, actual dreams are different, in the nature of the symbolism that emerges, and the nature of the rhythm and (in)consistency…
The two dreams I wrote down are:
Colors, a dream of life in an abstract colored world, with obvious parallels to transhumanism. This one is actually a recurrent dream I've had for years.
Copy Girl and the Pigeons of Paraguay, a whackier dream that rambles from one theme to another, but with the ultimate thesis that the Singularity is already here. This was an unusual dream in that it included a mushroom trip, and the trip in the dream was pretty faithful to the actual experience. I personally found this dream rather amusing, though I may be the only one (echoing Auden's famous comment that everyone loves the smell of their own fart….)
In Edge, I embedded the former dream inside the latter, just to go with the Arabian Nights theme — and because the latter dream did contain hints of the former throughout.
The most insane book ever written, a concoction of my favorite schizodelic alter ego Jesucopter Crudslinger…
As it says on Amazon.com,
Beyond plot, narrative, character and sense, at times even beyond insanity, "Plight of the Humans" is an anti-novel mourning and celebrating the loss of the human race, and an illustration of Antonin Artaud's dictum that "All true language is incomprehensible, like the chatter of a beggar's teeth." Leaving the likes of Burroughs, Celine, Henry Miller and Kathy Acker far behind in a cloud of quantum dust, Crudslinger's bizarrely rambling yet carefully wrought prose digs deeper than ever before into the mathematical precision of ultimate madness. Have you ever felt the urge to plunge simultaneously into the unconscious minds of a dozen different schizophrenics, including humanity itself, while experiencing thirty-three orgasms and a large dose of curiously tainted DMT? Do you have the guts to embrace the Plight of the Humans?
Here you go, free of charge except the infinite cost to your immortal soul: Plight of the Humans
The Last Aphhrodisiac
In gloriously seductive pdf, aqui
I was driving late at night listening to a Morphine CD in the car, then got home, lay in bed and fell asleep with the song "Cure for Pain" in my head. I had a number of dreams on the theme (what if pain were really eliminated, in some interesting sense? what would life be like? what if it were rediscovered?) and woke up plagued by this story. At first I thought it would take a single page to write down, but it wound up 15 pages, and the punchline doesn't start to unfold till page 7 or 8. This is the first story I've written in a long time that doesn't involve AI in any serious way. Rather, it uses future tech like uploading-to-superhuman-form and cranial jacks to enlarge upon certain aspects of human relationships, especially romantic ones. It's probably the closest thing to a maudlin love story I'll ever write (well, I hope so). Also, I think Suzy is my best female character so far — in my novels so far the female characters are largely props for the male ones (with the exception of the narrator Shahrizad in edge, but as the narrator Shahrizad doesn't get to do too much). But Suzy is definitely nobody's prop!
Warning for tots and tykes: there's not really any X-rated stuff here (unlike what may be found nested deep in my novels ;-p), but the theme is relentlessly "adult" … most of the story occurs in bed … (ahh, the things that can transpire between a man, a woman, and an illicit cranial jack modification device…!).
In 100% free pdf, just for you…
Listening to Buckethead's "In Search of The", and trying to practice Buddhist "Neti neti" practice while halfway in the middle of the dissipation of my second marriage…
The plight of the humans prelude on Buckethead?
I used to write a lot of poetry but I gave it up a decade ago, deciding prose-poetry matches my skill-set better. There are some pretty poetic portions of my novels, but still, hallucino-poetic prose is different than poetry.
I suppose this made me (for a while, anyway) one of the five people in the world who read poetry but don't write it!
However, one day when reading Kate Braverman's poem Ladies Night #2, I kept reading words different than the ones on the page. I was rewriting the poem in my mind, much as, when I listen to music, I often hear my own mental improvisations rather than what's being played in the outside world. So I wrote down my Goertzel-ized Braverman, and was also unable to resist mixing in some of Bukowski's poem back to the machine gun and the lyrics to the Hendrix song Third Stone from the Sun.
But, the whole thing is not plagiarisms and mutations — there is plenty of original unadulterated Goertzelitude in there as well…
Though there are some bright spots, overall I was clearly in a dark mood when I wrote this, frustrated by aspects of my relations with the "fairer" sex. When I'm in a perky mood I don't think about poetry, I play music. (Actually, music is great regardless of my mood 😉
I classify pretty much every piece of fiction or poetry I wrote before Echoes of the Great Farewell (which I started in 2006, I think) as "juvenilia." Which is another way of saying — no matter how cool the basic idea was, and how good some of the sentences are, still it kinda sucks….
Not that it all totally sucks though — there are some great bits and pieces — but the style overall was never really what I wanted.
Whereas the fiction I wrote and linked above, even if YOU think it sucks, truly did realize my vision for it….
Anyway, the thousands of pages of whacky fiction and poetry I wrote in the late 80's and early 90's, I now view as "practice at the art of writing." I didn't try to publish the stuff (except via posting it on my website and not advertising it at all) because I generally wasn't very happy with it.
True, in my mid-30's I was a pretty old juvenile, but I suppose the fact that I matured as a scientist earlier than as a writer can be attributed to the fact that the former was my profession and the latter "just a hobby." I always loved surrealist fiction and poetry writing but never spent as much time on it as on science. So it's not surprising my fiction/poetry took longer to get honed. (Of course, by "honed" I mean according to my own standards! My writing may still not be to anyone else's taste, but starting with Echoes, at least it's to my own taste!!)
Some of my writings from that period can be found here, in rather disorganized form. Muck around if you wish! There are a few jewels amongst the silliness, awkwardness and chaos. For instance, this quasi-random excerpt from my old unfinished rough-draft novel Wargasm, though badly formatted and organized, contains some pretty nifty psychotropic quasi-poems from my early and late twenties. I would love to find the time one day to filter through this stuff, and extract and clean up the good parts and make a real work of art out if it…. But that seems unlikely to happen, as writing new stuff is much more fun.
Also, in 2000 or so I wrote a quasi-theological prose-poem called The Journey of the Void , which isn't quite either fiction or nonfiction….
FYI, my favorite poem, for a long time, was The Petrifying Petrified, by Octavio Paz. The last & best verse of it is here. I'm not sure what my favorite poem is now. I think I may have come to prefer Paz's Blanco, finally.
And there were also some experiments with Web poetry — such as The Truth —
Zoltán says:
January 2, 2015 at 10:08 am	(UTC 0)
I also made art. i wont read all of these articles now.
my art i imagined was a number of crude scenes. for example a muscular female together with other squadmates engaged in fight with some other persons and then they get injured and i dont quite remember but a psychic warrior soon escorts one after the explosion th efemale having one leg lost and stating to Her something like on your feet or something.. but i dont remember this.
then also at another point sitting pondering with an arm in the hand (all of left from a squadmate, a male squadmate i think).
Zoltan says:
sometimes i sing but more like grunting around but it sounds cool at times from inside my head.
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September 28, 2018 at 11:44 am	(UTC 0)
Ahh I love it!! 🙂 I'm a little late on responding to these i know, but i wanted to comment anyway because they made me so happy to read. I want to read "Echoes of the Great Farewell". Sounds incredible to me. I love your writing style and subject matter. "hallucino-poetic prose" sounds beautiful and original. I mostly write poetry and spiritual/self-awareness stuff. haha That's what i'm used to writing and enjoy writing it. But i have had a AI Novel in my head for years that i hope to complete and give birth to one day in the not to distant future. I loved Ladies Night #3 😉 I liked reading about how you came up with it. I feel like that was an interesting and innovative process of creation. Thanks for sharing your art, i appreciate it.
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Insurance Coverage & Costs Access to Care Quality & Care Delivery Health Care Markets Employers/Consumers Health Plans Hospitals Physicians
Laurie E. Felland
Ellyn R. Boukus
Chapin White
Print This Page Email This Page Download pdf
Competitive Albuquerque Health Insurance Market Gears Up for Coverage Boom
RWJF Reform Community Report
Chapin White, Laurie E. Felland, Ellyn R. Boukus, Kevin Draper
ith pragmatism prevailing in New Mexico's political tug of war over national health reform, Albuquerque health insurers are eager to compete for new Medicaid enrollees and people eligible for subsidized private health coverage, according to a new Center for Studying Health System Change (HSC) study of the region's commercial and Medicaid insurance markets (see Data Source). While partisan differences and turf battles initially delayed implementation of key provisions of the 2010 Patient Protection and Affordable Care Act (ACA), state leaders have established a state insurance exchange and agreed to expand Medicaid to people with incomes below 138 percent of poverty as of January 2014. As a result, new carriers are entering the commercial health insurance market to offer products on the exchange, and Medicaid managed care plans are gearing up for a major state overhaul of the program that will coincide with an estimated 150,000 or more people gaining Medicaid coverage statewide.
Compared to many communities, Albuquerque has a relatively competitive health care market, which may contribute to a smoother transition under health reform. For example, two of the three major health plans are part of local integrated delivery systems that compete vigorously on costs and reputation. Also, the Medicaid program is unusually well integrated into the overall Albuquerque insurance market and delivery system, with many of the same plans and providers serving both Medicaid and commercial enrollees. Still, the ACA will require tightening of regulations in the nongroup, or individual, and small-group insurance markets. Key factors likely to influence how reform plays out in Albuquerque include:
Many low-income residents. Albuquerque is home to many low-income people and workers in small firms who face challenges gaining health insurance. As a result, the ACA will likely produce dramatic coverage gains, as Medicaid eligibility expands and new federal subsidies become available for lower-to-middle-income people to buy private coverage in new state health insurance exchanges.
Three competing hospital systems. Albuquerque hospital systems—Presbyterian Healthcare Services, Lovelace Health System and the University of New Mexico Health Sciences Center—compete in similar geographic service areas. Many physicians are aligned through employment or other means with a particular hospital system.
Local health plan competition. Three insurance carriers—Blue Cross Blue Shield of New Mexico (BCBSNM), along with two provider-owned plans, Presbyterian Health Plan and Lovelace Health Plan—compete vigorously with national insurers like UnitedHealth Group in the nongroup and small-group markets.
Limited networks accepted. Unlike many markets that have moved away from health maintenance organization (HMO) products that limit patients' choice of providers, HMOs are common in Albuquerque. Meanwhile, demand for high-deductible health plans, which offer lower premiums in exchange for higher out-of-pocket cost sharing, is relatively low.
Overhauled and expanded Medicaid program. Under a federal demonstration waiver, New Mexico is streamlining Medicaid managed care—which will be known as Centennial Care—by reducing the number of plans, integrating physical, behavioral and long-term care services that have been managed in a more piecemeal way, and steering patients to primary care. At the same time, Medicaid coverage will become available to tens of thousands of low-income people.
Competitive state insurance exchange. The three major local insurers are offering exchange products, and two new entrants to the commercial market—Molina Healthcare and New Mexico Health Connections, a co-op plan—are selling products in the exchange. BCBSNM has developed a low-premium, narrow-network product for the exchange, and other carriers are developing similar products.
Market Background
State Regulatory Approach
Large Medicaid Program
Three Competing Hospital Systems
Competitive Health Insurance Market
HMO Tradition Ties Plans to Providers
Revamping Medicaid Managed Care
Stop-and-Go Reform
Issues to Track
ith about 900,000 residents, the Albuquerque metropolitan area is relatively small compared to other metro areas, but the four-county region—Bernalillo, Sandoval, Torrance and Valencia—is home to almost half of New Mexico's residents (see map). The region is among the fastest growing areas in the country, with the population increasing by 22 percent over 10 years, more than double the national metropolitan average (see Table 1). New Mexico is one of a growing number of so-called majority-minority states—Latinos account for almost half of the Albuquerque population and almost 70 percent of population growth since 2000. Whites and blacks make up 42 percent and slightly more than 2 percent, respectively, of the population. The area has a strong pre-Columbian history and identity, and Native Americans, at about 6 percent of the population, constitute a relatively large share of residents.
Albuquerque-area residents tend to have lower incomes, with 37 percent of the population having incomes below 200 percent of poverty compared to the metropolitan average of about 32 percent. The proportion of Albuquerque residents without health insurance (16.6%) tracks the metropolitan average, but the region has a relatively low level of private health coverage—about 50.6 percent compared to the metropolitan average of 56.3 percent. The area also tends to have more small employers, which are less likely to offer health coverage. In New Mexico, half of workers are in firms with fewer than 50 employees, compared to 45 percent for states on average.1 Albuquerque residents on average have lower levels of diabetes and obesity than metropolitan areas overall but higher prevalence of asthma, smoking and fair or poor health status.
A bright spot in Albuquerque's economy is a relatively low unemployment rate, which was below the metropolitan average during and after the Great Recession of 2007-09. Along with many small firms, the region is home to large federal government institutions, including Sandia National Laboratories and Kirtland Air Force Base, and associated private contractors. Other large employers include Intel, the University of New Mexico, Albuquerque Public Schools and the three major hospital systems.
ew Mexico historically has imposed few rating restrictions on insurance carriers. The state currently allows nongroup carriers to deny individuals coverage and allows nongroup and small-group carriers to rate premiums by age, tobacco use, industry, gender and health status, albeit with some restrictions on the last two factors (see Table 2).2 To meet ACA requirements, New Mexico will start requiring nongroup plans to offer coverage to all (subject to capacity) and vary nongroup and small-group premiums only by age and tobacco use (see Table 3). Just before passage of the ACA, New Mexico implemented a medical loss ratio requirement of 85 percent for small-group products—more stringent than the ACA's 80 percent—and 75 percent in the nongroup market, which has since been raised to 80 percent to comply with the ACA. In 2011, New Mexico enacted a measure to allow the superintendent of insurance to review insurers' overall financial health and improve transparency of the rate-review process.
Before the ACA's passage, New Mexico also had implemented measures to help people gain private coverage. The New Mexico Health Insurance Alliance is a quasi-public alliance of health insurers created by the state Legislature in 1994 to sell coverage to small businesses, the self-employed, and individuals who lost group coverage and exhausted any continuation coverage. Funded by premiums and carrier assessments, the alliance offers a comprehensive coverage product through the major carriers. Unlike the nongroup market, the alliance offers coverage without medical underwriting, and, unlike the small-group market, it offers group coverage to the self-employed. Still, alliance enrollment has been relatively low—less than 4,300 in 2012—reportedly because of high premiums. The state initially envisioned that the alliance would serve as an insurance exchange—similar to the state exchanges under the ACA—although the alliance lacked the federal subsidies that the ACA will provide.
The state has operated a high-risk pool, the New Mexico Medical Insurance Pool (NMMIP), since 1988 for people denied coverage because of pre-existing conditions or charged a premium more than 125 percent of the standard rate. The NMMIP is administered by Blue Cross Blue Shield of New Mexico and had approximately 8,500 enrollees in 2012. The state folded an ACA-required federal high-risk pool into NMMIP, but enrollment in the federal high-risk pool was suspended in March 2013 because of dwindling federal funding.3
ew Mexico covers many low-income people through Medicaid and the state Children's Health Insurance Program (CHIP). The state is unusual in combining relatively expansive eligibility with relatively high provider payment rates—often states have one or the other. About 525,000 people were enrolled in New Mexico's Medicaid/CHIP program in April 2013—more than a quarter of the state's population and the fifth highest rate in the nation. Medicaid income-eligibility cutoffs for pregnant women and children 18 and younger are higher than in most states, at up to 235 percent of poverty for pregnant women and 185 percent for children, with CHIP covering children from 186 percent to 235 percent of poverty. Low-income parents can receive coverage: if working, up to 85 percent of poverty, if not working, up to 28 percent of poverty.
Nondisabled, childless adults are not currently eligible for Medicaid, but workers who earn up to 200 percent of poverty may receive coverage through the State Coverage Insurance (SCI) program, a Medicaid demonstration waiver. The SCI is offered to individuals or through employers and funded through a blend of individual and employer contributions, along with state and federal funds. This program offers limited benefits, charges modest premiums and includes sliding-scale cost sharing for services. The state has limited enrollment to 40,000 people since November 2009 because of an enrollment cap in the SCI waiver agreement.
Unrelated to the ACA, New Mexico has streamlined the Medicaid application process and conducted outreach activities to encourage enrollment, which also are expected help enroll additional people under reform. Children and pregnant women can gain immediate access to the program through presumptive eligibility, which offers short-term coverage for up to 60 days while formal applications are processed. The state also places workers at hospitals and health services organizations to screen and enroll Medicaid applicants on site. Starting in late-2013, the state is also rolling out a streamlined online application system.
Still, from an administrative perspective, New Mexico's Medicaid program is complex and fragmented. The state deems people eligible for the program if they fall in one of approximately 40 different eligibility categories and manages services for enrollees through 12 federal waivers. Respondents expect less fragmentation as the state expands Medicaid under the ACA and streamlines the program under Centennial Care.
hree hospital systems serve Albuquerque: Presbyterian Healthcare Services, with three acute-care hospitals and a total of more than 700 beds; Lovelace Health System with four acute-care hospitals and 500 total beds; and the University of New Mexico Health Sciences Center (UNM) with two acute-care hospitals and approximately 600 beds.4
The hospital systems' service areas overlap heavily—all three campuses are clustered downtown within a mile of each other, and all three systems have built facilities in the fast-growing areas west of the Rio Grande. As a teaching facility with the only Level 1 trauma center in the state, UNM provides a large safety net role for low-income patients, as well as specialized care that the other systems don't offer, giving UNM broad appeal as a so-called must-have provider in health plan networks. UNM also offers a program that coordinates and heavily subsidizes care for about 30,000 low-income, uninsured Albuquerque residents. Most Albuquerque physicians are employed, either in one of the hospital system's medical groups or in large independent practices.
Uninsured people and Medicaid enrollees in Albuquerque primarily receive care through the three health systems, several federally qualified health centers, other safety net clinics and some private-practice physicians. Given the relatively high proportion of Native Americans in the area, the Indian Health Service is also an important part of the Albuquerque safety net (see box below). Respondents indicated that relatively high Medicaid enrollment, coupled with relatively low rates of commercial coverage, leads most providers to accept Medicaid patients. New Mexico's relatively high Medicaid payment levels, with rates almost on par with Medicare payment, also reportedly encourage provider participation.
Albuquerque's per capita supply of hospital beds and physicians is similar to that of other metropolitan areas. Still, access to care can be challenging in the more rural areas of the market, which suffer from sparse provider supply and long travel distances to provider facilities. Further, respondents noted considerable concern that provider capacity will be insufficient throughout the market as many people potentially gain insurance coverage and seek health care services under health reform. One respondent noted that the state Legislature may consider expanding physician assistants' scope of practice as one way to address shortages of primary care providers.
Access to Care for Native Americans
To accommodate particular barriers to care and the rural nature of many Native American communities, the safety net for Native American pueblos, tribes and nations is broader than the traditional safety net. The federal Indian Health Service provides health care to Native Americans by operating outpatient facilities and is the payer of last resort for services received in other facilities.
Low-income Native Americans also are eligible for Medicaid and have the option of choosing a Medicaid health plan but are not required to be in managed care except for those receiving long-term care services or dually eligible for Medicaid and Medicare. A state proposal to mandate enrollment in managed care for Native Americans in Centennial Care, the state's revamped Medicaid program, was disallowed by the federal government, although Native Americans have the option to enroll. Also, new cost-sharing requirements under Centennial Care—including copayments for non-urgent emergency department use—do not apply to Native Americans because of federal requirements.
The ACA also includes special provisions for Native Americans—they are exempt from the individual mandate penalties, they will not face any cost sharing if they enroll in an exchange plan and have income below 300 percent of poverty, and they may enroll in exchange plans at any time, not just during an annual open-enrollment period.
n contrast to the increasingly consolidated commercial health insurance market in many metropolitan areas, the Albuquerque market remains relatively competitive. The region has long been served by three major plans: BCBSNM, a part of Health Care Service Corp., a mutual company that operates Blue plans in four other states; Presbyterian Health Plan, owned by nonprofit Presbyterian Healthcare Services;5 and Lovelace Health Plan, which is owned by Nashville, Tenn.-based Ardent Health Services, a for-profit hospital chain that also owns Lovelace Health System.
Although BCBSNM is the largest carrier in the state, the commercial insurance market in Albuquerque is fairly competitive across group size. Statewide, BCBSNM has about half of the nongroup sector, while Presbyterian has about a third of the market. BCBSNM, Presbyterian and Lovelace each hold roughly 30 percent of the small-group market. National carriers UnitedHealth Group and Cigna are also in the commercial market and account for the remainder of nongroup and small-group enrollment. In the large-group market, BCBSNM has about 40 percent of the market statewide, followed by Presbyterian with 29 percent and Lovelace with 24 percent.6
While both the Presbyterian and Lovelace health plans are closely tied to their respective hospital systems, respondents perceived Presbyterian as having stronger local roots and more stability, noting that employers that can afford a higher premium appear to prefer the Presbyterian brand. Lovelace, on the other hand, is viewed as aggressively competing on price for employers' business. Reportedly Ardent's acquisition of the Lovelace hospital system and health plan a decade ago undermined Lovelace's community ties and perception as a local plan, but recent investments in Albuquerque have strengthened the plan's community ties.
Three recent events also have contributed to speculation about Lovelace Health Plan's future. First, in late-2012, contract renegotiations broke down between Lovelace and ABQ Health Partners, a large multispecialty physician group that historically was central to the plan's identity. After an acrimonious public dispute, ABQ Health Partners left the Lovelace network. Second, Lovelace lost significant enrollment after losing a bid to continue serving Medicaid patients and subsequently sold its Medicaid enrollment to Molina Healthcare. And, third, the Lovelace Health Plan CEO abruptly departed in mid-2013, with Optum, a subsidiary of UnitedHealth Group, stepping in to manage the plan until a new CEO is selected.
hile HMOs with modest copayments and low or no deductibles all but disappeared from many markets, they continue to be the most popular product type in Albuquerque, followed by preferred provider organization (PPO) products. High-deductible health plans remain largely absent in Albuquerque. In line with the prevalence of HMOs, Albuquerque is well ahead of the national curve in employer and consumer acceptance of products with limited-provider networks.
Beyond the universal need to contract with the University of New Mexico flagship hospital, health plans in the market generally limit hospital contracts to either the Lovelace or Presbyterian systems. BCBSNM's hospital network includes UNM and Lovelace but excludes Presbyterian. Respondents reported that many employers and employees in the market generally accept that choosing a health plan equates to picking a hospital system and physician group.
There appear to be limited provider-payment innovations in the market, with the exception of the Presbyterian Health Plan, which puts affiliated hospitals and physicians at risk for the cost of patients' care through capitated—fixed, per-member, per-month—payments. Presbyterian Healthcare Services also developed a Medicare Pioneer accountable care organization in late 2011 but dropped out in 2013, citing difficulties achieving savings because service utilization was already low.7 Presbyterian also has accelerated acquisition of physician practices, although respondents perceived only limited administrative and clinical integration of the acquired practices.
ew Mexico has long supported Medicaid managed care. Approximately three-quarters of Medicaid enrollees statewide are enrolled in health plans participating in the state's risk-based managed care program Salud! Managed care is mandatory for pregnant women, parents, children and disabled individuals, except those who are Native American.
Historically, all three major commercial carriers in the market have also offered Medicaid managed care products statewide. Presbyterian Health Plan has been the largest Medicaid plan, with almost 45 percent of the state market in early 2013, followed by Lovelace Health Plan with a 21-percent market share and BCBSNM with about 10 percent. Molina Healthcare, a national for-profit carrier that specializes in Medicaid, serves about 23 percent of the market. Three other carriers have historically provided carve-out services to Medicaid patients: UnitedHealthcare Community Plan of New Mexico; Amerigroup, a WellPoint subsidiary, for long-term care; and Optum Health, a United subsidiary, for behavioral and mental health services.
However, plan participation in Medicaid is changing as New Mexico revamps its managed care program for 2014. The state aims to streamline administration of the program—which will be called Centennial Care—with a goal of containing costs and improving patient care. The state is combining 12 federal waivers tied to managing different services into one overall waiver and shifting to a patient-centered medical home model that emphasizes integrating and coordinating services across care settings. The state also required all participating health plans to bid competitively to provide all Medicaid-covered services—medical, behavioral and mental health, home- and community-based services, and long-term care—under fixed per-member, per-month payments, or capitation.
In February 2013, the state selected four plans to participate in Centennial Care for 2014: Presbyterian, BCBSNM, United and Molina. Several factors reportedly strengthened these plans' bids: Presbyterian is an integrated delivery system and has been the largest plan; Molina specializes in public programs; BCBSNM has strong brand recognition as a commercial plan; and United has experience serving commercial enrollees' broad health needs and managing long-term care services under the previous waiver. Lovelace lost its Medicaid contract, which represents a major shakeup for the plan and the state's Medicaid market.
With Lovelace's contract terminated, Molina recently acquired Lovelace's Medicaid members, which immediately doubled Molina's Medicaid enrollment, putting Molina on par with Presbyterian as far as market share. The transfer in enrollment was negotiated between Lovelace and Molina and was approved by the state. Lovelace plan enrollees who have switched to Molina can continue to receive care from Lovelace providers under the new arrangement.
In the coming years, Medicaid managed care enrollment will increase significantly in New Mexico. The ACA Medicaid expansion will extend coverage to almost all residents with incomes under 138 percent of poverty, including nondisabled, childless adults for the first time. And, the individual mandate and exchanges will likely lead many individuals to enroll in Medicaid who otherwise would not. How the enrollment increase, along with United's expanded role, will affect competition and market shares remains to be seen.
Provider networks reportedly are quite similar across Medicaid health plans, with the exception of the Presbyterian health system that, in the four-county metropolitan area, only serves Medicaid enrollees in the Presbyterian plan.
While Medicaid health plans now pay providers predominantly on a fee-for-service basis, the state wants Medicaid plans to implement new payment arrangements under Centennial Care. Respondents suggested that the state's more streamlined approach to plan contracting, as well as some health plans' alignment with providers, could facilitate the development of Medicaid accountable care organizations—groups of providers that are responsible for the cost and quality of care for a defined patient population.
hen the ACA passed in 2010, then-Gov. Bill Richardson (D) embraced reform and forged ahead with plans for a state-run insurance exchange. However, preparations stalled under his successor, Susana Martinez, a Republican who took office in January 2011. She initially vetoed legislation to establish a state-run insurance exchange and delayed a decision until January 2013 to expand Medicaid.
Gov. Martinez proposed establishing the New Mexico exchange administratively by designating the existing New Mexico Health Insurance Alliance (NMHIA) as the state exchange. The state Legislature resisted the approach, however, because NMHIA was led by appointees of the health plans and the governor. Legislators objected to simply designating NMHIA as the exchange without authorizing legislation, presumably because they wanted to be able to appoint some members to the exchange board.
Martinez, after working with the Legislature to find a compromise, signed legislation establishing an exchange in March 2013. The newly created exchange board includes six members appointed by the governor, six by the Legislature, plus the state superintendant of insurance and human services secretary. Although the new exchange is officially distinct from NMHIA, there is some continuity—the chairman of the new exchange board was on the NMHIA board, and the NMHIA executive director was hired as the interim CEO of the exchange.
Time pressures and technological challenges led the state in May 2013 to fall back on a hybrid model for the exchange. The small-group exchange will be state run, while the nongroup exchange will be federally facilitated, but the state will assume responsibility for plan management activities, including approving qualified health plans, regulating premiums and conducting enrollment outreach. At some point, the state intends to shift to a state-run nongroup exchange.
The state selected the largest small-group product, the Lovelace Classic PPO, as the benchmark essential health benefits plan. A number of consumer advocacy organizations and health professionals have criticized the Lovelace PPO for having weak coverage of mental health services.8
Respondents in Albuquerque cited a number of common questions and concerns about setting premiums for products offered in the exchange, similar to those heard in other markets across the country, including:
Risk pools—How sick will the newly insured be compared to the currently insured? Will young and healthy enrollees drop out because of higher rates and instead pay the tax penalty? Which small groups will drop coverage and how will this affect the risk pool?
Pent-up demand—will the newly insured make up months and years of forgone care by using large amounts of medical care?
Expanded benefits—how much utilization will occur, and how much will premiums increase because ACA minimums exceed benefits of many existing plans, especially in the nongroup market?
Risk adjustment—how will the health status of enrollees be measured, and how will funds be redistributed among carriers? Will this process adequately account for differences in risk profiles of plan members?
Along with these broader concerns, there are some additional ways these issues could play out more specifically in the Albuquerque market.
Broad health plan interest in the exchange. To date, five health plans are offering products for the Albuquerque market on the New Mexico insurance exchange. This group includes the established commercial plans—BCBSNM, Presbyterian and Lovelace—and Molina, a new entrant to the commercial market that previously served only Medicaid and Medicare enrollees. Additionally, a new co-op plan, New Mexico Health Connections (NMHC), is participating in the exchange. Molina offers nongroup products while the other four offer both nongroup and small-group products. According to a plan executive, the co-op will focus on supporting primary care through community health centers and collecting data on costs and patient outcomes. National plans Cigna and United are not offering exchange products in 2014.
Nongroup premiums expected to be relatively affordable. According to the state,9 premiums in 2014 for a silver-level policy for a 40-year-old nonsmoker in Albuquerque will range from $189 to $258 a month, with the second-lowest silver premium of $212 determining the level of federal subsidy an individual receives regardless of the plan chosen. New Mexico's insurance superintendent had expected premiums in the nongroup and small-group markets for similar products to rise by roughly 10 percent in 2014 but premiums are only about 5 percent higher on average.10 Also, one report indicates Albuquerque's premiums in 2014 will be lower than in most markets.11
Presbyterian's proposed rates were the highest among small-group products and roughly average among nongroup products. Proposed premiums from Lovelace are at or below average in both market segments, consistent with its reputation as an aggressive competitor on price. Lovelace's low premiums also may be a bid to gain enrollment following recent membership declines. As new entrants to the commercial market, Molina and New Mexico Health Connections had to set premiums without the benefit of any claims experience. Both are offering products with competitive premiums, lower than Presbyterian and Lovelace. BCBSNM is offering widely divergent plans. At one end are BCBSNM's PPO products, which offer a traditional network but with relatively high premiums. At the other end is BCBSNM's new Blue Community HMO, a narrow-network product offering by far the lowest premium in the exchange—$189 for silver-level individual coverage for a 40-year-old compared to an average premium of $232. Other health plans have not created new products specifically for the exchange.
Employers consider moves to sidestep regulations. As in other markets, Albuquerque respondents discussed ways in which employers may try to avoid ACA requirements. Although respondents reported that employers have been conservative about moving to self-insurance, a few respondents noted heightened interest among increasingly smaller employers, even as small as 25 employees. Currently, Lovelace and Presbyterian health plans will only offer a self-insured option to employers with at least 250 enrollees, though Presbyterian is creating a product targeting employers with as few as 25 employees. And a number of respondents predicted that some employers may choose to drop coverage and employer contributions altogether, shifting employees to the individual exchange, though they typically agreed this would be unlikely until after the first year of exchange operation.
Brokers feel secure. Unlike other markets, respondents did not express much concern about the role of brokers in the exchange environment. According to recommendations from a state task force, brokers will likely continue to assist small employers and individuals buy insurance and help individuals apply for coverage through the exchange or Medicaid.12 Brokers will continue to receive commissions from carriers, rather than from the exchange.13 Still, one respondent pointed out that the new medical loss ratio requirements are pressuring carriers to reduce administrative costs, with United ending broker commissions, leaving brokers to instead bill employers directly for their services.
Medicaid expansion moving forward. New Mexico is one of a growing number of states with Republican governors to opt for the ACA's Medicaid expansion. With nearly 40 percent of nonelderly adults in the state earning below 138 percent of poverty, one estimate predicts that full implementation of the Medicaid expansion will increase Medicaid/CHIP enrollment in New Mexico by about 35 percent, or more than 150,000 new enrollees.14
Respondents expect robust competition among Medicaid health plans. While BCBSNM is a relatively new entrant to the Medicaid market, many expected the Blue plan to attract many new enrollees by virtue of reputation and brand recognition. Three of the four Centennial Care plans—BCBSNM, Presbyterian and Molina—are selling commercial products on the exchange, positioning them to compete for the subsidized population and minimize coverage disruptions among those whose income fluctuates between Medicaid and subsidized private coverage eligibility. Despite these options, New Mexico is continuing to explore the possibility of establishing a Basic Health Program, which allows states to use federal funds to offer subsidized coverage to adults with incomes between 139 percent and 200 percent of poverty who would otherwise be eligible for premium subsidies on the exchange. However, federal implementation of this program has been delayed until 2015.
With more than 20 percent of New Mexicans currently uninsured, the number of residents expected to gain Medicaid coverage or other insurance under the ACA is expected to be large relative to other states. New Mexico's uninsurance rate is projected to drop by 16 percentage points under the ACA—the second-largest decline expected among states.15
Will efforts succeed to enroll the large uninsured population in Albuquerque in Medicaid or subsidized private coverage on the exchange? Will small employers add to exchange enrollment by dropping coverage in large numbers?
Will the Lovelace Health Plan overcome recent challenges to remain viable?
What impact will the state's overhaul of its Medicaid managed care program, coupled with the Medicaid expansion, have on health plan competition and enrollees' access to services, provider payment and overall program costs?
Will the New Mexico Health Connections co-op plan get off the ground in the exchange? How successful will it be in differentiating itself from the existing players?
In the exchange, will BCBSNM's new narrow-network HMO be popular?
Will UnitedHealth Group continue to stay out of the exchange? If so, will its Medicaid plan become less attractive because it cannot hold onto enrollees who "churn" between eligibility for Medicaid and subsidized private coverage?
Will New Mexico successfully manage the transition to a state-run nongroup exchange, and what implications will that have on plan participation and enrollment?
How adequate will provider supply be as more people gain coverage and seek services, particularly in rural areas already struggling with provider shortages?
1. U.S. Bureau of Labor Statistics, Quarterly Census of Employment and Wages, Table 4, Private Industry by Supersector and Size of Establishment: Establishments and Employment, First Quarter 2011, by State, http://www.bls.gov/cew/ew11table4.pdf (accessed Aug. 23, 2013).
2. Within any age group, health status may be used to vary premiums within a 250% (2.5:1) rate band. A maximum of 20% of this 250% total variation may be ascribed to gender.
3. In early 2013, the federal government notified states administering their own temporary high-risk pools of a contract change that would shift more financial responsibility to these states. The new contract would reduce the level of federal funding to states while allowing them to make necessary changes to premiums, benefit design, cost sharing and networks to remain solvent. States not wanting to accept these new terms could instead opt to transition to a federally run Pre-existing Condition Insurance Plan (PCIP). In May 2013, the NMMIP Board voted to accept the new terms and continue running the PCIP program, with supplemental funding from the state and insurers, rather than transition responsibility to the federal government.
4. HealthLeaders Interstudy, Market Overview: Albuquerque, Nashville, Tenn. (March 2012).
5. Presbyterian Health Services owns Presbyterian Health Plan and Presbyterian Delivery System, which is made up of eight hospitals statewide and Presbyterian Medical Group.
6. Kaiser Family Foundation, Large Group Insurance Market Competition, http://kff.org/other/state-indicator/large-group-insurance-market-competition-2011/?state=NM (accessed Sept. 30, 2013). Analysis of data from the Centers for Medicare & Medicaid Services, Center for Consumer Information & Insurance Oversight, Public Use File for 2011, http://www.cms.gov/CCIIO/Resources/Data-Resources/mlr.html (accessed Sept. 30, 2013).
7. Evans, Melanie, "Risk Was Too Great," Modern Healthcare, (July 20, 2013)
8. The New Mexico Center on Law and Poverty, comment letter concerning New Mexico's benchmark plan selection, http://nmpovertylaw.org/WP-nmclp/wordpress/WP-nmclp/wordpress/wp-content/uploads/2012/12/Comments-to-CCIIO-Letter-to-Franchini-Change-Benchmark-Plan-2012-12-21.pdf (accessed Sept. 30, 2013).
9. New Mexico Office of the Superintendent of Insurance, New Mexico Health Insurance Premium Summary 2014, http://nmhealthratereview.com/attachments/WebFormat_NMHI_2014.pdf (accessed Sept. 30, 2013).
10. Quigley, Winthrop, "Cost for Fed Health Insurance 5% More," The Albuquerque Journal (June 21, 2013).
11. Avalere Health, Exchange Premium Analysis, Washington, D.C. (June 19, 2013).
12. New Mexico Human Services Department, New Mexico Health Insurance Exchange Advisory Task Force Recommendations, Santa Fe, N.M. (April 9, 2013).
13. New Mexico Health Insurance Exchange, approved minutes of June 7, 2013, Exchange Board meeting, http://www.nmhix.com/wp-content/uploads/2013/05/NMHIX_June-7-2013_ApprovedBoardMinutes.pdf (accessed Sept. 30, 2013).
14. Kenney, Genevieve M., et al., State and Local Coverage Changes under Full Implementation of the Affordable Care Act, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, Washington, D.C. (July 2013).
15. Buettgens, Matthew, John Holahan and Caitlin Carroll, Health Reform Across the States: Increased Insurance Coverage and Federal Spending on the Exchanges and Medicaid, The Urban Institute, Washington, D.C. (March 2011). Additional enrollment growth is expected as a result of eligible but unenrolled individuals enrolling in the program.
As part of the Robert Wood Johnson Foundation's (RWJF) State Health Reform Assistance Network initiative, the Center for Studying Health System Change (HSC) examined commercial and Medicaid health insurance markets in eight U.S. metropolitan areas: Baltimore; Portland, Ore.; Denver; Long Island, N.Y.; Minneapolis/St. Paul; Birmingham, Ala.; Richmond, Va.; and Albuquerque, N.M. The study examined both how these markets function currently and are changing over time, especially in preparation for national health reform as outlined under the Patient Protection and Affordable Care Act of 2010. In particular, the study included a focus on the impact of state regulation on insurance markets, commercial health plans' market positions and product designs, factors contributing to employers' and other purchasers' decisions about health insurance, and Medicaid/state Children's Health Insurance Program (CHIP) outreach/enrollment strategies and managed care. The study also provides early insights on the impact of new insurance regulations, plan participation in health insurance exchanges, and potential changes in the types, levels and costs of insurance coverage.
This primarily qualitative study consisted of interviews with commercial health plan executives, brokers and benefits consultants, Medicaid health plan executives, Medicaid/CHIP outreach organizations, and other respondents—for example, academics and consultants—with a vantage perspective of the commercial or Medicaid market. Researchers conducted 14 interviews in the Albuquerque market between April and July 2013. Additionally, the study incorporated quantitative data to illustrate how the Albuquerque market compares to the other study markets and the nation. In addition to a Community Report on each of the eight markets, key findings from the eight sites will also be analyzed in two publications, one on commercial insurance markets and the other on Medicaid managed care.

redpajama_set_name: RedPajamaCommonCrawl


Jo is serving with a project called Creative Hands, which aims to share the gospel and improve the daily lives of people in a marginalised community built around a garbage dump. Jo is involved in ministry to women and youth through the church established by the project.
Ted and Rachel are Serving as Doctors in the Good News Hospital; Ted is a surgeon and Rachel is a paediatrician.
In Nottingham Friends International has two workers, Liz Middleton and Madeleine Bonicel. As well as being involved directly in student work themselves, staff workers support and encourage local churches to get involved in ministry among international students.


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LEmpire éthiopien (en amharique : , ), aussi connu comme Abyssinie, est un ancien empire d'Afrique fondé autour de 1270, lorsque Yekouno Amlak a renversé Yetbarek, le dernier souverain de la dynastie Zagwés, ce qui donne lieu à la fondation de la dynastie salomonienne, à cause de son origine revendiquée du roi Salomon ; Yekouno Amlak prit alors le titre de Negus neghesti (), ou « Roi des rois ».

L'empire a couvert une zone géographique comprenant l'Érythrée et la moitié nord de l'Éthiopie actuelle.
Mené presque continuellement par des membres du  (d'où le nom Abyssinie), principalement composé de Oromos, Amharas et Tigréens, l'Empire éthiopien a réussi à repousser les Arabes et les armées turques, à engager des relations amicales avec plusieurs pays européens, et à éviter la colonisation au cours du .

À la suite de l'occupation britannique de l'Égypte en 1882, l'Éthiopie et le Liberia ont été les deux seuls pays africains à rester indépendants au cours du partage de l'Afrique par les pays européens fin .

En 1974, l'Éthiopie était l'un des trois seuls pays dans le monde ayant comme chef d'État un empereur (avec l'Iran de la dynastie impériale des Palhavi, le dernier ayant été détrôné en 1979 ; et le Japon, qui a encore un empereur pour souverain).
L'Empire éthiopien prend fin avec la déchéance du dernier empereur d'Éthiopie, Haïlé Sélassié I, à la suite de la révolution de 1974. On peut cependant noter que peu après la chute de l'empire éthiopien, la Centrafrique a été également proclamée empire par son chef d'État, Jean-Bedel Bokassa, maintenant temporairement le nombre d'empires à trois, jusqu'en 1979. Depuis lors, ne subsite plus formellement comme empire que le Japon.

Histoire

D'mt et le royaume d'Aksoum

Pour les anciens Égyptiens, le pays de Pount connu en tant que pays d'or, faisait partie de l'Éthiopie. Selon le récit épique du Kebra Nagast, Menelik  a fondé l'Empire éthiopien en 980 avant Jésus-Christ. L'empire d'Axoum s'est développé à partir du   pour atteindre son apogée au . Vers 365 de notre ère, le royaume adopte le christianisme comme la religion d'État et devient ainsi l'un des premiers États chrétiens.

Moyen Âge éthiopien

Après la conquête de Aksoum par la reine Gudit (ou Yodit), commence une période que certains chercheurs appellent le Moyen Âge éthiopien. Selon la tradition éthiopienne, elle a régné sur les restes de l'Empire aksoumite pendant 40 ans avant de transmettre la couronne à ses descendants.

On sait très peu de choses sur cette reine et sur cet hypothétique État. Ce qui est évident, cependant, c'est que son règne a marqué la fin du contrôle axoumite en Éthiopie.

Dynastie Zagwés
Le dernier des successeurs de la reine Yodit a été renversé par Mara Takla Haymanot qui a fondé la dynastie Zagwés en 1137, qui a épousé une femme descendant du dernier empereur axoumite afin d'affirmer son héritier légitime. L'appartenance ethnique Zagwe était Agaw dont la puissance n'a pas été étendue beaucoup plus loin de leur région. La capitale était à Adafa, non loin de la moderne Lalibela dans les montagnes du Lasta. Le Zagwe a fait du christianisme la religion d'État poursuivant ainsi les traditions axumites. Ils ont construit de nombreuses églises magnifiques comme celles de Lalibela. La dynastie durerait jusqu'à son renversement par une nouvelle dynastie qui a fait descendre des anciens rois axumites la dynastie salomonique.

Dynastie salomonienne

En 1270 la dynastie Zagwe a été renversée par l'empereur Yekouno Amlak qui prétendait descendre par les empereurs axoumites du roi Salomon, ainsi la dynastie salomonienne a été fondée et dirigée par « le Habesha » .

Le Habesha a régné avec quelques interruptions de 1270 à la fin du . Ce fut sous cette dynastie que l'essentiel de l'histoire moderne de l'Éthiopie s'est déroulée. Au cours de cette période, l'Empire a conquis et incorporé pratiquement tous les peuples à l'intérieur de l'Éthiopie moderne. Les Éthiopiens ont combattu avec succès les armées italiennes, les Arabes et les Turcs. Ils ont établi des contacts fructueux avec des puissances européennes et se sont alliés notamment avec le Portugal contre les Ottomans et le sultanat de Somalie Adal dirigé par Ahmed Ibn Ibrahim Al-Ghazi lors de la conquête de l'Abyssinie.

Invasion par le sultanat d'Adal

En 1529, les forces du sultanat Afar musulman d'Adal, menées par Ahmed Ibn Ibrahim Al-Ghazi, surnommé Gragne (« le Gaucher »), envahissent l'Empire éthiopien dans ce qu'on appelle la guerre Adal-Éthiopie. L'occupation par Adal dure 14 ans. En 1541, l'empire maritime portugais envoie un corps expéditionnaire avec de l'artillerie pour soutenir l'empereur Claude (Gelawdéwos) qui résiste à l'occupant. João Bermudes (~1500-~1575), médecin portugais, prétendu , évoque ces événements. L'Empire ottoman musulman, à son tour, envoie une force de soutien avec des canons à Adal. En 1543, Ahmed Gragne est tué et la dynastie salomonide est restaurée. Gelawdéwos doit encore combattre les Oromos qui envahissent sa frontière nord. Entre 1554 et 1559, les Ottomans, de nouveau alliés à Adal, occupent la côte de la mer Rouge, l'actuelle Érythrée, qui devient la province ottomane de Habesh.

L'Ère des Princes

Entre 1769-1855, l'empire d'Éthiopie connut une période marquée par de nombreux conflits entre les ras et l'empereur, dont le domaine ne s'étendait plus que sur une zone autour de l'ancienne Gondar, qui entraînèrent une stagnation dans le développement de la société et de la culture. Les conflits religieux, aussi bien au sein de l'Église orthodoxe éthiopienne que contre les musulmans étaient souvent utilisés comme un prétexte pour des affrontements mutuels. L'Ère des Princes a pris fin avec le règne de Téwodros II.

L'empereur Théodore II et le partage de l'Afrique
En 1868, à la suite de la détention de certains missionnaires et représentants du gouvernement britannique, le Royaume-Uni lance une expédition punitive en Éthiopie. La campagne est un succès pour la Grande-Bretagne et l'empereur Théodore II de l'Éthiopie se suicide. L'année 1880 est caractérisée par la partition de l'Afrique. L'Italie est à la recherche d'une présence coloniale en Afrique, elle envahit alors l'Éthiopie et obtient avec succès certaines régions côtières et signe avec l'empereur Ménélik II le traité de Wouchalé, la colonie d'Érythrée est alors créée. Toutefois, des différences significatives entre la traduction italienne et amharique sont présentes dans le traité de Uccialli : l'Italie demande la mise en protectorat de l'Éthiopie, cette dernière répudie le traité en 1893. Humilié, l'Italie déclare la guerre à l'Éthiopie en 1895. La Première Guerre italo-éthiopienne mène à la bataille d'Adoua dans 1896, lorsque l'Éthiopie bat de façon décisive l'Italie. En conséquence, le traité d'Addis-Abeba est signé en octobre, qui délimite les frontières de l'Érythrée et force l'Italie à reconnaître l'indépendance de l'Éthiopie. Les délégations du Royaume-Uni et France dont les colonies bordent l'Éthiopie décident alors d'aller dans la capitale éthiopienne pour négocier leurs propres traités alors que les campagnes de Menelik II de 1875 à 1900 ont triplé la superficie de son empire.

Occupation italienne

L'Éthiopie est occupée par l'Italie, de 1936 à 1941 jusqu'à sa libération par des forces anglaise et arbenuoch (Résistance éthiopienne) attaquant l'armée italienne au nord et des forces belgo-congolaises attaquant au sud. Le Negusse Negest Haïlé Sélassié  est réinstallé sur son trône.

Derg et la chute de la monarchie
En 1974 une organisation armée marxiste-léniniste aux positions pro-soviétiques, le Derg, dirigé par Mengistu Haile Mariam, met fin au règne de Hailé Selassié. Ce dernier est emprisonné et meurt en août de l'année suivante dans des circonstances encore inexpliquées. Une des hypothèses avancées est qu'il est mort des suites de ses conditions de détention, et de l'absence de traitement médical. Certains spéculent aussi qu'il a été assassiné. La monarchie est officiellement abolie le .

Mengistu Haile Mariam est déposé en 1991. Il s'enfuit alors au Zimbabwe où il est accueilli par Robert Mugabe. Il est condamné à mort par contumace en 2006 par un tribunal éthiopien sous l'inculpation de génocide et de crimes contre l'humanité.

Notes et références

Annexes

Articles connexes

 Dynastie Zagoué
 Dynastie salomonide
 Liste des rois d'Éthiopie
 Haïlé Sélassié
 Négus

Bibliographie
  Addis Hiwet, « Ethiopia: from autocracy to revolution », Londres, Review of African Political Economy, Occasional publication , 1975, IV-115 p.
 Marie-Laure Derat, Le domaine des rois éthiopiens (1270-1527), Paris, Publications de la Sorbonne, 2003, 383 p.
 .

Histoire de l'Éthiopie
Fondation au Xe siècle
Ancien pays en Afrique

redpajama_set_name: RedPajamaWikipedia


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Home » Reader's Articles » Roma: A Harmonious Marriage of Style and Substance
Roma: A Harmonious Marriage of Style and Substance
Roma is an evocative craft with efficient set pieces, revolving around a doting nanny and exploiting the narcotic effect photographic images can have on the beholder
The popular aphorism is that power flows from the barrel of the gun. History has been witness to guns being used to propel as well as quell violence. Guns have been used to catalyse not only muscle power but also political power. But, an act of eschewing violence but being scathing nonetheless, is facilitated by the camera. Power also flows from the lens of a camera. Cinema is the most powerful tool to comfort the afflicted and afflict the comfortable. In Mexican director Alfonso Cuaron's 2018 monochrome memory piece Roma, Mexico City of the 70s breathes and basks under the assiduous oeuvre of the camera.
The opening shot of Roma is a static meditation on soap water getting splashed around on a floor. While the relevance of this shot is later weaved into the narrative, the cinematography establishes a mode of gaze fixation for the audience. The film offers us vignettes of a fictional recreation of Cuaron's childhood in the eponymous neighbourhood of Roma, Mexico City. This, alone, is sufficient to appreciate how personal the project is to the creator. He stages deeply moving and unnerving set pieces throughout the film as the narrative unfolds from the perspective of Cleo, who is employed as a nanny to the children of the family central to the story. Cleo, played with a stupefying disposition by an indigenous Mexican non-actor Yalitza Aparicio, is the pivot and Cuaron keeps her at the receiving end of various heart-rending ordeals. Cuaron deploys extreme wide-angle shots, pans, tracks across the city landscape as the characters move in and out of the frame like pedestrians in a busy thoroughfare. Fastidious mise-en-scene complements the slow and contemplative pace of the film, while the black-and-white aesthetic from the 65 mm camera lends seamlessly vivid images to the film. It is interesting to note Cuaron's aesthetic choice of capturing the Roma neighbourhood in monochrome despite it being home to vibrant and colourful facades.
Given that Cuaron has admittedly taken recourse to his memory lane to craft this project, he has burdened himself with certain responsibilities of representation. The uproarious response Roma has generated among casual movie watchers and cineastes alike, has raised a question regarding whether Roma has transcended the boundary of criticism and become sacrosanct. Cuaron uses Cleo's character as a knife just sharpened with a whetstone. She is a working-class, introverted woman who falls victim to sexual promiscuity. A pregnant Cleo is deserted by her lover who belongs to the same economic background as Cleo. Here Cuaron deliberately depicts a working-class man as an antagonist in order to provide leverage to the sympathy and care extended to Cleo by his upper-class mother and grandmother. In addition to this, he tries to portray the relationship between Cleo and her employers as one of love and mutual compassion. Thus, the question of representation of class division comes into picture. Whether Cuaron's mother's attitude toward Cleo was that of genuine affection or just liberal empathy, we will never know. But, we can safely infer from our own lived experiences that working-class people, people devoid of 'class consciousness', like domestic helps, have historically borne the brunt of class antagonism. It is a futile debate whether Cuaron trivialises the issue of class because the film is not so much interested in relationships as it is on one individual and her trials and tribulations.
There is also a feminist narrative which seems half-baked, running parallel to the storyline. Cuaron shows Cleo and Sofia (actually his mother) bonding over the common desertion of the men in their lives. Sofia tells Cleo things like 'women will always be alone' and thus Cuaron makes way for template message-packaging. Cleo, in one of her very few agentive actions, goes the extra mile to seek answers from her former lover, only to be greeted by his disavowal. Roma features the Corpus Christi Massacre of 1971, shows the government-paramilitary nexus and marries personal anecdotes with the contemporary socio-political landscape of Mexico, though nothing significant props out of this marriage other than the fact that Cleo's estranged lover was one of the student demonstrators. The film pits Cleo against the world and is, at one level, her story of surviving against odds. Therefore, Cuaron's memory actually serves as nothing but a vehicle for his nanny's experiences. Interestingly enough, the storytelling ingredients of Roma can be succinctly but effectively summed up using the title of Cuaron's debut feature : Love in the Time of Hysteria. The film has so much on its plate that it is hard to be absolutely objective about it. However, I cannot but think about the effectiveness of the end-product if we were to take away the self-conscious visual grandeur on display.
The same person donning the troika of writer, director and cinematographer means complete authorial control over a film. This control shows in every instant and the film can very well be his magnum opus, but Roma is actually a glorious revelation of Cuaron, the cinematographer. Unarguably the finest aspect of the film, the cinematography of Roma is breath-taking and lyrical. It will be criminal negligence to not mention the beach scene, which is filmed in a single shot, placed toward the fag end of the film. The magnificence of this scene is inexplicable yet mind-numbing ; my obeisance to Cuaron for pulling it off. Roma is an evocative craft with efficient set pieces, revolving around a doting nanny and exploiting the narcotic effect photographic images can have on the beholder.
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The perfect weather of September makes it the ideal time to begin preparing your home for the colder winter months. The list below not only helps maintain your home so you can continue to comfortably live in it, but the list also serves as a great checklist of fall projects to better prepare your home for selling in the Fall months.
You've been wanting to organize the garage for months. Now is a perfect time. You can find all the winter equipment, put away camping equipment, and throw away the broken toys summer may have produced. You'd be surprised at what a difference an organized garage can make in the comfort of your home as well as when you show it to sell.
To keep your home looking fresh and to maintain that great curb appeal, we recommend taking the early fall months to power wash or repaint the house. Again, the weather is perfect, ensuring a smooth coat of paint or quick power wash.
There is nothing worse than discovering during the first big snowstorm of the year that your furnace is on the fritz. Prevent that mishap by giving your furnace a tune up in September. Or if it's an older furnace, consider an upgrade to better heat the house while being energy efficient.
This month is the perfect time to remove the popsicle stains and grime that summer always seems to track into the house. Regularly cleaned carpets can help a home stay looking fresh, feel nicer, and even help it sell if that is your goal.
Now is the ideal time to trim back your trees and bushes for a polished looking yard. Doing so gives the plants plenty of recovery time before big frost hits and ensures fewer mid-winter mishaps such as branches breaking due to heavy snow.
Before it gets too cold, air out your home and conduct a deep clean. Get rid of the clothes cluttering your closet, throw away unused toys, and wash the baseboards and windows. The soon-to-be-here gloomy months of winter are a little more bearable with a freshly deep-cleaned home. If you are thinking of selling, we recommend the 3 D's (Declutter, Deep Clean, and Depersonalize).
Just because summer is over, it doesn't mean your home can't have major curb appeal with fall foliage. Mums, Ornamental Kale, and other colorful fall options can boost the color in your landscaping and keep your home's exterior looking lovely.
September is the best time to review the roof. Take a minute to climb up and ensure there are no leaks, to clean the gutters, and to repair any damage before winter hits.
On the cusp of October, consider preparing your lawn for the colder months. Experts recommend raking away any leaves/twigs or moss that may be settling onto your lawn, aerating the soil, and applying an autumn fertilizer. Doing so will keep your lawn looking great now and prepare it to look amazing into the next year.


Skills and abilities: As the child of two master thieves she was presumably trained in the art of infiltration, stealth, lock picking etc.
Powers: Medea's power is that of rapid-fire chain lightning in a manner similar to her father's energy blast ability.
In the year 2035 most of the X-men are dead and the children of the X-men now lead by Wolverine and an elder Kitty Pryde. Her world is one of cinder and ash where the thieves Gambit and Storm fell in love. Teammates in her timeline are Gull (daughter of Archangel), Salamander (son of Nightcrawler), Metallique (daughter of Colossus), Wolverine, and Lockheed (large and in charge). Their mission is to defeat the Morlocks of their time who have decided to finally surface and ravage the planet.


Top 11 Tips for Planning an Outdoor Wedding That Your Guests will Rave About!
Planning an outdoor wedding that your guests will rave about…it's easier said than done! It's tempting to get seduced by the rolling hills, ocean views and floral splendor of an outdoor venue. We get it. About 95% of our events here in Southern California have an outdoor component. We love 'em! Can't get enough of 'em! But even here in Cali, with its mild climate year-round, it takes a lot more than blue skies and pretty scenery to pull off a comfortable, delightful, memorable outdoor event, so before you go running for the hills with the sound of music playing in the background, we're going to break down some realities of the outdoor wedding scenario. Read on for our top tips for ensuring your outdoor wedding goes off without a hitch!
Regardless of the time of year you are getting married, if you have an outdoor component, you need to plan for the elements. Mother Nature can be unpredictable at times, so don't get stuck out in the rain/snow/wind/heat wishing you had planned better. It is always important to have a contingency plan in place. Check with your venue about an alternative indoor space in the event of rain or colder than usual temperatures. If you're at an all-outdoor venue, reserve a tent through your rental company. I promise you, guests will complain about your wedding experience FOREVER if you have not accounted for the elements and made sure they are comfortable. Plan ahead!
Paper goods and candles absolutely do not mix with wind. Add chimneys to your taper candles to ensure they stay lit. Make double sided tape your best friend and secure place cards to the tables. Create napkin pockets to keep your menus from blowing away. Use sturdy, heavy floral vessels to ensure your centerpieces don't tip over. Oh, the stories we could tell about the our early days of planning and gusts of wind literally blowing away our wedding receptions.
We want guests to feel as comfortable celebrating outside as they would at an indoor event. There are simple ways to provide a little extra comfort for your guests when they are spending an afternoon and evening outside. Stock their welcome bags with goodies like sunscreen, sunglasses and snacks for the bus ride to your location. Welcome them to the event with a refreshing beverage. At the ceremony, provide parasols to protect them from the blazing sun overhead. We love printing the ceremony program onto paper fans that pull double duty to provide information and a bit of a breeze for your guests. At cocktail hour, large umbrellas provide shade for mingling. Offering pashminas to guests who feel chilly and rolling in heaters after sunset is a great way to ensure your guests stay toasty during dinner and dancing. These are the elements and special touches that keep your guests focused on the important moments of the evening rather than distracted and upset because they are uncomfortable. Keep them happy and they will rave about your wedding for years to come!
The beauty of an outdoor space is its simplicity. The downside is that, oftentimes, there is no infrastructure in place. Let's talk about the basics: electricity. Yes, it's the truly unglamorous side to planning a wedding, but these components are invaluable. Your outdoor venue may or may not be equipped with power, so look into renting generators (be sure to get the quiet ones!) for the musical entertainment, kitchen, lighting and restrooms.
Wait, what about restrooms? Oh yes, friends. I'm sure you never dreamed of using the words "wedding" and port-a-potty" in the same sentence, but nonetheless, it's a problem we need to solve at a more minimal blank slate outdoor event location. But don't worry, they make really fancy "luxury" trailers that are infinitely nicer than the plastic festival potties.
If you've dreamt of a canopy of twinkle lights over your dance floor or floral installations dripping down over your dinner tables, you'll need to have structures built to accommodate these design elements. Metal truss is often used as a foundation for these decorative additions and can be softened by covering it in fabric or custom wooden facades. These structures help to define your event spaces and create height and dimension to an otherwise flat area.
And then there's all the additional "stuff" needed to comfortably hold an event. Seating, dining tables and tabletop items, a functioning kitchen for preparing and serving your meal, garbage cans, heaters, etc. Plan to reserve a healthy portion of your wedding budget for rental items (approximately 25-35%), because you're going to be renting EVERYTHING.
Honestly, blank outdoor spaces are what we live for because they offer the freedom to design the space however we want to achieve our clients' vision, but getting there is a complex logistical web. It sounds like a complicated process…and, no doubt, it is…but with the right team, anything is possible!
Level ground is something we take for granted on the daily. Professional venues designed for events are likely to have level graded ground, but private residences and more rustic outdoor spaces and parks might not. Rather than lay out wobbly tables and chairs, your rental company might need to shim your table legs to make them even or you might consider installing temporary flooring under the entire event space. Flooring can be quite costly, but the results are beautiful and create a very comfortable experience for guests.
We schedule many of our outdoor events around the timing of sunset. Generally, the ceremony takes place in late afternoon with cocktail hour to follow. The sunset generally coincides with the end of cocktail hour, allowing our photographer to steal our couple away for those gorgeous golden hour photos before dinner. Guests sit for dinner at dusk and the natural light fades to twinkling lights and stars overhead for dancing. The lighting sequence is one of the most magical parts of outdoor events! So before you create your event day timeline, check in with sunset for the day and then work around that time.
Unless otherwise specified, you can expect that at least some of your guests will arrive in heels. The last thing anyone wants is muddy Manolos, so be sure to get the word out early-on through your wedding website that the events will take place on soft surfaces that you recommend wedges or thicker heels. But also provide heel protectors for those non conformists who wouldn't dream of leaving their stillettos at home. Guests will be relieved that their heels will be spared and the venue will thank you for keeping the grounds intact.
Check the watering schedule of the grounds and kindly ask your venue to forego the sprinklers at least one day before and after the event. The last thing you want is a soggy lawn to create muddy messes for partygoers. On the flip-side of the event, any rentals being left overnight will be spared a shower because you've paused the sprinkler schedule until the rentals have been picked up. You don't want to learn the hard way how much that plush vintage couch costs to replace after it got an unexpected bath on the lawn overnight.
Rental items left out too long in hotter, sunnier climates can damage pristine lawns. Many outdoor event venues are very specific about how long dance floors and metal lighting pole bases can be left on the ground because the heat generated underneath those items left in the sun all day can actually scorch the grass. It shouldn't be a deal breaker for an outdoor event, but be sure you know the venue's restrictions and plan for your rentals to be delivered on a schedule that accommodates these specific policies.
Even if your venue appears to be bug-free, take extra precautions. We have seen our fair share of oceanfront weddings that are buzzing with mosquitos. Check with the venue to see if they can spray a day before the wedding to keep these little pests at bay and always include a couple cans of bug spray in your toiletry baskets or for your wedding planner to have on hand in case your guests are being eaten alive.
The standby guy is the unsung hero of events everywhere. Who is he? Where does he come from? How do I get one? Let me tell you, he'll be the best $400-1000 you spend on your wedding. He's the person that the rental company leaves behind for the duration of the party to troubleshoot any technical issues with their equipment: lighting, kitchen appliances, heat lamps, chairs. You name it, he's there to help with any issues. Because when you're out in the middle of nowhere at an outdoor location, probably with a bad cell signal, and the stove in the makeshift kitchen is not working, you'll be thrilled you sprung for the standby guy, now your best friend, who was able to fix the issue with no disruption to the event. Every outdoor event needs at least one. I cannot stress this enough. You will not be sorry!
Why is every outdoor event venue a black hole for cell service? Without a doubt, on wedding day, when we have about 100 people to communicate with, we're looking at 0 bars. Know this going into the day so you can be prepared. The entire vendor team should have everything they need sent to them well before event day with the event address and load-in instructions. Guests should receive everything they need to know on your wedding website. If your event is in a remote area, let guests know that their Uber service will be non-existent. Provide transportation for guests with a robust schedule of departures every 30 minutes or so to allows guests a departure on their terms rather than feeling trapped for the entire night.
After nearly a decade of planning and designing weddings, particularly outdoor ones, we think of ourselves as experts in the field (haha, field, get it?) and hopefully these real talk tips exposing the not so glamorous side of an outdoor event will help you make an informed decision about the best way to prepare for this type of celebration.
It's always worth it, but you have to know what you're doing, or have a strong planner on your team to ensure you and your guests are well cared for. Would you plan an outdoor wedding? Tell us below in the comments!