Monday, June 22. 2009
I majored in Statistics in college (with a minor in English Lit), but my stats sophistication is a bit rusty now. But it's not so rusty that I do not raise my brow at any latest stats reported in medicine, or especially in Psychiatry - and especially genetic studies.
As Gene Expressions points out, it's partly because a p-value of 0.05, commonly used in such studies, is unrealistic for these things. It's straight out of How to Lie with Statistics, which is essential reading for all high school students.
As the man says, if there is a genetic serotonin link with trauma and depression, it has yet to be proven.
In his second post on the topic, Why are most genetic associations found through candidate gene studies wrong? he makes the key point:
For nearly all diseases, reproducible associations have small effect size and are only detectable when one has sample sizes in the thousands or tens of thousands (for many psychiatric phenotypes, even studies with these sample sizes don't seem to find much). The vast majority of candidate gene association studies had sample sizes in the low hundreds, and thus had essentially zero power to detect the true associations. By the argument above, in this situation the probability that a "significant" association is real approaches zero. The problem with candidate gene association studies is not that they were only targeting candidate genes, per se, but rather that they tended to have small sample sizes and were woefully underpowered to detect true associations.
While I find the field of behavioral genetics to be as fascinating as anything else in this world, I always read the latest gene-behavior studies with the highest skepticism. (Do I think real Bipolar Disorder has some provable genetic underpinning? Yes, I do, even though I do not think it has been adequately proven yet. But not much else genetic in Psychiatry has been adequately proven in my view. Schizophrenia maybe, IQ almost certainly, but possibly not homosexuality, or depression, or alcoholism.
The trick to getting papers published is to run your numbers so they show something. It's not rocket science if you know how to do it: just look at the climate studies. (Even Einstein fudged his math. He happened to turn out to be right, though, as far as we know today.) Science is about hypotheses, not Truth.
The Madame Hardy Rose, a Damask Rose, was bred by Alexandre Hardy in 1832.
My brother in CT emailed the photo with this note: "You gave this plant to me 15 years ago, and it's still doing well. I have never had a rose survive this long."
Saturday, June 20. 2009
The New York Times, otherwise known as the Grey Lady, might more appropriately be known as Obama’s Shady Lady. Believe its poll and get a Times Square disease.
The lead headline is about a NYT/CBS News Poll, trumpeting “Wide Support for Government-Run Health.” The lead paragraph:
Americans overwhelmingly support substantial changes to the health care system and are strongly behind [72%] one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll.
BUT, according to the actual poll data, of the 73% of respondents who said they voted in 2008 only 34% voted for McCain and 66% for Obama. The actual vote was 46% (corrected) McCain. So, 29% of McCain voters ignored by the poll must not be Americans, according to the NYTs methodology, and there are about as much an overpolling of Obama voters. NYT's Shady Lady polling.
A sucky day. Two tooth extractions last evening as prep for some implants, and then today the basement flooded (17/20 of the past days with heavy rain). It's raining as I type, too.
Six guys here all day with a dumpster and suction hoses removing everything from the basement (old tax records and other records too, totally soaked), the carpet, the tiles and linoleum underneath, the wood shelving, etc etc. How heavy is soaked carpet? Plus the wallboard took a terrible hit: it's done. Fans and dehumidifiers humming away right now. What an f-ing mess.
Glad I have homeowner's insurance. Sorry I do not have dental insurance - but I'd be uninsurable in that regard.
I tell myself that if these are my worst problems, I am probably in pretty good shape. But my jaw hurts. Don't you hate it when people complain? It makes others feel like they should say or do something to make it better, or to fix it.
Well, at least I am not in an iron lung ward. That must have really sucked. The last iron lung inhabitant died last year. My brain makes me wonder how they avoided bedsores, how they pooped, and why they didn't unplug the damn thing late at night while the nurses were dozing:
In the wake of trying to squelch three federal Inspector Generals, there’s this story about how those who try to expose Obama, Obama administration, and Obama ally activities are dealt with.
[UPDATE: ACORN tries to hide behind a change in name, and more about it trying to squelch former members. Same smell remains.]
ACORN/ProjectVote has filed a suit against Anita Moncrief, asking damages of well over $5 million. Anita Moncrief is a former employee who has distributed internal emails to exhibit illegal ties between the Obama presidential campaign and ACORN/ProjectVote, and she has testified and written widely about what she knows. ACORN/ProjectVote has received tens of millions of federal funds and is slated to receive many, many more millions.
The 30-page civil action filed by ProjectVote is downloadable here. Legal papers are not my usual Saturday morning reading, but this one caught my eye as an illustration of legal thuggery.
The charges are basically three:
Moncrief misappropriated about $1700 while an employee, of which she’paid back about $500 before Moncrief’s employment was terminated. She helped expose how a former executive stole $1million. In a blogpost by Moncrief last November, she admits her own misuse of funds and takes responsibility, pleading extreme need due to poor health insurance benefit and pay. Yet the suit presents nothing about trying legally to recover the remaining funds from her. The charge appears in order to lay groundwork for reducing Moncrief’s credibility and as reason for her seeking vengeance.
The next charge is that Moncrief misappropriated ProjectVote’s trademark by her use of the email address projectvotenews@mail.org to distribute internal emails exhibiting embarrassing doings to donors. This appears a weak charge as in this grey area of law it does not appear she infringed on the trademark. See, for example, “Fair Use of Trademarks” at the The Publishing Law Center.
The next charge is that Moncrief damaged relationships with donors. No impact on donations is presented. Another weak charge.
The complaint includes, in addition to Moncrief, a “John Doe”, another employee who may have supplied Moncrief with additional internal material. This appears an effort to unearth the remaining whistleblowing mole.
A competent legal team for Moncrief should be able to deal with the charges, and in the process of discovery and media coverage bring further to light ACORN/ProjectVote’s nature. Hopefully, Moncrief will obtain it, or be squelched by her own lack of funds to defend herself and our right to know where and how our tax dollars are used.
Of note, the New York Times shut down its investigation of ACORN/ProjectVote. Newsbusters describes some of the details.
But apparently Moncrief's information was suddenly no good when it might have embarrassed the Obama campaign.
Heidelbaugh testified before a congressional committee in March that the nonprofit group violated a host of tax, campaign finance, and other laws. She said the Obama campaign sent ACORN its "maxed out donor list" and asked two of the avowedly nonpartisan group's employees "to reach out to the maxed out donors and solicit donations from them for Get Out the Vote efforts to be run by ACORN."
 A CT friend emailed these (you can readily tell in what sorts of directions his interests lie):
Danbury Railway Museum
Connecticut Antique Machinery Association
The Shore Line Trolley Museum
and, if your travels happen to take you near Coalbrookdale, England,
Ironbridge, Birthplace of Industry.
Photo: An old trolley at the Trolley Museum. I remember how the old trolley tracks could twist your bike tires when you rode over them as the tracks were gradually consumed by layers of asphalt. The bus lobby beat out whatever trolley lobbies there were and roads, unlike tracks, were built and maintained by government. A shame.
Photo below: Cylinder of a Corliss Steam Engine at the Machinery Museum
Friday, June 19. 2009
My grandmother, advocate of the turn of the century (that’s early 1900’s) democratic socialism based in defense of the little guy from rampant big business, taught me that the biggest myth in America is the efficiency of big business. So, government grew in regulations and programs, and so did unions, to counter big business and favor the little guy. ‘Till now it’s a truism that big government is inefficient and too little the friend of the little guy, and big unions are money founts for their leaders at the expense of labor having jobs. Meanwhile, big business has more and more become an ally of big government and unions to divide the spoils, and stifle competition and innovation. All that leaves to maneuver for the little guy against the increasing encroachments of the biggies is small business and individuals.
It’s time for more small businesspeople and individuals to defy the biggies with a chant of I am Spartacus, or I am an American.
(No, I didn’t purposely ignore big academia. It has made itself largely irrelevant via meaningless coursework enriching self-serving pedants.)
Consider a few datapoints:
Investigative journalist Tim Carney reminds us that in 1993 the biggest insurers supported Hillarycare, to shift liability risk onto taxpayers and profit from claims-processing contracts. Small insurers, brokers who work with small companies, and individuals revolted. Today, the big insurers are again cooperating with the government-dictated health care advocates, as long as the big insurers can profit from more premium payers steered their way.
The Canadian medical societies remind us not to go north for a model of government-dictated health care, as the waits are excessive by even long-wait standards approved by the government.
The former Chief Economist of the US Chamber of Commerce reminds us (sorry, a subscription only column) that when government as umpire controls a team, bad and self-serving calls are to be expected.
Michelle Malkin reminds us that Mrs. Obama and President Obama’s chief political operative worked to reduce care for the poor, to enrich her employer (and her compensation).
Mickey Kaus reminds us that unions are to be exempted from Obamacare, and further benefit from attracting members through higher benefits than the rest of us.
The CEO of the consumer highest-rated insurer in the US reminds us that he doesn’t so much fear government-plan competition but, “more about the federal government’s ability to do this at all, much less do it well. Merely coordinating basic demographic information between Social Security, Medicare and Medicaid - three big federal programs that millions of Americans belong to - can be a chore for beneficiaries, their children, and their health plans.”
Be Spartacus. Say "I am American. I refuse to be pushed around by the biggies, or under their thumb."
Write or call your congressional representatives to represent your views.
Ask your employer and your doctors to do so too.
Thursday, June 18. 2009
It’s not yet time to beat a dead horse, but it’s increasingly obvious that the Left’s horse is faltering badly before the finish line of grasping control of healthcare.
The Pew Research Center reports that public support for healthcare reforms is lower now than in 1993 for HillaryCare.
More centrist congressional Democrats are staking out a more moderate position than the Democrat Party’s more radical leadership.
Jennifer Rubin, at Commentary’s Contentions blog, chuckles at Leftist naïf Ezra Klein’s revealing the Senate Democrats are being forced to significantly scale back their grand scheme: “One has to laugh: no Santa and no universal healthcare plan that ‘holds down costs.’ ”
How much longer before President Obama has to throw this dead horse under the bus, or falls off his high-horse?
As the Wall Street Journal points out:
This was supposed to be a red-letter week for national health care, as Democrats started the process of hustling a quarter-baked bill through Congress to reorganize one-sixth of the economy on a partisan vote. Instead it was a fiasco.
Most of the devastation was wreaked by the Congressional Budget Office, which on Tuesday reported that draft legislation from the Senate Finance Committee would increase the federal deficit by more than $1.6 trillion over the next decade while only partly denting the population of the uninsured. The details haven't been made public, but the short version seems to be that President Obama's health boondoggle prescribes vast new spending without a coherent plan to pay for it even while failing to meet its own standards for social equity.
Big headline in this morning’s San Diego newspaper: “Californians largely favor health care fixes.”
The [Field Poll] survey of registered voters in California found that a huge majority favors President Barack Obama's proposal to allow people to choose between a government-sponsored health plan and private insurance.
The poll also showed considerable bipartisan agreement among voters about various health care proposals, but sharp disagreement between Democrats and Republicans about how to pay for them.
Basically, looking at the actual poll tabulations, about 90% of those polled having health insurance, there’s generally broad agreement among Democrats and Independents on nice sounding goals (“Given the serious economic problems facing the country, which of the following two statements comes closest to your own views regarding what should be done about health care reform?” It is more important than ever: Democrats 85%, Independents 69%, Republicans 39%) but an lesser willingness to personally pay more for them, preferring that someone else does (“Having a new value added tax which is like a national sales tax” Favor strongly or somewhat: Democrats 53%, Independents 39%, Republicans 25%; Compare to “Limit the tax deductions available to families making more than $250,000 a year” Favor strongly or somewhat: Democrats 69%, Independents 60%, Republicans 42%).
When it has come, however, to actual votes, even the liberal California state legislature has shied away from imposing government-dictated health care schemes. As the “progressive” New America Foundation said of the lesson from the rejected 2007 scheme for California, “the issues of affordability for families and sustainability for taxpayers must be satisfactorily addressed.” An understatement. As a Kaiser Foundation 2009 poll sums up: “A slim majority of Democrats (53%) are willing to pay more for providing coverage, while 38% of independents and 29% of Republicans say the same.” Other polls indicate that even among those willing to pay more, the amount is nominal. For example, among the uninsured, those of small income (under $20,000/year) are willing to pay $100 per month and those earning much more ($80,000) $200, versus actual comprehensive insurance costs of about $400 for individuals and over $1,000 for families.
The overall California results and the split between Democrats, Independents and Republicans is more marked than elsewhere, but indicative of splits elsewhere. California is a heavily Democrat state, with the proportion of registered Democrats and Democrat leaning Independents increasing significantly between 2004 and 2008. The Field Poll is of those registered to vote, not of those who do vote. Even though registered voters are whiter, earn more and are older than the population, those moved to vote are even more so.
Take note Congress.
Pro-government-dictated health care pup Ezra Klein points out that, according to a cited study, only about 10% of early deaths from disease are due to “shortfalls in medical care,” versus from “behavioral patterns, 40 percent” or “genetic predispositions, about 30 percent.” Klein asks, then, “If medical care has such a minor impact on a person's longevity, why are we spending so much time and energy reforming the industry?” Klein says it’s because the focus is on the profits, jobs and government-largesse at stake for the interests involved. I would add, it’s because of the power that can be garnered by Washington over our lives and pockets, and the contributions that can be garnered by politicians.
Take note taxpayers. Take note citizens. Take note those in real health care need. It’s not about you.
BTW: According to the latest New York Times poll, only 7% see health care problems as the nation’s top priority, versus 38% the economy and 19% jobs. That’s why the Times reports, “fewer than half [44%] of Americans saying they approve of how he has handled health care and the effort to save General Motors and Chrysler [41%].” 56% say the government is doing too much that is better left to individuals and business. 60% say Obama hasn’t a clear plan to deal with the budget deficit. They’re wrong. Obama clearly aims to deepen the deficit.
Wednesday, June 17. 2009
 Kondratiev (once a JAG Corps Lieutenant Commander) got a rare opportunity this week to attend a “Current Strategy Forum” which is periodically put on by the U. S. Naval War College in Newport, R.I. It was a fabulous event, featuring Greg Mortenson, author of Three Cups of Tea, subtitled One Man’s Mission to Promote Peace . . . One School at a Time. Other keynote speakers were Kenneth Rogoff, Harvard University; Admiral Gary Roughead, Chief of Naval Operations, Raymond Mabus, Secretary of the Navy; Anne-Marie Slaughter, Esq., Director of Policy Planning, U.S. Department of State; and General James T. Conway, Commandant of the Marine Corps.
Panel discussion members included Stephen Walt, Harvard University; G. John Ikenberry, Princeton University; Mitchell Reiss, The College of William and Mary; Donald Kagan, Yale University; Eliot Cohen, Johns Hopkins University; Daniel Byman, Georgetown University; Michael Doran, New York University; Thomas Fingar, Stanford University; Shibley Telhami, University of Maryland; Michael O’Hanlon, Brookings Institution; Thomas G. Mahnken, Johns Hopkins University; and Patrick M. Cronin, National Defense University. The conference was a spectacular demonstration of the talent the U.S. Government can bring to bear at this time, regardless of the party in power.
Focusing on the Greg Mortenson talk, NBC newscaster Tom Brokaw calls Mortenson "one ordinary person, with the right combination of character and determination, who is really changing the world." In a 1993 climb of Pakistan's treacherous K2, the world's second highest mountain, Greg stopped 500 yards from the summit and had a sense of failure. On returning to a village below, he was struck by the desperate, unfulfilled desire of the inhabitants for education, and made a rash promise to somehow return to build a school.
Since 1993, Mortenson has dedicated his life as a humanitarian devoted to promote education, especially for girls, in remote, volatile regions of Pakistan and Afghanistan, and as of 2007, Mortenson had established 58 schools in rural Pakistan and Afghanistan, which provide education to over 24,000 children, including 14,000 girls, where few education opportunities existed before.
His efforts (and the efforts of others like Educate Girls Globally) have been generally received well by the Afghans and the Pakistanis. Although the MSM doesn’t have time or space to report it, in year 2000, 800,000 Afghani children attended school. In 2008, 8,600,000 were attending school, and of these, 2,300,000 are girls.
It has not been easy. In 1996, he survived an eight day armed kidnapping in the Northwest Frontier Province tribal areas of western Pakistan, and escaped a 2003 firefight with feuding Afghan warlords by hiding for eight hours under putrid animal hides in a truck going to a leather-tanning factory. He has overcome two fatwehs from Islamic mullahs, one of which banished him from the country for teaching girls. He appealed to the top cleric, agreeing to leave if that was the decision, and after several weeks received a letter in a gift box which described his work as blessed by Allah.
Mortenson is a living hero to rural communities of Afghanistan and Pakistan, where he has gained the trust of Islamic leaders, military commanders and tribal chiefs from his tireless effort to champion education, especially for girls.
His cross-cultural expertise has brought him to speak on U.S. Capital Hill, national think tanks, the Pentagon, the Department of Defense, the U.S. State Department, libraries, outdoor groups, universities, schools, churches, mosques, synagogues, business and civic groups, women's organizations and many more.
As General Conway said, he, Admiral Mike Mullen (Chairman of the Joint Chiefs), and others in high places all read Three Cups of Tea (which has been on the NY Times best-seller list for 123 weeks) on their wives’ recommendations, but this essay comes from the discovery that they are all taking it very, very seriously!
It was the view of Professor Michael Doran, another speaker with broad State Department experience, that the State Department is an entity which exists to “negotiate behind closed doors with duly appointed representatives of recognized governments”. As an organization whose mission is “process”, success or failure are not important considerations – they are just a part of the process.
However, for the military on the ground in the Middle East, success is enormously important - in fact, an issue of life or death, and failure is unacceptable. It always takes several years of war for the American military and its political bosses to sort out the warriors from the politicians, and now it is done. To the U.S. government, Greg has advised listening, listening long and listening genuinely.
Admiral Mullen, General Stanley McCrystal, General Conway and one other top guy (I missed his name) have visited Afghanistan 32 times in the last year. On Adm. Mullen’s last trip he gave a slightly offended Karzai an hour or less and then spent twelve hours meeting local imams and elders, drinking tea and listening to them, and they said some things that were not very polite, but he listened. And then he flew to the tribal areas of Pakistan and drank tea listened to another group of leaders for another twelve hours.
Speaker after speaker among the academics agreed that it was only the U.S. military which had the intellectual ability, the motivation, the tools, the cultural sensitivity and the presence to relate to the people of diverse cultures around the world. They are not perfect, but they are the best the United States has to offer.
Incidentally, Greg is from Montana, of Norwegian Lutheran extraction, and will not accept a penny from the U.S. government. He has a new book coming, fans, about his recent experiences, which will be titled Stones into Schools. On his way to K2, he was not sensitive to the misery in the villages, and had he succeeded in reaching the summit, he might never have been.
No good deed goes unpunished.
Well, that is surely not always true, but with the economic downturn, the charity medical clinic at which I volunteer one day per week has seen a sharp upturn in lawsuits against us Docs and the clinic this year.
The medical defence lawyer we have now engaged (we have had no complaints or suits for 10 years until January 2009) tells us that we should now regard each patient as a potential enemy. (Our clinic's founding Christian philosophy is to regard every patient as a friend and neighbor.)
He tells us that our notes must be guided by the principle of CYA (your notes are legal documents, not medical reminders as we had thought) and that every decision a doc makes contains some basis for a suit in the hands of a hungry lawyer because all medical decisions are judgement calls and every situation is unique.
He also told us that recessions tend to see more suits against doctors because more folks are looking for cash, and much more so in charity settings. Plus the tort lawyers are hungry too - but they always are. He also advised us to refuse to treat any patients with substance abuse histories for our protection - other than alcohol.
He actually said "Do not be kind. They will screw you whenever they decide to." He has been around the block a few times.
I do not like this at all. A Psychiatrist/Psychoanalyst cannot do the job under such conditions. Furthermore, I can not and will not endure any relationship in my life without mutual trust. I am considering resigning (even though I was one of the founders of the place) and finding some other outlet for my charity. Maybe prison work, where you can safely begin with the assumption that everybody is a liar and cheater and working the system - and take it from there.
My position on the Board, plus my volunteer time (all unpaid) doubles my legal liability. I just want to do my best, tithe and double-tithe my time, and avoid hassles that do not fit into my life - and legal fees that I cannot comfortably afford.
And no, I would never work for ObamaCare. Never. I did not go into medicine to be a government employee. I went into medicine to work for my patients, doing my best, with no intention of looking out for lawyers.
Tuesday, June 16. 2009
Somebody please remind me what the alleged rationale is for a government take-over of medical care in America.
It sure isn't those uninsured, since the plan admits it would only cover 1/4 of them (16 million out of a supposed 50 million uninsured).
Is it to reduce the cost of medical care to Americans by rationing medical care by an appointed board charged with cost-effectiveness? Nobody would put up with that.
Or is it a simple power grab of a large % of the US economy by the politicians, who admit that they intend to eliminate any private medical care and any private medical insurance thus putting us all helplessly and powerlessly into the hands of a government monopoly?
I, for one, would hate to see the destruction of American medicine purely for ideological (Socialist) and power-lust reasons. Primum non nocere. Mind you, I always thought that Social Security and Medicare should be means-tested for the poor, and not general entitlements.
Related: This is what happens when medical care becomes politicized. Do you think some ER Doc wants to spend a half hour on the phone explaining to a government bureaucrat why he wants you to have a CAT scan when he has an acute MI in the next bed, a GI bleeder in the next room, and a non-English-speaking drunk attacking your security guard down the hall?
Related: Moonbattery puts it this way
 I don't think we posted this already, but maybe we did. This interview was with MTV producer Bill Flanagan in anticipation of the release of Dylan's Together Through Life in April.
Bob is a smart man and always interesting, especially when discussing music.
Parts 1-3 together here.
Part 4 here.
Part 5 here.
Once small excerpt:
BF: Have you ever tried to fit in?
BD: Well, no, not really. I'm coming out of the folk music tradition and that's the vernacular and archetypal aesthetic that I've experienced. Those are the dynamics of it. I couldn't have written songs for the Brill Building if I tried. Whatever passes for pop music, I couldn't do it then and I can't do it now.
BF: Does that mean you create outsider art? Do you think of yourself as a cult figure?
BD: A cult figure, that's got religious connotations. It sounds cliquish and clannish. People have different emotional levels. Especially when you're young. Back then I guess most of my influences could be thought of as eccentric. Mass media had no overwhelming reach so I was drawn to the traveling performers passing through. The side show performers - bluegrass singers, the black cowboy with chaps and a lariat doing rope tricks. Miss Europe, Quasimodo, the Bearded Lady, the half-man half-woman, the deformed and the bent, Atlas the Dwarf, the fire-eaters, the teachers and preachers, the blues singers. I remember it like it was yesterday. I got close to some of these people. I learned about dignity from them. Freedom too. Civil rights, human rights. How to stay within yourself. Most others were into the rides like the tilt-a-whirl and the rollercoaster. To me that was the nightmare. All the giddiness. The artificiality of it. The sledge hammer of life. It didn't make sense or seem real. The stuff off the main road was where force of reality was. At least it struck me that way. When I left home those feelings didn't change.
BF: But you've sold over a hundred million records.
BD: Yeah I know. It's a mystery to me too.
Kimball discusses a topic on which I am often hammering here: the topic of wealth creation. Liberals and Lefties often talk about money as if it grew on trees, and talk about themselves as if they were being generous by taking it and spending it.
The Boris Johnson piece which prompted Kimball's post is here. One quote from it:
I want to hear politicians talk less about themselves and their priorities and more about the entrepreneurs, the people who get up at 5am to organise their business or cut deals with the other side of the world. Every time you hear politicians swanking about what they are going to do with public funds, remember that wealth was ultimately created by private enterprise; and, if they don't help the wealth creators, they won't have any money to spend.
And from Kimball's piece:
Mr. Johnson has tailored his comments to the situation in London. But they apply equally to the United States. One of the many blighting effects of socialism is the distorted view of economics it disseminates. Economics is not primarily about the distribution of wealth. Rather, it is about the creation of wealth. That is the conditio sine qua non of the whole game. That is why capitalism is superior to every other economic arrangement yet contrived: given its head, it is a far more efficient engine for the creation of wealth than all its competitors. Remember this the next time you hear "politicians swanking about what they are going to do with public funds": the money they are planning to distribute "was ultimately created by private enterprise; and, if they don't help the wealth creators, they won't have any money to spend."
I have never understood why Lefties and Liberals disparage business. Without business, they would be nowhere. Business is the engine that makes everything work, and entrepreneurs, inventors, businessmen, financiers and investors run the engine for us. We should be grateful to them because, without those guys, we'd all be out of work.
h/t, Blue Crab
Monday, June 15. 2009
“…I found on most of these questions that the desire for change and support for reform was slightly stronger 16 years ago…”
So says Stanley Greenberg, CEO and co-chair with Dem pitbull James Carville of polling firm Greenberg Quinlan Rosner. Greenberg served as a polling advisor to President Bill Clinton, was deeply involved in Clinton’s failed 1993 effort to rewrite Americans’ health care, and is today a prominent Democrat pollster.
Greenberg points out that, “the country has maintained the same anxieties about government's ability to improve the system.” Greenberg continues:
…Our inability to talk credibly about how we would reduce health care spending or costs for individuals and the country built a contradiction into all our efforts--the more we talked about the comprehensiveness of our plans, the more voters worried this would yield higher premiums or higher taxes. Very quickly, voters came to conclude that their families would face higher costs.
And those dynamics are still in play. In my recent polling, I found that voters are skeptical about claims that reform will reduce costs and personal health outlays. Claims about simplicity, information-technology modernization, and best practices don't seem to be enough to persuade them otherwise.
For example: “It may surprise you that Obama has already lost seniors, according to our current survey--only one-third approve of his plan. It doesn't take a rocket scientist to see there isn't much in it for them.” Similarly for union members: “Yet the members will ultimately judge whether the plan is good for their families--and I'm certain that all the talk about taxing insurance contributions has not gone unnoticed.” Similarly for blue collar Americans: “Ross Perot is a distant memory, but his more libertarian, blue-collar male voters are very much alive. They are pretty certain government will mess this up--and only about 30 percent support Obama's health care plan right now. With Republicans reciting their mantra about no ‘government takeover’ of health care, the plan's opponents have found a common text.”
Greenberg ends with:
He [Obama] must respect the thoughts, feelings and calculations of ordinary citizens who are not easily spun on important issues. People will take out their calculators when he lays out his plan, and he can't avoid speaking candidly about its costs and consequences. And he can't forget that he has a big story to tell about a changed America, one in which health care is but a pile of bricks in the new foundation he is laying.
“Health care is but a pile of bricks in the new foundation” by Obama for America? Pile of bricks or pile of statist BS? Most Americans can tell the difference.
Sunday, June 14. 2009
 Another quote from the Steyn piece we posted and commented on yesterday:
"Health" is potentially a big-ticket item, but so's a house and a car, and most folks manage to handle those without a Government Accommodation Plan or a Government Motor Vehicles System – or, at any rate, they did in pre-bailout America.
And another:
In Britain, once the crucible of freedom, civic life is all but dead: In Wales, Northern Ireland and Scotland, some three-quarters of the economy is government spending; a malign alliance between state bureaucrats and state dependents has corroded democracy, perhaps irreparably. In England, the ground ceded to the worst sociopathic pathologies advances every day – and the latest report on "the seven evils" afflicting an ever more unlovely land blames "poverty" and "individualism," failing to understand that if you remove the burdens of individual responsibility while loosening all restraint on individual hedonism the vaporization of the public space is all but inevitable.
By way of contrast with the excellent Steyn essay, economist Robert Frank thinks we'll all be happier if we're taxed more and controlled more, presumably because we are incompetent, dysfunctional morons. A quote from a comment on his book:
Behaviorist economics has become the latest fad among liberals. Classic free-market economists hold that individuals are rational, or at least act rationally: thus free decisions in a free market deliver optimal economic results. The behaviorists, among whom Frank is a pioneer, propose by contrast that government should protect us against the consequences of our passions. Behaviorist economics has supplied a scientific rationale for increasing taxes, imposing additional regulations, and limiting individual choice. It’s all for our own good.
One wonders to what extent the current success of behaviorism on the liberal left might implicitly draw on the American Puritanical tradition. In the name of science (global warming, healthy living, and so on), the liberal academic community seeks to impose limitations on individual free choice, the same way the old-time Puritan pastors did. (When I raised this historical precedent in a conversation with Frank, who sees himself as a God-free libertarian, he was speechless.)
Frank's vision is of citizens as a herd of happy, peaceful, benighted sheep, grazing, screwing and reading comics in a meadow while producing wool for the State's mills - and ruled by wise, altruistic men like him (who of course lack the passions of us peons - other than the passion to run the world their way. And who wants their life to be fully rational anyway? Not me.).
Problem is, as our post on technocrats and policy wonks yesterday discussed, the People have far more accumulated wisdom and life experience than any group of scheming technocrats or condescending academics who wish to create a world in their own image.
I would much prefer Sippican, Vanderleun, Glenn Reynolds, or my neighbor as President than the smartest guy in the Harvard School of Government. They understand why the energetic people of the world want to come to America.
Furthermore, we have seen all over the world in the 20th Century 1. how dispiriting powerful States are to the inventiveness and productivity of the aspiring, imaginative, creative and energetic individual (and how, if you dispirit the producers, there's no money to fund anything), 2. how entire sociopathic populations and cultures can be created (as in the Soviet Union) by energetic and resourceful people working the system and sneaking around it, and 3. how States politicize everything, and how power corrupts.
Frank is thus dangerously naive to idealize the State as some benevolent, altruistic, all-wise entity - almost like a god - and he is ignorant to view his fellow Americans as needing control and direction at gunpoint. It is an infantile and grandiose vision, and one which every proud red-blooded American should find demeaning and insulting. Un-American. Steyn's point about civic life is very well-taken by us Yankees: civic life isn't the Federal Government - it's your neighborhood and town.
I thought this debate was over when the Berlin Wall fell. Who imagined that the fall of Communism across the world would just provide a fresh opportunity for these soul-destroying weeds to sprout up again?
Count me as a Jeffersonian in this respect: "The government which governs least, governs best." We are not idiots, Prof. Frank.
Saturday, June 13. 2009
Steyn on medical care and the nanny state. Great piece. One quote:
...there is a cost to governmentalizing every responsibility of adulthood – and it is, in Lord Whitelaw's phrase, the stirring up of apathy. If you wander 'round Liverpool or Antwerp, Hamburg or Lyons, the fatalism is palpable. In Britain, once the crucible of freedom, civic life is all but dead: In Wales, Northern Ireland and Scotland, some three-quarters of the economy is government spending; a malign alliance between state bureaucrats and state dependents has corroded democracy, perhaps irreparably. In England, the ground ceded to the worst sociopathic pathologies advances every day – and the latest report on "the seven evils" afflicting an ever more unlovely land blames "poverty" and "individualism," failing to understand that if you remove the burdens of individual responsibility while loosening all restraint on individual hedonism the vaporization of the public space is all but inevitable. In Ontario, Christine Elliott, a candidate for the leadership of the so-called "Conservative" party, is praised by the media for offering a more emollient conservatism predicated on "the need to take care of vulnerable people."
Look, by historical standards, we're loaded: We have TVs and iPods and machines to wash our clothes and our dishes. We're the first society in which a symptom of poverty is obesity: Every man his own William Howard Taft. Of course we're "vulnerable": By definition, we always are. But to demand a government organized on the principle of preemptively "taking care" of potential "vulnerabilities" is to make all of us, in the long run, far more vulnerable. A society of children cannot survive, no matter how all-embracing the government nanny.
What's my view? I am in favor of providing help with medical costs for the poorest and most helpless, but we already have that. It's called Medicaid. Furthermore, the charity clinic I work in one day a week will see anyone who makes under $50,000/yr and who lacks insurance, on a sliding fee scale. We will see nobody for nothing, though: that would be degrading both to patient and to the docs. (Such clinics are a good example of "civic life.")
I know there seem to be more people around today who long for a parental State than there were 20 or 30 years ago. I worry that they do not know that they are selling their freedom, dignity, and can-do spirit - literally their American birthright - for a bowl of lentils.
Friday, June 12. 2009
In my dotage I have two young sons. Both are smart. And, I help and drive them. I worry about whether I’ll instill enough in them so that after I’m a goner they’ll be able to handle life’s decisions well. I also worry how well the major financial investment in college will work out.
So I got drawn into a series of blog posts from the American Enterprise Institute about a study listing colleges’ graduation rates, based on US Department of Education gathered data. The discussion has centered on why many rankings don’t make sense. The latest post reveals that colleges are not under any compunction to accurately report data.
For example, “Arkansas Baptist College, which boasts a 100 percent graduation rate in the database, admitted that the school’s data were reported erroneously.” An author of the AEI study comments: “It is worth noting again that these data are congressionally mandated and collected by a major federal agency. Would we tolerate such inaccuracies from the companies who report workplace injury rates to the Occupational Safety and Health Administration or the state agencies that administer the food stamp program?”
I don’t think my sons will end up at Arkansas Baptist College. But, before Washington funnels hundreds of millions or many billions of taxpayer dollars into higher education, it does seem reasonable to require greater accountability, of Washington and of colleges.
 The Letterman thing exposes something. Something other than what's being discussed. It's difficult to write, and in turn, tell jokes. Really funny people rarely tell jokes. They outline a narrative in a humorous way. If you sprinkle in a funny turn of phrase here and there, those are jokes, but they're not the point. If you've ever seen a good comedian appear in a nightclub when they're working on new material, it's generally really disjointed and unfunny. There's no thread running through it yet, and the jokes bomb or get a laugh, but you can't get a wave to ride on. A monologue done nightly is just watercooler chat. The day's happenings in a stream. But Letterman's DOA joke about Sarah Palin's daughter wasn't really topical, and it wasn't funny, and it stuck out like a sore thumb. It was an excuse to be vicious, and it showed that Letterman had been waiting for quite a while for any chance to say something unpleasant about someone he really doesn't like.That's why it seemed so jarring. Letterman likes to trade on his midwestern homeliness, and likes the association people have always made between him and Johnny Carson. Carson was from the midwest, too, of course, and Carson liked Letterman and had a lot to do with his success. It always rankled Letterman that he didn't replace Carson. He's become bitter about it, and it shows. But the impetus of the joke that bombed is exactly why Letterman never replaced Carson. Carson was talented, and funny, and wry, and light on his feet, and he was every bit the equal of every star that sat across from him. He knew what to talk to stars about, because he was a star. Letterman was always a kind of lame-o Lucifer to Carson's Archangel, and everybody knew it. Letterman made his name by being the king's fool. The king suffered someone aping him, to amuse him, but a fool is always a fool. You're allowed to say what you want, but there's no promotion ever in the offing. You get to hang around until you put your foot in it. And when you displease your sovereign, you get the ax, not the hook. Letterman's congenital problem manifested itself in spades. He is a Beta male in an industry filled with Beta males. Even the industry's a Beta. He's not even an entertainer -- his job is to talk to and about entertainers. They say politics is show-business for ugly people, and the similarities are manifest. Politics is often home to Beta males that try to cut in front of the big men on life's campus by the side door. Same deal. That's why they get along famously.
Continue reading "Hey Jenny Slater. Hey Jenny Slater. Hey Jenny Slater"
Thursday, June 11. 2009
 Insty notes that one would think that California legislators would have more to worry about than day care center diets. Maybe not.
They want 2 year-olds to eat vegetables and skim milk to deal with the "obesity crisis." What they apparently forgot is that the natural diet of 2 year-olds is sweet, fatty Mother's Milk.
And what they probably never bothered to learn is that normal brain development depends on getting the right fats. Myelenization of the brain continues through adolescence. Whole milk is the right thing for kids, whether it's Mom Juice or Cow Juice.
Wednesday, June 10. 2009
Hugh Hewitt has been calling on the nation’s doctors to take their customary leading role of trust by Americans to oppose Obamacare, especially the so-called “public” (read, government) health insurance that would displace private insurance at astronomical costs, bureaucracy, and interference in medical advancements and treatment decisions. Hewitt has been pessimistic they would, feeling the American Medical Association is “cowed…by the Obama/Pelosi/Reid hard-left edge of the Democratic Party.”
Hewitt should have had more faith in the AMA’s 250,000 doctors. The New York Times reports:
But in comments submitted to the Senate Finance Committee, the American Medical Association said: “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”
If private insurers are pushed out of the market, the group said, “the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.”
The New York Times tries to cushion the blow to Obamacare advocates by saying:
The A.M.A., an umbrella group for 180 medical societies, does not speak for all doctors. One group, Physicians for a National Health Program, supports a single-payer system of insurance, in which a single public agency would pay for health services, but most care would still be delivered by private doctors and hospitals.
However, the New York Times fails to mention that the Physicians for a National Health Program claims just “more than 16,000 members,” and that one does not have to be a physician to join, its joining page requiring just “$40 / Year -- Health reform advocates (Non Physicians)” to be a member.
I suppose that the NYTs’ coverage of Obama’s speech to the AMA’s convention next Monday will laud Obama for his great courage in telling the overwhelming majority of the nation’s doctors they don’t know medicine.
92% of labor unions’ political contributions have gone to Democrats since 1990. The unions are slated to get another payoff from Congressional Democrats’ proposed health care legislation.
Senator Max Baucus, lead on the legislation in Congress, the Washington Post reports, “told reporters that taxing employer-provided benefits is ‘perhaps the best way to raise money for an overhaul of the health-care system’ and offered details about the form that tax is likely to take.”
Among the details: “And it would be likely to ‘grandfather’ in health benefits set as part of a collective-bargaining agreement, he said, allowing union plans to remain tax-free until new contracts can be negotiated.”
This is in contrast to the contractual rights of bondholders in the heavily unionized auto industry being overridden (not “negotiated”), and unions given a disproportionate share of the reorganized companies to support their comparatively lavish health care benefits. The priority of unions and their bought Democrat legislators will be to preserve their overly large piece of the pie in such “negotiations.”
The latest count from the US Bureau of Labor Statistics has 7.6% of private industry workers as members of unions, and 36.8% of public sector workers. Their often gilt-edged health care coverage is to be given higher protection than that of non-unionized workers. The US Bureau of Labor Statistics also reports, as USA Today relates:
Public employees earned benefits worth an average of $13.38 an hour in December 2008, the latest available data, the Bureau of Labor Statistics (BLS) says. Private-sector workers got $7.98 an hour.
Overall, total compensation for state and local workers was $39.25 an hour — $11.90 more than in private business. In 2007, the gap in wages and benefits was $11.31.
The gap has been expanding because of the increasing value of public employee benefits. Last year, government benefits rose three times more than those in the private sector: up 69 cents an hour for civil servants, 23 cents for private workers.
Labor costs account for about half of state and local spending, according to BLS and Census data. Benefits consume a growing share of that, now 34%.
The rest of the two-thirds of the population under age 65 with employer-provided health insurance be darned, sayeth the Democrats with the union label.
While your reading, don't miss Ed Morrissey on Big Labor's Fiscal Insolvency, just desserts for where they're taking the rest of us.
Tuesday, June 9. 2009
It's tough for doctors because we are often held responsible for people who either do not want, or do not accept, our help and advice. But, as long as their name remains on our rolls and as long as we persist in trying to be constructive, the lawyers can get us.
I have been burned several times by keeping them on the rolls in the charity clinic, only to be sued by them eventually for not doing a better job "taking care of them." What? I am not a professional mother and I do not "take care of" anybody. I am a doctor, not a caretaker and, despite the modern lingo, not a "care-giver" either.
Like all doctors, I try to work with my patients - and do not take care of them, or I to try to bring them around to where I can work with them.
If I were more self-protective, I would not even try and would just say "I cannot help you. Good bye," but that is not my medical tradition. My medical tradition is that you are a friend to your patients, whoever they are.
Novalis presents such a case. More practical docs than I am would just throw them out of the office. However, after being punished and hassled legally several times by going the extra mile, my heart grows harder.
Indeed, good deeds often are punished and yes, it does lead to some bitterness especially when it is performed on a charity basis. I have never been sued or hassled by a private, self-paying patient.
 A few easy-growing salad (and I hate salad - rabbit food) greens for the garden that even I enjoy. I would never use these things in a mixed green salad, because you lose the flavor and character of the individual thing.
These are greens that you can plant every two or three weeks during the spring and summer, and harvest small and tender. Some of them will grow back after harvesting the leaves. They are often commercially grown hydroponically these days.
My favorite is Mache (aka Corn Salad), a sweet, tender mayonnaise-tasting leaf
Frisee, a member of the Chickory family. Bitter, tangy, crunchy: good to precede a game meal, grilled lamb, or steak. Never salad with the main course, in our view, unless it's a buffet, because salad dressing messes up the flavors of the main course.
Garden Cress, a member of the Mustard family. Sort of like Watercress.
Dandelion. Spicey with a bit of crunch.
Arugula. The strange kerosene flavor grows on you. Just try to ignore the fact that Liberals like it.
Monday, June 8. 2009
 Mnemosyne was impregnated by Zeus for nine consecutive nights, thus producing the nine muses. Among other things, she was a goddess of memory.
The number of muses increased over time from the original three. Poetic license and creeping specialization. I had been looking up Euterpe, the muse of music and of lyric poetry, called "the giver of delight." The muse of song, but got sidetracked on the general topic of the Muses.
I posted briefly on inspiration the other day, and we had "Sing, Goddess..." recently. It remains fascinating to me that our mental creations seem to come from "elsewhere," to the extent that we can imagine that they come from a supernatural source.
In my line of work, we say that such things come from the "preconscious" or the "unconscious," but that's not much different from saying they are gifts of a Muse.
Whenever a preacher says "May the words of my mouth, and the thoughts and meditations of my heart, be acceptable to You," he or she is echoing the classical plea to the Muses. Our civilization remains a Greek one.
This site tries to personalize the Muses.
Image is Dante Gabriel Rossetti's Mnemosyne (1881)
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