The Economics of Health Care

I Am Not a Health Reform | New York Times

The most bizarre aspect of the current American “debate” on health care reform is the fact that the only people who talk about the economics of health care are the “liberals”. In this opinion piece, two Harvard researchers emphasize the horrific waste that characterizes the current system.

With the exception of Dennis Kucinich, the Democratic presidential hopefuls sidestep an inconvenient truth: only a single-payer system of national health care can save what we estimate is the $350 billion wasted annually on medical bureaucracy and redirect those funds to expanded coverage. Mrs. Clinton, Mr. Edwards and Mr. Obama tout cost savings through computerization and improved care management, but Congressional Budget Office studies have found no evidence for these claims.

The Congressional Budget Office‘s studies and projections over the past 20 years or so have been remarkably accurate. The reasons why “conservatives” who are ostensibly pro-business oppose realistic health care reform that is guaranteed to save ungodly sums of money and even rescue companies like General Motors elude me utterly. Why is Kucinich the pro-business candidate?

Crime and the Punishment of Municipalities

Detroit declared most dangerous US city | Yahoo! News

The American obsession with rankings and the “competition” that rankings are believed to spur is so fervent, so strong and so overwhelming that any ranking–no matter how unscientific, how thoroughly biased or how flawed–is bound to get press. The college football and basketball rankings, the US News & World Report’s annual college rankings, hospital rankings, etc., etc., etc. So many rankings exist that they have obscured the more important question of whether all universities, hospitals or whatever are competent at all. After all, overall competence and excellence is the goal of standards, not individual competence or excellence. Who cares if you have 50 good universities (or even 200), if 1000 universities are lousy? A thousand competent hospitals do much more for public health than five stellar ones.

The 14th annual  City Crime Rankings: Crime in Metropolitan America published by Congressional Quarterly threatens to be the most irresponsible of such rankings primarily because it is published by a trusted source. When a report on crime is anticipated by such criticism from the highest sources on criminology, the reasons why anyone gives it press become baffling. The criticism included in the above article include:

The study drew harsh criticism even before it came out. The American Society of Criminology launched a pre-emptive strike Friday, issuing a statement attacking it as “an irresponsible misuse” of crime data.  

Critics also complain that numbers don’t tell the whole story because of differences among cities.

“You’re not comparing apples and oranges; you’re comparing watermelons and grapes,” said Rob Casey, who heads the FBI section that puts out the Uniform Crime Report that provides the data for the Quitno report.The FBI posted a statement on its Web site criticizing such use of its statistics.”These rough rankings provide no insight into the numerous variables that mold crime in a particular town, city, county, state, or region,” the FBI said. “Consequently, they lead to simplistic and/or incomplete analyses that often create misleading perceptions adversely affecting communities and their residents.”

But, most appalling is the CQ Press’s own insistence and admission that the study is worthless:

 CQ Press spokesman Ben Krasney said details of the weighting system were proprietary.    

Thus, the publisher asserts that it is propounding a hypothesis–their statistical model–that they refuse to have tested independently. This runs contrary to all scientific principles of inquiry. In all sciences–including social sciences like sociology–openness is the most essential ingredient. Without it, hypotheses cannot be tested independently in order to be verified. Without independent verification, there is no truth. By making the hypothesis proprietary, CQ Press is disallowing scrutiny and forbidding independent verification. Thus, CQ Press propagates an untested notion, a falsehood. In effect, it is acting as a propagandist. 

Hopefully other silly rankings will soon be discredited by similar confession of inadequacy by their publishers. 

Battle Fatigue

2007 Toll A Record For U.S. In Iraq | washingtonpost.com

The statistics in this article are encouraging, but hardly indicative of any comfortable end to hostilities in Iraq. What Lt. Col Dale Kuehl says of the cost at which the current scenario has been achieved expresses the fundamental problem of cost that nobody wishes to address.

“I am confident that we have established a much more secure environment for the people we have been tasked to protect,” Kuehl added. “However, a part of me is afraid to believe what we have accomplished, knowing what it has cost to get us to today.”

Is any price for victory a fair price to pay? What remains elusive in popular discourse on this military intervention remains its cost. The absence of this discussion is an absolute travesty for it is the price that determines whether a military campaign is a victory or not. Vietnam was not a military defeat because military progress was not made. Rather, it was a loss because the price paid for the meager victories on the battlefield were so staggeringly large.

There is an awfully dear lot that hinges on the ability of the American populace to weigh the gains against the losses (both mortal and financial) that have been incurred by the United States. Do people avoid the analysis because they lack the ability to carry it out, or because they do not acknowledge the costs involved?

Modern Propaganda: Creating and Selling “Truth”

Environment Unlimited | Climate change | The denial industry

Global warming and its putative cause were always controversial within the scientific community. Global warming was an outlandish thesis from its inception because it was difficult to conceive that the scale of human activity would ever account for a measurable fraction of nature’s output. A century later, however, the scale of human activity has multiplied by several orders of magnitude (more than several thousand times), and its effects on the composition of oceans, groundwater and the atmosphere are now measurable by modern methods. Consequently, the controversy surrounding the most fundamental basis for the greenhouse effect–that human output can be so prodigious as to disrupt the earth’s natural cycles–has largely subsided. (See evidence from the polar ice pack, for one example.)

As a result, the most strenuous objections to the greenhouse thesis no longer originate in the scientific community. Even though objections still exist in the scientific community, the objections are no longer focused on the veracity of the statistics as much as whether these statistically accurate models have enough predictive power to merit the changes that are proposed. The scientific debate–if it can be called that–is concerned with estimating the magnitude of the disaster. The imminence of disaster is assured, it is accepted. The only subject of discussion is the enormity of the coming disaster.

Unlike political debates, scientific debates ultimately end peacefully, no matter how bitter the journey to consensus is. To be sure, careers are ruined as experimental evidence demonstrates that the hypotheses on which scientists had staked their reputations were utterly false. Hence, it is completely misleading to intimate that the politics behind scientific debates are as inconsequential as political debates. The consensus on global warming, or climate change, must, therefore, be accepted as scientific fact for it is the destination at which decades of scientific exploration has arrived.

So, who is objecting to this finding? Modern propagandists. Industry, the oil industry in particular (read article cited above), is attempting to obscure, to weaken and outright to deny scientific findings that they could not contradict by funding research. And, how is industry doing it? They do it by funding propaganda machines. They fund politically connected institutes that advocate whatever position their patrons desire. The oil industry’s patronage with the Cato Institute, the Heritage Foundation and other “think tanks” cited in the Guardian article above has paid off quite handsomely. For paltry sums of millions of dollars, oil companies (and power companies, of course) have managed to avoid upgrades that would have cost them hundreds of millions of dollars, ostensibly.

Alas, few have the resources to recognize modern propaganda for what it is. Given the scale of modern global industries, the imprimatur of a scientist possessing a doctorate has never been cheaper. The surfeit of doctors of philosophy desperate for a job coupled with the coming of age of a generation so thoroughly indoctrinated by the conservatism propagated by the same organization over the past three decades has created the ideal conditions for big industry. For measly sums of money, they can have Ph.D. scientists untrained in atmospheric sciences proclaim that global warming is a myth in countless magazines and news programs. For mere pennies, industries put the veneer of scientific legitimacy on their propaganda.

Thus, companies have created a propaganda system that is much more sinister than traditional systems. The Nazis used remarkable force in quashing their opposition and to deny the truth. Modern propagandists crush their opposition and obscure the truth without firing a single shot, without imprisoning a single dissident and without presenting the specter of an organized power against which opposition may be raised. In the Soviet Union and in Nazi Germany, it was clear whom one had to oppose: the state. In contrast, modern propaganda hides its perpetrators perfectly.

Naturally, were articles like the Guardian article cited above ever to get wide distribution in the mainstream media, no problems would exist. This limited distribution of the truth is also another sinister characteristic of modern propaganda. The Nazis spent considerable effort usurping the national media and creating their distribution system. In modern propaganda, corporations take control of the mainstream media with money alone. The profit motive that drives modern media conglomerates makes them willing participants in the scheme. They gladly accept the propaganda prepared by industry supplicants and supplant the news with it. Thus, unlike the Nazis, industry groups need not even build or usurp a distribution system. They simply employ the existing, vast network for a pittance.

Ultimately, what makes the modern propaganda system particularly petty is the fact that the onus of responding to global warming will not affect the profitability of large corporations. After all, public utilities will recover their costs through rate surcharges on consumers: their contracts with public utilities commissions guarantee profits. Similarly, oil companies will recover their costs through higher gasoline prices. Thus, the entire propaganda endeavor is undertaken for an extra 2-3% in profits. Performing the upgrades might reduce the profit margins of these companies from 10% to 8%. The fact that cleaner air will save billions of dollars to the aggregate economy is no matter. Industry is sacrificing the national economy for a measly 2% margin of profit.

Are we to believe that this is a sign of economic might?

The French Laugh Next

DONALD RUMSFELD CHARGED WITH TORTURE DURING TRIP TO FRANCE | Center for Constitutional Rights

This is rather shocking news indeed. This indictment of Rumsfeld does not bode well for the rest of the Bush Administration. Those who had predicted that nobody in the Bush Administration will be able to travel abroad were absolutely correct.

Perhaps some will manage to deliver their expensive lecture through video conferencing. Then again, the “war against terror” may well be used by the indicting bodies to choke these communications as well. It tastes like justice. Turn about is fair play, many say.  

Officially Disastrous Cost of the Iraqi Conflict

Congressional Budget Office – July 2007 Testimony on the Costs of the Military Conflict in Iraq (pdf)

It was quite a few months ago when I began composing this post, and it seems as if the journalism community has finally caught on to the fact that the Congressional Budget Office’s phenomenal economic forecasts of the past two years have declared the Iraqi war an economic disaster. In fact, mainstream reporting on the costs of the military conflict in Iraq has been so abysmal that I am utterly shocked that somebody at Reuters finally bothered to look at numbers that are available to everyone through the CBO web site, and that somebody at Yahoo! had the good sense to put the bleeding obvious on the front page.

What will journalists read next? Perhaps, that Clinton’s economic policies succeeded and Bush’s policies failed, as demonstrated in this budget projection (read chapter 1)?

It is true that the information age is here, and that most information is available to anyone anywhere. Nevertheless, it is also clear that mainstream news sources have gone out of their way to make themselves irrelevant. After all, it has taken them an entire year to report number that have been publicly available all along.

How to Reduce the Number of Abortions

Family Planning Reduces Abortion Rate | The Lancet

The most comprehensive study carried out to date demonstrates that education and easy access to contraception reduce the number of abortions. Hence, if the Bush Administration, the Vatican, and virtually every “pro-life” organization that exists are to be believed when they equate abortion with murder, then every one of them is committing mass murder–by their own reasoning–when they deny funding for sex education and contraception. By denying people sex education and contraception, they are increasing the number of abortions. Thus, they are contributing to mass murder, it would seem. 

Of course, those who do not subscribe to these extreme notions of “life” and the protections that it requires do not see a crime for which these “perpetrators” should be punished. Curiosity does drive me to ask, however, what punishment these groups prescribe for contributing to mass murder. 🙂 After all, many American pro-life groups equate the number of abortions to the Holocaust, and, if this Lancet study is to be believed, these “pro-life” groups are now faced with the reality that they are complicit in this embryo “holocaust”.

Then again, denial and double standards are the hallmarks of extremism. 

Is Less But Poor Regulation Better Than More But Good Regulation?

US demands air passengers ask its permission to fly | The Register

This is an absolutely incredible step that the United States government is taking against the airline industry. It is hard to conceive of how a complete passenger manifest can be produced 72 hours before a flight is to take off, yet the Transportation Safety Administration seems intent on forcing the airline industry to do the impossible: produce a definitive list of passenger 72 prior to a flight’s departure. 

The names on this manifest are then going to be compared against a massive list of terror suspects in order to clear the flight for departure. The number of names on this list of suspects is astonishing.

ACLU’s Barry Steinhardt quoted press reports of 500,000 to 750,000 people on the watch list (of which the no-fly list is a subset). “If there are that many terrorists in the US, we’d all be dead.”

TSA representative Kip Hawley noted that the list has been carefully investigated and halved over the last year. “Half of grossly bloated is still bloated,” Steinhardt replied.

What is most  vexing about this proposition is that the TSA has offered little evidence that this draconian measure will reduce the threat of terrorism in any measurable way. Hence, the airline industry–arguably the must competitive on the planet–is going to be forced to lose money by refusing to sell tickets during the 72 hour period before a flight without any real justification. This step by the TSA provides significant support for the contention that the only reason Americans resent government regulation is that American government regulation tends to be ineffective and senseless. Perhaps Frank Zappa said it best: 

 The United States is a nation of laws: badly written and randomly enforced.

West Hollywood Book Fair

The West Hollywood Book Fair is not by any means the largest in the country or even in LA. The largest book fair in the primordial soup is indisputably the Los Angeles Times Festival of Books, which is held annually at UCLA. The West Hollywood Book Fair is a very small and civilized affair held in West Hollywood Park. (The term “park” is used liberally here, for the actual plot of land allotted to the public under this designation is astoundingly paltry. Public spaces in the primordial soup typically are astoundingly paltry.)

The WeHo Book Fair is composed primarily, naturally, of gay and new age literature. A healthy contingent of writing groups are also well represented because this is the city where nearly 50% of the population (yours truly excluded, for now) are writers. And, last, though by no means least, are the various political groups: the ACLU, Pacifica Radio and other fringe groups. Especially radical groups were pleasantly and conspicuously absent.

I was surprised to see John Dean‘s name listed on a panel that was about to start in five minutes, so I lingered to hear what he and the others were going to say. The other panelists were Dennis Loo and Susan Estrich, who neglected to show up.

It proved to be an instructive panel to attend primarily because of the juxtaposition of an eminently rational man like John Dean against a polemicist like Dennis Loo. (The juxtaposition would be instructive were it made with any polemicist, even with Bill O’Reilly.) Such a juxtaposition is the perfect means of demonstrating the intellectual deficiencies of the political fringes. Whether it’s the radical right or the radical left, placing either one next to a man who coolly and civilly advocates the boring, fair and historically proven method of due process vanquishes all doubt regarding whom people need to support politically: the boring guy.

Lest one be tempted to dismiss the boring guy, one must bear in mind that the boring guy here, John Dean, brought down the entire Nixon Presidency. Hence, it is absurd to think that such men are ineffective or otherwise useless in the establishment of an effective government. Quite the contrary, history and the cabal of fanatics that has been in control of the US government since 1994 clearly demonstrate that it is the fanatics that invariably destroy governments and subsequently nations. Hitler, Mussolini, Khomeini, Pol Pot, Karadzic, Mugabe and countless others have proved the destructive force of fanaticism beyond the shadow of any doubt. Yet, we are stuck with fanatics.

And, what do we do against fanatics? Dean admirably argued for the restoration of the processes that have kept fanatics out of the political system and have kept in check the fanatics who managed to enter politics. Loo argued for buying and wearing orange colored products in order to advocate impeachment of Bush and Cheney.

Dean argued that the processes that assert the will of the people and that advocate the interests of the nation need to be restored. Loo asserted that we need a “hero” to fight this battle against the titans of evil who are governing our nation. Dean advocated a practical focus on winning elections. Loo simply asserted that elections are hopeless, and that we have no remedy, though he did offer hope in the form of his book. 

The moderator gave me the microphone, and I asked these men what we, the disenfranchised public, can do to reverse the nation’s course? Loo suggested that I buy orange personal decorations, because it was his brilliant idea to start an “orange campaign” for impeachment. Dean reasserted the fact that the Republicans understand the importance of process enough to have modified it heavily in their favor. He, therefore, advocated that Democrats erase these imbalances while they wield power. Loo did not disagree with this, but all he could advocate was wearing orange and protesting.

Loo also employed fear tactics for no apparent reason. He insisted that the US will attack Iran, that electronic voting machines are hackable and will be hacked, that impeachment is the only answer even if diverts resources from worthwhile causes. Naturally, he offered no real remedy to these doomsday scenarios. An ostensibly educated man, Loo could not offer so much as a notion of a process by which electronic voting machines could be challenged. Fear of the devices was apparently enough for him.

And, that is where I lost my faith in the “left” in American politics. The American “left” differs little tactically from the radical right in American politics. Its tactics consist of fear. Practically, the difference is like night and day. The right, as Dean correctly noted, understands process. It understands power, and it has the desire to wield it. It will go far in corrupting the process, as Hitler did (Dean’s comparison, not mine!), in order to wield absolute power. And, the American “left” responds to this corruption of process with a symbolic orange campaign. In insisting on a “hero” it was almost as if Loo was begging for another Martin Luther to start a new movement, a new government, a new nation.

Heroes are the desire of the hopeless. I have no heros for I have some confidence (still) in my abilities. Dean asked for no heroes because he has been in politics enough to know that process has a far greater impact than the impact that any one “hero” can have. After all, the only difference between democracy and fascism is, in fact, the process. 

Perhaps it’s in keeping with the American tradition of creating a new religious sect or movement when one is not satisfied with one’s innate religion. The American left’s fantasies of revolution (a mantra repeated ad nauseum by the left and the right), however, can never become reality. Freedom of religion enables new religions. The Constitutional system provides little recourse for change outside the Constitution itself. Hence, Dean is absolutely right when he says that it is important to restore and repair the processes of governance, and Loo and his fellow “leftists” are little more than egomaniacal fear mongers who are far more content with selling orange clothing than they are with advocating action. “Turn on, tune in, drop out” is a message that many baby boomers are happy to propagate, albeit from their comfortable tenured positions. And, somehow, they are mystified by the (good) fact that they wield no power.

Ahhh, to be free to think and to act. Neither the left nor the right will ever advocate freedom of thought and expression, for this freedom is inimical to the stupidity that both sides advocate under the headings of objectivism, neo-conservatism, liberalism, communism and, yes, even conservatism. 

Failing Infrastructure is not News

Online NewsHour: America’s Infrastructure Needs Crucial Repairs — April 4, 2006

Ever since one of the major bridges connecting Minneapolis to suburbs across the Mississippi river spontaneously collapsed, considerable time has been spent on the discussion of the state of the American infrastructure. In all of these discussion, little mention was ever made of the bipartisan report commissioned by the Center for Strategic and International Studies. The results were released over a year and a half ago, and the commission endorsed the findings of the Association of Civil Engineers’ estimates.

What the association of civil engineers has done — and they do this every two or three years — is they do some kind of a balance sheet of the nation’s public assets. And they give it a grade, about A, B, C, D, on the level of being adequate.

And they’ve come up — their latest figure is that it would take a $1.6 trillion dollars to bring the infrastructure of this country up to an acceptable level of decency. We’re falling another $300 billion every two or three years behind because we don’t provide adequate support to this problem.

Now, I can also tell you that it’s very difficult to do this if you religiously think that you can’t raise taxes, and that you can’t raise revenues, and that fees are a problem, and, certainly, taxes are a problem.

Future failures of the sort that unraveled so dramatically in Minnesota in August of 2007 should therefore come as no surprise to anyone. We were all adequately forewarned, it would seem.